Mechanical Thrombectomy in Acute Ischemic Stroke: Initial Single-Center Experience and Comparison with Randomized Controlled Trials

被引：19

作者：

Carvalho, Andreia ^{[1
,2
]}

Cunha, Andre

Rodrigues, Marta ^{[3
]}

Figueiredo, Sofia ^{[1
,2
]}

Paredes, Ludovina ^{[2
]}

Gregorio, Tiago ^{[2
]}

Morais, Hugo ^{[1
]}

Pinheiro, Joaquim ^{[1
]}

Cruz, Vitor Tedim ^{[4
]}

Roriz, Jose Mario ^{[4
]}

Pinho, Joao ^{[5
]}

Ferreira, Carla ^{[5
]}

Torre, Edgar ^{[6
]}

Nunes, Joana ^{[3
]}

Castro, Sergio ^{[3
]}

Ribeiro, Manuel ^{[3
]}

Veloso, Miguel ^{[1
,2
]}

Barros, Pedro ^{[1
,2
]}

机构：

[1] Ctr Hosp Vila Nova Gaia Espinho, Dept Neurol, Vila Nova De Gaia, Portugal

[2] Ctr Hosp Vila Nova Gaia Espinho, Stroke Unit, Vila Nova De Gaia, Portugal

[3] Ctr Hosp Vila Nova Gaia Espinho, Imagiol Dept, Neuroradiol Unit, Vila Nova De Gaia, Portugal

[4] Ctr Hosp Entre Douro & Vouga, Dept Neurol, Santa Maria, RS, Brazil

[5] Hosp Escala Braga, Dept Neurol, Braga, Portugal

[6] Unidade Local Sa Alto Minho, Stroke Unit, Viana do Castelo, Portugal

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2017年 / 26卷 / 03期

关键词：

Acute ischemic stroke; endovascular treatment; mechanical thrombectomy; stent retrievers; ENDOVASCULAR TREATMENT; CONSENSUS STATEMENT; REVASCULARIZATION; RECANALIZATION; MANAGEMENT; THERAPY; SCORE;

D O I：

10.1016/j.jstrokecerebrovasdis.2016.11.116

中图分类号：

Q189 [神经科学];

学科分类号：

071006 [神经生物学];

摘要：

Background: Until recently, intravenous thrombolysis was the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. However, this treatment option has low recanalization rates in large-vessel occlusions. The search for additional treatments continued until 5 randomized trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) revealed the superiority of mechanical thrombectomy for anterior circulation large-vessel occlusion. After 1 year of performing thrombectomy with stent retrievers in our tertiary hospital, we intended to answer the question: is it possible to achieve similar results in a "real-world" setting? Methods: We analyzed data from our prospective observational registry, compared it with the trials aforementioned, and concluded that the answer is affirmative. Results: Our study population of 77 patients, with a mean age of 68,2 years and 48,1% men, is comparable with these trials in much of selection criteria, baseline characteristics, and rate of previous intravenous thrombolysis (72,7%). Recovery of functional independence at 90 days was achieved in almost two thirds of patients, similarly to the referred trials. We devoted special emphasis on fast recanalization, keeping a simple image selection protocol (based on non-enhanced and computed tomography angiography) and not waiting for clinical response to thrombolysis in patients eligible for mechanical thrombectomy. We emphasize a successful recanalization rate of 87% and only 2,6% symptomatic intracranial hemorrhage. Conclusion: In summary, mechanical thrombectomy seems to be a safe and effective treatment option in a "real-world" scenario, with results similar to those of the recent randomized controlled trials.

引用

页码：589 / 594

页数：6

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