Feasibility and safety of direct catheter-based thrombectomy in the treatment of acute ischaemic stroke. Cooperation among cardiologists, neurologists and radiologists. Prospective registry PRAGUE-16

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F17%3A43913061" target="_blank" >RIV/00216208:11120/17:43913061 - isvavai.cz</a>

Výsledek na webu

<a href="http://dx.doi.org/10.4244/EIJ-D-16-00979" target="_blank" >http://dx.doi.org/10.4244/EIJ-D-16-00979</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.4244/EIJ-D-16-00979" target="_blank" >10.4244/EIJ-D-16-00979</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Feasibility and safety of direct catheter-based thrombectomy in the treatment of acute ischaemic stroke. Cooperation among cardiologists, neurologists and radiologists. Prospective registry PRAGUE-16

Popis výsledku v původním jazyce

This single-centre, prospective observational registry based on the pre-specified protocol included three months of follow-up. The decision to perform acute stroke intervention was made by a neurologist based on the clinical and imaging findings. Inclusion criteria were moderate-to-severe acute ischaemic stroke (NIHSS GREATER-THAN OR EQUAL TO6), &lt;6 hours from symptom onset, no large ischaemia on the admission CT scan and CT evidence for an occluded large artery. The primary outcome was functional neurologic recovery (mRS 0-2) at three months. Key secondary outcomes were the angiographic recanalisation rate and symptomatic intracranial bleeding. A total of 115 consecutive patients (mean age 66 years) were enrolled during a period of four years: 84 patients underwent d-CBT and 31 patients bridging thrombolysis with immediate catheter intervention (TL-CBT). The annual number of procedures increased from 13 (initial 12 months) to 41 (last 12 months). Angiographic success (TICI flow 2b-3) was 69% after d-CBT and 81% after TL-CBT. It was higher in isolated occlusions of the middle cerebral artery (MCA, 74% and 100%) or of the proximal internal carotid artery (ICA, 80% and 100%), while it was lower in combined ICA+MCA occlusions (63% and 70%) and in basilar or vertebral occlusions (57% and 50%). Neurologic recovery (mRS LESS-THAN OR EQUAL TO2 after 90 days) was achieved in 40% of patients. It was higher (43%) in anterior circulation strokes than in posterior circulation strokes (25%). Direct CBT led to neurologic recovery in 36%, while in TL-CBT this was 52%. Best clinical outcomes (51% and 71% neurologic recovery rates) were achieved among patients with isolated MCA occlusion. Any symptomatic intracranial bleeding was present in 3.6% (d-CBT) and 6.5% (TL-CBT). Vessel perforation or major dissection occurred in 5.2% overall, and distal embolisation to other territory in 3.5% of patients.

Název v anglickém jazyce

Feasibility and safety of direct catheter-based thrombectomy in the treatment of acute ischaemic stroke. Cooperation among cardiologists, neurologists and radiologists. Prospective registry PRAGUE-16

Popis výsledku anglicky

This single-centre, prospective observational registry based on the pre-specified protocol included three months of follow-up. The decision to perform acute stroke intervention was made by a neurologist based on the clinical and imaging findings. Inclusion criteria were moderate-to-severe acute ischaemic stroke (NIHSS GREATER-THAN OR EQUAL TO6), &lt;6 hours from symptom onset, no large ischaemia on the admission CT scan and CT evidence for an occluded large artery. The primary outcome was functional neurologic recovery (mRS 0-2) at three months. Key secondary outcomes were the angiographic recanalisation rate and symptomatic intracranial bleeding. A total of 115 consecutive patients (mean age 66 years) were enrolled during a period of four years: 84 patients underwent d-CBT and 31 patients bridging thrombolysis with immediate catheter intervention (TL-CBT). The annual number of procedures increased from 13 (initial 12 months) to 41 (last 12 months). Angiographic success (TICI flow 2b-3) was 69% after d-CBT and 81% after TL-CBT. It was higher in isolated occlusions of the middle cerebral artery (MCA, 74% and 100%) or of the proximal internal carotid artery (ICA, 80% and 100%), while it was lower in combined ICA+MCA occlusions (63% and 70%) and in basilar or vertebral occlusions (57% and 50%). Neurologic recovery (mRS LESS-THAN OR EQUAL TO2 after 90 days) was achieved in 40% of patients. It was higher (43%) in anterior circulation strokes than in posterior circulation strokes (25%). Direct CBT led to neurologic recovery in 36%, while in TL-CBT this was 52%. Best clinical outcomes (51% and 71% neurologic recovery rates) were achieved among patients with isolated MCA occlusion. Any symptomatic intracranial bleeding was present in 3.6% (d-CBT) and 6.5% (TL-CBT). Vessel perforation or major dissection occurred in 5.2% overall, and distal embolisation to other territory in 3.5% of patients.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

EuroIntervention

ISSN

1774-024X

e-ISSN

—

Svazek periodika

13

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

FR - Francouzská republika

Počet stran výsledku

6

Strana od-do

131-136

Kód UT WoS článku

000405055700017

EID výsledku v databázi Scopus

2-s2.0-85019936202