{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:23:19Z","timestamp":1787289799740,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Randomised clinical trials have shown that functional outcomes after acute ischaemic stroke decline with each hour of delay to endovascular treatment. However, these estimates may not fully reflect real world practice because trial populations are highly selected and workflow conditions differ from routine care. We therefore examined the associations of prehospital and in-hospital treatment times with functional outcomes and safety endpoints among patients undergoing endovascular thrombectomyat a large comprehensive stroke centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a study of consecutive patients with large vessel occlusion treated with endovascular therapy between 2024 and 2025. The primary outcome was the modified Rankin Scale at 90\u202fdays, analysed using ordinal logistic regression. Secondary outcomes included excellent, independent, and favourable recovery, mortality, successful reperfusion, and symptomatic intracranial haemorrhage. Models were adjusted for demographic factors, prestroke functional status, baseline stroke severity, infarct burden, and occlusion characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 288 patients, longer onset-to-puncture time was independently associated with worse functional outcome. Compared with treatment achieved within less than 4.5\u202fh, onset-to-puncture intervals of 4.5 to 6\u202fh and greater than 6\u202fh were associated with higher odds of poorer modified Rankin Scale outcomes. Delays beyond 6\u202fh were also associated with increased 90-day mortality. No significant associations were observed between treatment timing and successful reperfusion or symptomatic intracranial haemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In routine clinical practice, shorter onset-to-puncture times are associated with more favorable functional outcomes after endovascular thrombectomy, whereas treatment beyond 6\u202fh is associated with higher mortality. These findings highlight the importance of minimizing avoidable delays in acute stroke care while underscoring the need to interpret time-based metrics within the context of patient selection and stroke heterogeneity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1808012","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:00Z","timestamp":1787286180000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment time metrics and functional outcomes after endovascular thrombectomy in routine clinical practice"],"prefix":"10.3389","volume":"17","author":[{"given":"Yu","family":"Qiao","sequence":"first","affiliation":[{"name":"Department of Neurology IV, Xingtai People\u2019s Hospital","place":["Xingtai, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology VI, Xingtai People\u2019s Hospital","place":["Xingtai, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengfei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology I, Longyao County Hospital","place":["Xingtai, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology IV, Xingtai People\u2019s Hospital","place":["Xingtai, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology VI, Xingtai People\u2019s Hospital","place":["Xingtai, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S1474-4422(25)00356-4","article-title":"Endovascular thrombectomy for acute stroke: evolving eligibility criteria and adjunct therapies","volume":"25","author":"Glavan","year":"2026","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3020","DOI":"10.1161\/STR.0000000000000074","article-title":"2015 American Heart Association\/American Stroke Association focused update of the 2013 guidelines for the early Management of Patients with Acute Ischemic Stroke Regarding Endovascular Treatment: a guideline for healthcare professionals from the American Heart Association\/American Stroke 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Alberta stroke programme early CT score","volume":"355","author":"Barber","year":"2000","journal-title":"Lancet"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"3054","DOI":"10.1161\/STROKEAHA.121.034480","article-title":"Standardized Nomenclature for Modified Rankin Scale Global Disability Outcomes: Consensus Recommendations From Stroke Therapy Academic Industry Roundtable XI","volume":"52","author":"Saver","year":"2021","journal-title":"Stroke"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1161\/circulationaha.117.032600","article-title":"Time to endovascular treatment and outcome in acute ischemic stroke","volume":"138","author":"Mulder","year":"2018","journal-title":"Circulation"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e46","DOI":"10.1161\/STR.0000000000000158","article-title":"2018 guidelines for the early Management of Patients with Acute Ischemic Stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"49","author":"Powers","year":"2018","journal-title":"Stroke"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.1161\/STROKEAHA.117.017182","article-title":"Rethinking Thrombolysis in Cerebral Infarction 2b: Which Thrombolysis in Cerebral Infarction Scales Best Define Near Complete Recanalization in the Modern Thrombectomy Era?","volume":"48","author":"Tung","year":"2017","journal-title":"Stroke"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1161\/STROKEAHA.121.034919","article-title":"Improvements in endovascular treatment for acute ischemic stroke: a longitudinal study in the MR CLEAN registry","volume":"53","author":"Compagne","year":"2022","journal-title":"Stroke"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1177\/23969873221112279","article-title":"Timing of symptomatic intracranial hemorrhage after endovascular stroke treatment","volume":"7","author":"van der Steen","year":"2022","journal-title":"Eur Stroke J"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e764","DOI":"10.1161\/STROKEAHA.121.034865","article-title":"Thrombectomy complications in large vessel occlusions: incidence, predictors, and clinical impact in the ETIS registry","volume":"52","author":"Happi Ngankou","year":"2021","journal-title":"Stroke"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1161\/STROKEAHA.120.031869","article-title":"Current status of endovascular treatment for acute large vessel occlusion in China: a real-world Nationwide registry","volume":"52","author":"Jia","year":"2021","journal-title":"Stroke"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1056\/nejmoa1713973","article-title":"Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging","volume":"378","author":"Albers","year":"2018","journal-title":"N Engl J Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2051","DOI":"10.1161\/STROKEAHA.119.027974","article-title":"Endovascular thrombectomy for acute ischemic stroke beyond 6 hours from onset","volume":"51","author":"Casetta","year":"2020","journal-title":"Stroke"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"CD005610","DOI":"10.1002\/14651858.CD005610.pub2","article-title":"Interventions to reduce waiting times for elective procedures","volume":"2015","author":"Ballini","year":"2015","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1808012\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:01Z","timestamp":1787286181000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1808012\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":25,"alternative-id":["10.3389\/fneur.2026.1808012"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1808012","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"1808012"}}