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Background <p>This study assessed the early implementation of transradial access (TRA) for mechanical thrombectomy (MT) in a primary stroke center (PSC) using a retrospective sequential cohort design with propensity score matching.</p> Methods <p>We retrospectively analyzed patients with acute large vessel occlusion who underwent MT between January 2022 and December 2024. Patients were assigned to a transfemoral access (TFA) period (January 2022–June 2023) or a TRA period (July 2023–December 2024) based on the timing of formal TRA adoption. Propensity score matching (1:1) was used to reduce baseline imbalance. Primary outcomes were successful recanalization and favorable 90-day functional outcome (modified Rankin Scale 0–2). Secondary outcomes included access-site complications, hospital length of stay, and symptomatic intracranial hemorrhage (sICH).</p> Results <p>Of 74 eligible patients, 56 were included after matching (28 pairs). Successful recanalization (89.3% vs. 85.7%, <i>P</i> = 1.000) and favorable 90-day outcomes (53.6% vs. 46.4%, <i>P</i> = 0.796) were similar between the TRA and TFA groups. Major vascular complications were rare (0% vs. 3.6%, <i>P</i> = 1.000). Total access-site events were less frequent with TRA, although not statistically significant (3.6% vs. 25.0%, <i>P</i> = 0.052). Hospital stay was shorter during the TRA period (median, 7.0 vs. 10.0&#xa0;days; <i>P</i> = 0.008). No significant differences were observed in sICH or 90-day mortality.</p> Conclusions <p>Early TRA implementation in a PSC appeared feasible, with similar reperfusion and functional outcomes and a favorable safety profile. These findings should be considered exploratory given the small sample size and potential temporal improvements in stroke care.</p>

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Early implementation of transradial mechanical thrombectomy in a primary stroke center: a sequential cohort propensity score-matched study

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Yinsheng Huang,
  • Xujian Miao

摘要

Background

This study assessed the early implementation of transradial access (TRA) for mechanical thrombectomy (MT) in a primary stroke center (PSC) using a retrospective sequential cohort design with propensity score matching.

Methods

We retrospectively analyzed patients with acute large vessel occlusion who underwent MT between January 2022 and December 2024. Patients were assigned to a transfemoral access (TFA) period (January 2022–June 2023) or a TRA period (July 2023–December 2024) based on the timing of formal TRA adoption. Propensity score matching (1:1) was used to reduce baseline imbalance. Primary outcomes were successful recanalization and favorable 90-day functional outcome (modified Rankin Scale 0–2). Secondary outcomes included access-site complications, hospital length of stay, and symptomatic intracranial hemorrhage (sICH).

Results

Of 74 eligible patients, 56 were included after matching (28 pairs). Successful recanalization (89.3% vs. 85.7%, P = 1.000) and favorable 90-day outcomes (53.6% vs. 46.4%, P = 0.796) were similar between the TRA and TFA groups. Major vascular complications were rare (0% vs. 3.6%, P = 1.000). Total access-site events were less frequent with TRA, although not statistically significant (3.6% vs. 25.0%, P = 0.052). Hospital stay was shorter during the TRA period (median, 7.0 vs. 10.0 days; P = 0.008). No significant differences were observed in sICH or 90-day mortality.

Conclusions

Early TRA implementation in a PSC appeared feasible, with similar reperfusion and functional outcomes and a favorable safety profile. These findings should be considered exploratory given the small sample size and potential temporal improvements in stroke care.