Stroke care pathways at CHU de Montpellier

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Multiple randomized controlled trials have recently proved the superiority of mechanical thrombectomy compared to the best medical therapy in patients with recent cerebral infarct and large vessel occlusion in the anterior circulation. There are 6 Stroke Units in the Occitanie-East region, formerly Languedoc-Roussillon. Only one of these units, the Comprehensive Stroke Center (CSC) of the Montpellier hospital, has a centre of interventional neuroradiology (NRI) that can perform mechanical thrombectomy.

Patients with a suspicion of stroke are referred to the nearest stroke unit, then the candidates for mechanical thrombectomy are transferred secondarily to the CSC in Montpellier. Currently, there is no evidence that initial management in a proximity stroke unit and a secondary transfer for a mechanical thrombectomy is associated with a less positive outcome, compared to patients initially treated at the regional stroke centre.

The objective of our local clinical research registry is to compare the clinical outcome of patients first admitted in the CSC of Montpellier with those transferred from the Proximity Stroke Unit. In this way, the implementation of a local database will allow us to generate information and knowledge about stroke patients’ management in our region in order to contribute to the achievement of Ictusnet objectives.

The aim of CHU Montpellier’s participation in ICTUSnet as partners is to describe the management of suspicion of large vessel occlusion in our region, compared to other participating regions. In order to improve stroke patients’ management, we need to evaluate the delay of mechanical thrombectomy and clinical outcome of patients after 3 months