{
  "abstract": "Objective\n\nMechanical thrombectomy (MT) is the standard of care for acute large vessel occlusion (LVO); however, off-hours treatment may be delayed because of limited staffing. We compared MT outcomes between on-hours and off-hours at a single center and investigated factors associated with 90-day modified Rankin Scale (mRS) 0-3.Methods\n\nWe retrospectively analyzed 101 consecutive patients with anterior circulation LVO and a pre-stroke mRS 0-2 who underwent MT at Tokorozawa Central Hospital between January 2020 and December 2025. Patients were classified into on-hours (9:00-17:00 on Mondays through Saturdays, excluding national holidays and the period from December 31 to January 3) and off-hours groups based on hospital arrival time. The primary endpoint was 90-day mRS 0-3. Secondary endpoints included Thrombolysis in Cerebral Infarction (TICI) grade 2b-3, symptomatic intracranial hemorrhage (sICH), and any intracranial hemorrhage. Time metrics, including onset-to-door time (ODT), door-to-image time, door-to-needle time, image-to-puncture time (IPT), door-to-puncture time (DPT), puncture-to-recanalization time (PRT), door-to-recanalization time (DRT), and onset-to-recanalization time (ORT), were compared between the 2 groups, and factors associated with 90-day mRS 0-3 were evaluated using univariable and multivariable logistic regression analyses.Results\n\nThe on-hours group comprised 46 patients and the off-hours group 55 patients. Compared with the on-hours group, the off-hours group had significantly longer IPT (median 83 vs. 51 min, p <0.001), DPT (median 103 vs. 71 min, p <0.001), and DRT (median 151 vs. 124 min, p = 0.003). ODT and ORT did not differ significantly between the groups (median 105 vs. 89 min, p = 0.825, and median 285 vs. 234 min, p = 0.154, respectively). PRT did not differ significantly between groups (median 53 vs. 48 min, p = 0.626). The proportion of patients achieving 90-day mRS 0-3 did not differ significantly between groups (45.5% vs. 50.0%, p = 0.692). No significant differences were observed in TICI 2b-3 (80.0% vs. 82.6%, p = 0.802) or sICH (3.6% vs. 4.3%, p = 1.000). In the multivariable logistic regression, younger age (odds ratio [OR] 0.922, p = 0.002) was an independent predictor of 90-day mRS 0-3, whereas off-hours status was not (OR 0.917, p = 0.845).Conclusion\n\nDespite prolonged time from hospital arrival to treatment initiation in the off-hours group, the proportion of patients achieving 90-day mRS 0-3 did not differ significantly between groups. In multivariable logistic regression, younger age was an independent predictor of 90-day mRS 0-3. Further efforts are needed to identify the causes of off-hours delays and to improve our clinical care system.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Tokorozawa Central Hospital, Tokorozawa, Saitama, Japan.",
    "Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yu Kanazawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomoyoshi Kuribara"
    },
    {
      "affs": [
        0
      ],
      "name": "Yusuke Nitta"
    },
    {
      "affs": [
        1
      ],
      "name": "Shinya Kohyama"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroshi Miyazaki"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroshi Nawashiro"
    },
    {
      "affs": [
        0
      ],
      "name": "Hideyuki Kita"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1ymj9me1saawq.bib",
  "cited_by": 0,
  "doi": "10.5797/jnet.oa.2026-0065",
  "fulltext_url": "https://europepmc.org/articles/PMC13713151",
  "id": "1ymj9me1saawq",
  "issns": [
    "1882-4072",
    "2186-2494"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948832",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2713|Acute Ischemic Stroke Management"
    ]
  ],
  "openalex": "W7223203532",
  "pdf_url": "https://europepmc.org/articles/PMC13713151?pdf=render",
  "pmcid": "PMC13713151",
  "pmid": "42948832",
  "published": "2026-10-23",
  "publisher": "The Japanese Society for Neuroendovascular Therapy",
  "ris": "https://research.draconitic.com/paper/1ymj9me1saawq.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948832",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948832"
    },
    {
      "first_seen": "2026-10-31T12:23:33Z",
      "native_id": "PMC13713151",
      "source": "pmc",
      "url": "https://doi.org/10.5797/jnet.oa.2026-0065"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Acute Ischemic Stroke Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Current Status and Treatment Outcomes of Mechanical Thrombectomy for Acute Large Vessel Occlusion during On- and Off-Hours in Our Institution.",
  "title_text": "Current Status and Treatment Outcomes of Mechanical Thrombectomy for Acute Large Vessel Occlusion during On- and Off-Hours in Our Institution.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:33Z",
  "url": "https://research.draconitic.com/paper/1ymj9me1saawq",
  "venue": "Journal of neuroendovascular therapy",
  "versions": []
}