Acute Ischemic Strokes: Outcomes of Time-Sensitive Interventions Following Aeromedical Transfer

Abstract

Acute ischemic stroke (AIS) outcomes depend on rapid intervention, and aeromedical transport is often used to expedite access to tertiary care. This retrospective cohort study examined adult AIS patients transported via helicopter between January and December 2025 to evaluate the timeliness of intervention. Among 157 cases reviewed, 148 met the inclusion criteria (mean age 65.5 years; 59.2% male). Interventions were performed in 66.9% of patients, including thrombectomy (35.8%) and tenecteplase (29.1%). All interventions were initiated within 60 minutes of hospital arrival, demonstrating strong adherence to treatment benchmarks. However, 33.1% of patients did not receive intervention, primarily due to treatment window limitations, contraindications, or ineligibility. The mean total transfer time was 106.5 minutes, with substantial variability, and no significant association with stroke severity was found.