Transfer to the Closest Local Stroke Center vs. Direct Transfer to Endovascular Stroke Center of Acute Stroke Patients With Suspected LVO. RACECAT

OBJECTIVES	To determine whether, in a non-urban areas, direct transport to a thrombectomy-capable center is beneficial compared with transport to the closest local stroke center.
STUDY	Multicenter, population-based, spatial-temporal cluster-randomized trial, with blinded endpoint assessment, embedded within a mandatory registry of patients with stroke, including patients with suspected acute large vessel occlusion stroke attended by emergency medical services in areas where the closest local stroke center was not capable of performing thrombectomy in Catalonia, Spain, between March 2017 and June 2020.
POPULATION	466 consecutive patients with acute stroke screened, randomly assigned (1:1) to be treated directly in the angiosuite or conventional workflow from September 2018 to November 2020. 174 patients with suspected LVO acute stroke within 6 hours of symptom onset were included.
ENDPOINTS	The primary outcome was disability at 90 days based on the modified Rankin Scale in the target population of patients with ischemic stroke. Secondary outcomes included rate of intravenous tPA administration and thrombectomy in the target population and 90-day mortality in the safety population of all randomized patients.

Transfer to the Closest Local Stroke Center vs. Direct Transfer to Endovascular Stroke Center of Acute Stroke Patients With Suspected Large Vessel Occlusion in the Catalan Territory. RACECAT