{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T19:33:27Z","timestamp":1775331207201,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Stroke Journal"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>We aim to evaluate the association between door-to-needle time (DTN) and outcomes in a population of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT)\u2009+\u2009mechanical thrombectomy (MT) in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods:<\/jats:title>\n                    <jats:p>Patients with AIS secondary to middle cerebral artery or intracranial internal carotid artery occlusion with known times of symptoms onset, directly presenting to an MT-capable center, were included in the analysis. According to pre-defined DTN cut-off values (\u2a7d30, \u2a7d45, and \u2a7d60\u2009min), we evaluated the association between DTN and outcomes by multivariate logistic regression analyses. Effectiveness outcomes were 3-month functional independence, 3-month excellent outcome and successful reperfusion. Safety outcomes were any intracranial hemorrhage (ICH), symptomatic intracerebral hemorrhage (sICH), and 3-month mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>About 1602 patients were included in our analysis. After logistic regression analysis, a DTN\u2009\u2a7d\u200960\u2009min was significantly associated with 3-month functional independence (OR 1.36; 95%\u2009CI 1.02\u20131.82). DTNs\u2009\u2a7d\u200930, \u2a7d45, and \u2a7d60\u2009min were significantly associated with successful reperfusion (OR 2.66; 95%\u2009CI 1.6\u20134.43; OR 1.68; 95%CI 1.25-2.26; OR 1.57; 95%\u2009CI 1.21\u20132.05; respectively). A DTN\u2009\u2a7d\u200960\u2009min was also significantly associated with lower rate of any ICH (OR 0.61; 95% CI 0.43\u20130.86). DTNs\u2009\u2a7d\u200930, \u2a7d45, and \u2a7d60\u2009min were significantly associated with lower 3-month mortality (OR 0.24; 95%\u2009CI 0.08\u20130.67; OR 0.45; 95%\u2009CI 0.29\u20130.72; OR 0.58; 95%\u2009CI\u20090.39\u20130.84; respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In patients with AIS treated with IVT\u2009+\u2009MT, a shorter DTN is associated with better outcomes if IVT is initiated within 1\u2009h of hospital admission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873251368720","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T06:06:24Z","timestamp":1757916384000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between door-to-needle time and outcomes in acute ischemic stroke patients treated with intravenous thrombolysis plus mechanical thrombectomy: Analysis from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS)"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-465X","authenticated-orcid":false,"given":"Fabrizio","family":"Sallustio","sequence":"first","affiliation":[{"name":"Unit\u00e0 Di Trattamento Neurovascolare, Ospedale Dei Castelli-ASLRoma6, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo Paolo","family":"Mascolo","sequence":"additional","affiliation":[{"name":"Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2786-8312","authenticated-orcid":false,"given":"Federico","family":"Marrama","sequence":"additional","affiliation":[{"name":"Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Diomedi","sequence":"additional","affiliation":[{"name":"Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giordano","family":"Lacidogna","sequence":"additional","affiliation":[{"name":"Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fana","family":"Alemseged","sequence":"additional","affiliation":[{"name":"Royal Melbourne Hospital, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Da Ros","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Sabuzi","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Fainardi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche, Sperimentali e Cliniche, Neuroradiologia, Universit\u00e0 degli Studi di Firenze, Ospedale Universitario Careggi, Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4099-8875","authenticated-orcid":false,"given":"Ilaria","family":"Casetta","sequence":"additional","affiliation":[{"name":"Neurology Unit, University of Ferrara, Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Vallone","sequence":"additional","affiliation":[{"name":"UO Neuroradiologia, AOU Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Bigliardi","sequence":"additional","affiliation":[{"name":"UO Neurologia - Stroke Unit, AOU Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Allegretti","sequence":"additional","affiliation":[{"name":"SC Neuroradiologia Osp. 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