Achieving an endovascular therapy door-to-device time under 90 minutes in patients with ischemic stroke was associated with 90-day mRS

Background The American Heart Association (AHA) has a current goal of performing 50% of endovascular therapy (EVT) procedures with a door-to-device (DTD) time of 90 minutes or less for direct arriving patients. Initiatives to improve DTD times need evidence of patient benefit to justify long-term adoption.Methods We performed a retrospective study of patients who underwent endovascular thrombectomy for ischemic stroke. The likelihood of a favorable patient outcome was quantified for patients with a DTD time ≤90 minutes compared to patients with a DTD time >90 minutes.Results DTD ≤90 minutes was associated with an increased odds of having a more favorable (0-2) modified Rankin Score at 90-days (AOR, 1.51; 95% CI, 1.15-2.00; P = .004) post stroke compared to DTD >90 minutes. We did not find that DTD under or over 90 minutes had a significant association with discharge home (AOR, 1.21; 95% CI, 1.00-1.46; P = .051) or patients' length of stay (β, -0.48; 95% CI, -1.30-0.34; P = .20).Conclusions Our study supports that EVT completed with DTD time ≤90 minutes was associated with better functional outcomes for patients.