Extended Time Window Mechanical Thrombectomy for Acute Stroke in Brazil.
J Stroke Cerebrovasc Dis
; 29(10): 105134, 2020 Oct.
Article
en En
| MEDLINE
| ID: mdl-32912530
ABSTRACT
BACKGROUND:
Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) caused by large vessel occlusion of the anterior circulation within 6 hours of symptoms onset and can be performed with an extended window up to 24 hours in selected patients. Nevertheless, the outcomes of MT with extended window are unknown in developing countries.OBJECTIVE:
Explore the safety and efficacy of MT for AIS performed beyond 6 hours from symptoms onset in Brazil.METHODS:
We reviewed data from AIS patients treated with MT beyond 6 hours of stroke onset, from 2015 to 2018 in a Brazilian public hospital. Patients had an occlusion of the intracranial internal carotid artery and/or proximal segment of the middle cerebral artery. CT Perfusion mismatch was evaluated using the RAPID® software. We evaluated the modified Rankin scale (mRS) and mortality at 90 days, and rate of symptomatic intracranial hemorrhage (sICH).RESULTS:
Fifty-four patients were included, with a mean age of 65.6 ± 16.1 years, 55.6% were male, and the median NIHSS score at presentation was 17. Successful recanalization (TICI 2b to 3) was obtained in 92.6% of patients and sICH rate was 11.1%. Overall, 34% of the patients had a good outcome (mRS ≤2) at 90 days and the mortality rate was 20.3%.CONCLUSION:
Our study, the first series of MT for AIS treated with extended window reported in Latin America, shows that MT can be performed with safety and lead to adequate functional outcomes in this context. Further studies should explore the barriers to broad implementation of MT for AIS in Latin America.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Arteria Carótida Interna
/
Circulación Cerebrovascular
/
Estenosis Carotídea
/
Trombectomía
/
Arteria Cerebral Media
/
Infarto de la Arteria Cerebral Media
/
Tiempo de Tratamiento
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Asunto de la revista:
ANGIOLOGIA
/
CEREBRO
Año:
2020
Tipo del documento:
Article