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

• Type: Article in International Scientific Journal
• Date: 2017

Authors

Carvalho, A (Author) Other; Cunha, A (Author) Other; Rodrigues, M (Author) Other; Figueiredo, S (Author) Other; Paredes, L (Author) Other; Gregorio, T (Author) Other; Morais, H (Author) Other; Pinheiro, J (Author) Other; Cruz, VT (Author) Other; Roriz, JM (Author) Other; Pinho, J (Author) Other; Ferreira, C (Author) Other; Torre, E (Author) Other; Nunes, J (Author) Other; Castro, S (Author) Other; Ribeiro, M (Author) Other; Veloso, M (Author) Other; Barros, P (Author) Other

Journal

Title: Journal of Stroke and Cerebrovascular Diseases

Vol. 26

Pages: 589-594

ISSN: 1052-3057

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 11 Citations

Scopus - 16 Citations

Other information

Authenticus ID: P-00M-P6H

DOI: 10.1016/j.jstrokecerebrovasdis.2016.11.116

Abstract (EN): 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6