ABSTRACT NUMBER: ESOC2026A1466 EXPERIENCE OF A SINGLE THROMBECTOMY-CAPABLE STROKE CENTER IN POLAND. THE CONTEXT OF EXPANDING TREATMENT GUIDELINES AND INCREASING PATIENT ADMISSION VOLUME

Abstract Background and aims Thrombectomy-capable stroke centers (TCSCs) are integral to stroke treatment infrastructure in Poland. Study investigates the evolution of single TCSC. Enhancing patient volume - collaboration with other centers in drip-and-ship and extending treatment time window - associated with the learning curve and experience acquisition. Methods Retrospective analysis - 250 patients of TCSC 2020 - 2025, 2 subgroups: initial 100, subsequent 150 patients. Additional comparison - directly admitted vs the drip-and-ship; early and expanded time windows. Results Differences were observed between the first 100 and the subsequent 150 patients in terms of admission scheme (97% vs. 70%, p<0.0001), extended time window treatment (8% vs. 17.3%, p<0.05), and IVT qualification (81% vs. 65.3%, p<0.01). Improvements in time intervals, procedural aspects noted in the second group, indicating enhanced operator experience (groin-to-first pass time: 27 vs. 23 minutes, p<0.05). Comparison between direct admission and drip-and-ship models revealed extended time intervals in the latter (door-to-groin: 110 vs. 159 minutes, p<0.001; door-to-recanalization: 158 vs. 200 minutes, p<0.001; door-to-CT: 9 vs. 16.5 minutes, p<0.001; and door-to-IVT: 21 vs. 43 minutes, p<0.001). Patients in the extended time window- lower IVT rates (78.2% vs. 29.4%, p<0.0001), prolonged door-to-groin (117.5 vs. 150 min, p<0.005), door-to-CT (10 vs. 19.5 min, p<0.01), and door-to-IVT (25 vs. 77.5 min, p<0.001) times. No differences in complication rates, clinical outcomes, mortality. Conclusions Data demonstrate the enhancement of operators' experience, favorable clinical outcomes, and low rates of complications and mortality, even when treating patients with prolonged time due to transportation and late window qualification. Conflict of interest Artur Dziadkiewicz: nothing to disclose