Endovascular Recanalization in the Treatment of Acute Occlusion of the Brain Arteries

Czech version

Authors: A. Krajina ¹; D. Krajíčková ²; Miroslav Lojík ¹; V. Chovanec ¹; J. Raupach ¹; M. Kubíková ²; M. Vališ ²; Z. Špriňar ¹; R. Taláb ²; P. Ryška ¹; J. Schreiberová ³; J. Holubová ²; J. Šimko ²; O. Renc ¹; Eva Čermáková ⁴; S. Řehák ⁵
Authors‘ workplace: LF UK a FN Hradec Králové Radiologická klinika ¹; LF UK a FN Hradec Králové Neurologická klinika ²; LF UK a FN Hradec Králové Klinika anesteziologie, resuscitace a intenzivní medicíny ³; LF UK a FN Hradec Králové Ústav lékařské biofyziky ⁴; LF UK a FN Hradec Králové Neurochirurgická klinika ⁵
Published in: Cesk Slov Neurol N 2010; 73/106(6): 678-684
Category: Original Paper

Overview

Purpose:
The purpose of this study was to assess the role of mechanical endovascular recanalization techniques in the treatment of acute occlusions of the brain arteries in a single-centre group of consecutive patients treated between September 2006 and September 2009. Methods: This is a retrospective analysis of 33 patients (18 women, 15 men) of average age 58.2 years (range 31–80) suffering from acute ischemic stroke (mean NIHSS 16.3; range 7–25). The main inclusion criterion was proven penumbra on perfusion CT. Occlusion in the anterior circulation appeared in 22 patients (67%), and occlusion in the vertebrobasilar circulation in 11 patients (33%). The procedure started within 5.3 hours on average. The following therapies were used: mechanical clot retrieval alone (12 cases), and combined with intra-arterial thrombolysis (17 cases). Angioplasty aspiration and intravascular stents were used in the remaining non-embolic cases. A subgroup analysis comparing functionally good and poor patients and anterior and posterior stroke was performed. Results: Eighteen patients (54.5%) had a mRS of 2 or less at 3 months. The TIMI 3 and 2 recanalization rate was 66%. Three patients (9%) had symptomatic intracranial hemorrhage, and the 90-day mortality was 18%. Conclusion: Using a dedicated mechanical recanalization device has become a primary approach to the treatment of acute embolic ischemic stroke.

Key words:
stroke – mechanical thrombectomy – cerebral revascularization – thrombolytic therapy

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