Abstract P482: Outcome of Endovascular Thrombectomy for Ultra-Long Aeromedical Transfers: The Experience of 1 Hub and 11 Spoke Sites Covering More Than 1.8 Million Km 2

Background: Local endovascular services for acute stroke in rural and remote regions remain a significant challenge despite higher rates of stroke in these regions. Aim: We present time metrics, logistical, safety and outcome data on large vessel occlusion (LVO) patients receiving endovascular thrombectomy (EVT) that were aeromedically transferred from rural and remote “spoke” sites to the Gold Coast University Hospital (GCUH) “hub”. Methods: This is a retrospective observational study utilizing prospectively collected stroke database from December 2018 to March 2020. Aeromedical transfers from ten rural and remote Queensland sites and one northern New South Wales site were included, covering more than 1.853 million km 2 catchment. Results: 20 out of 26 transferred patients underwent EVT over this period. Mean distance was 1380.5 km, median time of ictus to re-canalization was 928 minutes and TICI 2b-3 was achieved in 90% of the patients. One out of 20 patients (5%) had symptomatic ICH (sICH), and 9 out of 20 (45%) achieved functional independence (mRS 0-2) at 90 days; similar to the recent pivotal trials. Conclusions: Our 12-center network experience confirms real world reproducibility of trial results including ultra-long transfers and supports such transfers at other centers worldwide.