Treatment Result in the Initial Stage of Kanazawa Mobile Embolectomy Team for Acute Ischemic Stroke
| Autor: | Ryo Higashi, Yukihiko Kohda, Masanao Mohri, Hisato Minamide, Kouichi Misaki, Takashi Asahi, Tomoya Kamide, Mitsutoshi Nakada, Masayuki Iwato, Yoshitaka Hamada, Yuya Yoshida, Naoyuki Uchiyama, Katsuo Shoin, Yuichi Hirota, Daisuke Kita |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Embolectomy Revascularization recanalization law.invention 03 medical and health sciences 0302 clinical medicine Reperfusion therapy Japan Randomized controlled trial law Modified Rankin Scale ischemic stroke medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Cerebral infarction business.industry Retrospective cohort study Thrombolysis Middle Aged medicine.disease Stroke Treatment Outcome Emergency medicine Female Original Article Surgery Neurology (clinical) business Mobile Health Units 030217 neurology & neurosurgery |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 0470-8105 |
| DOI: | 10.2176/nmc.oa.2016-0101 |
| Popis: | Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy. In this article, we report early treatment outcomes and validate the effectiveness of a network between affiliated hospitals and KMET. Between January 2014 and December 2015, 48 patients, aged 45–92 years (mean: 73.0 years), underwent acute reperfusion therapy provided by KMET in 10 affiliated hospitals of Kanazawa University Hospital. The pre-treatment NIHSS scores ranged from 5 to 39 (mean: 19.1). ASPECTS+W ranged from 1 to 11 (mean: 7.3). Successful revascularization, defined as thrombolysis in cerebral infarction (TICI) 2b or 3, was achieved in 38/48 cases (80%), and a good outcome, defined as modified Rankin Scale (mRS) score from 0 to 2 at 90 days after the treatment, was achieved in 24/48 cases (50%). There were two cases of intracranial bleeding (4%). Mean time from onset to recanalization was 297 min. These results, which are similar to those of five previous RCTs, suggest that a collaborative network between affiliated hospitals and KMET is effective for acute reperfusion therapy in local areas wherein experienced neuroendovascular specialists are insufficient. |
| Databáze: | OpenAIRE |
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