Abstract Number: Esoc2026a661 Impact of Starting a 24/7 Thrombectomy Service on Other Hyperacute Stroke Pathway Admission Metrics in a Comprehensive Stroke Centre in Southern England

Abstract Background and aims The stroke service at University Hospital Southampton started 24/7 MT in March 2025 in recognition of the increasing need to provide reperfusion therapy around the clock. We analysed the improvements in perfomance data with increases in overnight cover. Methods Our stroke advanced care practitioner (ACP) workforce started overnight cover alongside 24/7 MT and involved the resident medical or neurology registrar for reperfusion cases. Previously thrombolysis had been arranged by the Emergency Department with input from the registrars. We wanted to review the impact on the presence of a stroke ACP on door to needle times and HASU admissions. Results 22 patients underwent intravenous thrombolysis in early 2025 before 24/7 cover started. Mean door to needle time was 01:12min. 14 patients received tenecteplase once 24/7 began, and mean door to needle time was 00:50min, 22min faster. Mean door to CT was 3hrs 39 min pre 24/7 cover falling to 1hr 4min afterwards. In the first 10 months of 24/7, an additional 94 patients were treated with MT, with 360 predicted by the end of 2025 Conclusions Expanding provision for 24/7 MT has had wider benefits to acute stroke admissions with faster CT scanning, thrombolysis times and a significant increase in patients treated overnight with thrombectomy. The next steps are to increase medical cover to reduce unnecessary stroke mimic admissions, which will in turn create more HASU bed capacity as demand rises and expand out of hours advanced imaging for extended reperfusion time windows across the Wessex region to achieve this aim. Conflict of interest Richard Marigold: nothing to disclose