Drip and ship and mothership models of mechanical thrombectomy result in similar outcomes in acute ischemic stroke of the anterior circulation

Impact of Direct Transport to Thrombectomy-Capable Center vs. Nearby/Distant Local Stroke Centers on Stroke Outcome in Patients Undergoing Thrombectomy: A Real-Life Study

“…In some of these observational studies, the secondary transfer model showed a lower percentage of patients receiving IVT [14], while others observed higher rates of IVT in this model [16]. In our cohort, we did not find significant differences in this regard.…”

“…In our cohort, we did not find significant differences in this regard. As expected, real-life studies, including our own, have demonstrated a lower onset-to-groin time in the direct transfer group [14,19]. In a Dutch study, a comparative analysis was conducted by changing the protocol from a secondary to a DT model.…”

“…However, the relative benefit from the MT did not differ significantly in the two groups [13]. Other real-life studies with a design similar to ours have not reported significant differences in the functional outcome, substantial recanalization, or symptomatic hemorrhagic transformation between the two transfer models, although the process times were longer in the secondary transfer groups in most cases [14][15][16][17][18][19][20][21].…”

“…None of these studies stratified the data according to the distance from the primary center or the transfer time to the TC in order to assess the specific impact of distance on the transfer models. In some cases, the primary centers were located within less than 17 km [14], while in others, the distance was significantly greater and heterogeneous between centers or not reported [15,16,22]. In a study by Rinaldo et al, the mortality was significantly lower among directly admitted patients than among transferred patients, and an increased distance between the transferring hospital and the TC was associated with an increased risk of mortality [23].…”

The evolution of acute stroke care in Germany from 2019 to 2021: analysis of nation-wide administrative datasets

“…Newer concepts have been developed to direct patients from rural areas to larger MTE centers. Concepts such as transfer of IS patients with large vessel occlusions to MTE centers after initial treatment with or without IVT in community hospitals (drip and ship model) or encouraging direct presentation of patients likely to have a large vessel occlusion directly to MTE centers (mothership model) have been shown to equally improve patient outcomes and have dramatically improved access to MTE for patients in developed countries [ 2 ]. Alternative approaches to send mobile neurointerventional teams to smaller MTE centers as part of a ship the doc or flying interventional team (FIT) concept have also reduced door to MTE times [ 8 ].…”