ABSTRACT NUMBER: ESOC2026A1857 TIME IS BRAIN - BUT TEAMWORK DELIVERS TREATMENT: A TRANSLATIONAL SIMULATION APPROACH TO ENDOVASCULAR THROMBECTOMY

Abstract Background and aims Endovascular thrombectomy (EVT) is a multidisciplinary intervention where team coordination influences clinical outcomes. Simulation-based training is increasingly used in EVT, yet impact remains inconsistent, potentially reflecting differences in how simulation design aligns with system needs. Translational simulation conceptualises simulation as a system-level strategy aligned with clinical care improvement. This study aimed to evaluate how an iterative translational simulation programme was associated with changes in EVT workflow processes, anaesthetic management, and patient outcomes. Methods A sequential mixed-methods programme evaluation was conducted across three phases. Phase 1 quantitatively assessed associations between an in situ EVT simulation programme and clinical outcomes. Phase 2 used qualitative focus group interviews to explore team experiences and identify limitations in simulation design and clinical practice. These findings informed an adapted simulation programme, designed to better align training with multidisciplinary system requirements, including engagement of anaesthesia professionals as simulation co-faculty, and evaluated quantitatively in Phase 3. Results Initial simulation implementation was associated with a reduction in groin puncture–to–reperfusion time (median 54 to 35 minutes, p=0.003), without corresponding improvements in anaesthetic management or patient outcomes. Qualitative findings highlighted gaps in role clarity and anaesthesia integration. Following programme adaptation, haemodynamic management improved, with reduced time outside systolic blood pressure thresholds (37.0% to 27.7%, p=0.02), and excellent functional outcome (mRS 0–1) increased from 23.4% to 42.6% (p=0.001). Conclusions The clinical impact of simulation in EVT appears to depend on alignment of simulation design with multidisciplinary system requirements, underscoring the importance of including all professions critical to care in simulation design. Conflict of interest Caroline Guldberg Fugelli. nothing to disclose