ABSTRACT NUMBER: ESOC2026A883 THE INTERVENTIONAL NEUROLOGIST IN THE STROKE UNIT: A WINDOW INTO THE PAST OR A DOOR TO THE FUTURE? A FIVE YEARS SINGLE-CENTER EXPERIENCE

Abstract Background and aims Acute large vessel occlusions (LVOs) represent a severe form of acute ischemic stroke (AIS). In our university hospital, a collaborative approach between neuroradiologists and neurologists in performing endovascular thrombectomy (EVT) has been set up, shaping the role of "interventional neurologist". The study analyses the characteristics of patients treated in our center between December 2017 and May 2024, focusing on outcomes and treatment differences, particularly on a five-year period, during which all EVTs were performed by a team of neuroradiologists and neurologists. Methods This is a retrospective, single-center, observational cohort study that included patients with AIS, treated with EVT between December 2017 and May 2024, divided into two groups: (A) treated by a team composed of neuroradiologist and neurologist (2018-2023), and (B) treated only by the neuroradiologist (2023-2024). We collected data about clinical characteristics, times of treatment, recanalization (TICI), complications and outcomes. Results During the study period, 1091 patients received EVT. Group B showed significantly longer door-to-imaging (DTI) and door-to-groin (DTG) times, with a lower groin-to-recanization time (GTR), indicating delays in accessing neuroradiology and EVT, but shorter procedures. Reducing the sample of group A to patients treated between June 2021 and May 2023, only DTG differences remained significant. Logistic regression identified the presence of interventional neurologist, IV thrombolysis at the spoke hospital, and anterior circulation involvement as independent predictors of DTG <90 minutes, while procedures at night or on holidays predicted delays. Conclusions Interventional neurologist can improve access times to neuroimaging and endovascular treatment, contributing to the efficiency and duration of the angiographic procedure. Conflict of interest Dr. Zini received consulting and speaker fees from Angels Initiative, Boehringer-Ingelheim, Alexion, Daiichi Sankyo, Pfizer, Amgen, Aurora Biopharma, and fees for Advisory Board from Bayer, Daiichi Sankyo, Astra Zeneca, and Boehringer-Ingelheim, none relevant to this work. The other authors have nothing to disclose.