Nurse Practitioner Contribution to Shortening the Time from Angiography Suite Entry to Puncture in Mechanical Thrombectomy for Acute Ischemic Stroke

Objective: Minimizing the time to reperfusion is a critical determinant of the prognosis of acute ischemic stroke (AIS). To reduce the workload of neurosurgeons, improve efficiency, and shorten the time required for AIS management delivered by the neurosurgical department, a nurse practitioner (NP) was introduced in April 2019. However, the effect of NP involvement on post-door-to-needle (D2N) intervals, particularly time to reperfusion, has not been clarified. This study examined whether NP participation was associated with shorter post-D2N time metrics in patients with AIS undergoing mechanical thrombectomy (MT). Methods: This study included all consecutive patients with AIS due to intracranial large vessel occlusion who underwent MT between April 2019 and March 2024 at our institution. Patients with NP involvement were assigned to the NP group, and those without NP involvement were assigned to the non-NP group. NP participation was randomly determined according to their duty schedule. The primary outcomes were the median times from angiography suite entry-to-puncture (E2P) and from suite entry-to-recanalization (E2R). Secondary outcomes included onset-to-puncture (O2P), puncture-to-recanalization (P2R), door-to-entry (D2E), door-to-puncture (D2P), and the proportion of patients with a modified Rankin Scale (mRS) score of 0-2 at discharge. Statistical analyses included univariate and multivariate linear regression analysis, with significance set at p