<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Mechanical thrombectomy as an active treatment method has recently been chosen for patients with large artery occlusions and thrombolysis beyond a time window. The aim of our study was to evaluate the results of endovascular treatment in patients with proximal vessel occlusion, compare this group with the intravenous thrombolysis group, and to identify possible criteria of active treatment. The prospective study included 81 patients hospitalised in the Pauls Stradiņš Clinical University Hospital due to acute ischemic stroke; 48 of them received mechanical thrombectomy and 33 - intravenous thrombolysis. Thrombectomy (TE) was performed using Solitaire FR stent retrievers. The NIHSS score was used for evaluation of early therapy results and mRS (modified Rankin Scale) was used for late therapy results. ASPECTS was used to define the lesion size using imaging on admission and after treatment. Median NIHSS on admission was higher in the TE group - 16 (range 12 to 19) than in the TL group - 12 (range 8 to 15) (p &lt; 0.05). Ninety days after treatment, mRS (0-2) was seen in 67% of patients in the TE group (n = 29), and 34% of patients in the TL group (n = 9) patients (p &lt; 0.05). Median ASPECTS was lower in TE group - 5, in comparison to the TL group - 7 (p &lt; 0.01) Mortality frequency was higher in the TL group (p > 0.05). Frequency of symptomatic intracerebral haemorrhages was similar in the groups. Mechanical thrombectomy can achieve better late functional outcome than thrombolysis in a selected patients group.</p></abstract>

Mechanical thrombectomy as an active treatment method has recently been chosen for patients with large artery occlusions and thrombolysis beyond a time window. The aim of our study was to evaluate the results of endovascular treatment in patients with proximal vessel occlusion, compare this group with the intravenous thrombolysis group, and to identify possible criteria of active treatment. The prospective study included 81 patients hospitalised in the Pauls Stradiņš Clinical University Hospital due to acute ischemic stroke; 48 of them received mechanical thrombectomy and 33 - intravenous thrombolysis. Thrombectomy (TE) was performed using Solitaire FR stent retrievers. The NIHSS score was used for evaluation of early therapy results and mRS (modified Rankin Scale) was used for late therapy results. ASPECTS was used to define the lesion size using imaging on admission and after treatment. Median NIHSS on admission was higher in the TE group - 16 (range 12 to 19) than in the TL group - 12 (range 8 to 15) (p < 0.05). Ninety days after treatment, mRS (0-2) was seen in 67% of patients in the TE group (n = 29), and 34% of patients in the TL group (n = 9) patients (p < 0.05). Median ASPECTS was lower in TE group - 5, in comparison to the TL group - 7 (p < 0.01) Mortality frequency was higher in the TL group (p > 0.05). Frequency of symptomatic intracerebral haemorrhages was similar in the groups. Mechanical thrombectomy can achieve better late functional outcome than thrombolysis in a selected patients group.

Acute Ischemic Stroke Endovascular Treatment of Patients With Large Vessel Occlusions / Akūta Cerebrāla Infarkta Endovaskulāra Ārstēšana Pacientiem ar Maģistrālo Artēriju Oklūzijām

Department of Doctoral Studies, Rīga Stradiņš University, Dzirciema iela 16, Rīga, LV-1007, LATVIA

Institute of Diagnostic Radiology, Pauls Stradiņš Clinical University Hospital, Pilsoņu iela 13, Rīga, LV-1010, LATVIA

Department of Neurology, Pauls Stradiņš Clinical University Hospital, Pilsoņu iela 13, Rīga, LV-1010, LATVIA

Department of Neurology and Neurosurgery, Rīga Stradiņš University, Pilsoņu iela 13, Rīga, LV-1010, LATVIA

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Mechanical thrombectomy as an active treatment method has recently been chosen for patients with large artery occlusions and thrombolysis beyond a time window. The aim of our study was to evaluate the results of endovascular treatment in patients with proximal vessel occlusion, compare this group with the intravenous thrombolysis group, and to identify possible criteria of active treatment. The prospective study included 81 patients hospitalised in the Pauls Stradiņš Clinical University Hospital due to acute ischemic stroke; 48 of them received mechanical thrombectomy and 33 - intravenous thrombolysis. Thrombectomy (TE) was performed using Solitaire FR stent retrievers. The NIHSS score was used for evaluation of early therapy results and mRS (modified Rankin Scale) was used for late therapy results. ASPECTS was used to define the lesion size using imaging on admission and after treatment. Median NIHSS on admission was higher in the TE group - 16 (range 12 to 19) than in the TL group - 12 (range 8 to 15) (p  0.05). Frequency of symptomatic intracerebral haemorrhages was similar in the groups. Mechanical thrombectomy can achieve better late functional outcome than thrombolysis in a selected patients group.

Mechanical thrombectomy as an active treatment method has recently been chosen for patients with large artery occlusions and thrombolysis beyond a time window....

Acute Ischemic Stroke Endovascular Treatment of Patients With Large Vessel Occlusions / Akūta Cerebrāla Infarkta Endovaskulāra Ārstēšana Pacientiem ar Maģistrālo Artēriju Oklūzijām

Publié en ligne: 12 avr. 2016

Pages: 205 - 209

Reçu: 12 mai 2015

DOI: https://doi.org/10.1515/prolas-2015-0030

© by Arturs Balodis

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.