Acute Stroke Interventions Performed by Cardiologists: Initial Experience in a Single Center.
JACC Cardiovasc Interv
; 12(17): 1703-1710, 2019 09 09.
Article
em En
| MEDLINE
| ID: mdl-31488297
ABSTRACT
OBJECTIVES:
The aim of this study was to evaluate the technical and clinical success of acute stroke interventions performed in our interventional cardiology center.BACKGROUND:
Dedicated interventional stroke centers remain limited. Interventional cardiologists have established networks of catheterization laboratories and the necessary infrastructure to provide around the clock interventional therapy. These networks may also provide the currently lacking universal rapid access to prompt stroke intervention.METHODS:
Between July 2012 and July 2018, 70 consecutive patients underwent acute stroke intervention for large-vessel occlusions. Seventeen patients (24%) had tandem or multiple vessel occlusions. The majority (n = 63, 90%) were admitted via our local stroke unit, and 7 (10%) patients were transferred from other regional referral centers.RESULTS:
In 43 (61%) patients, systemic fibrinolytic therapy was started after baseline imaging. Mean time between symptom onset and arrival to the cath lab was 138 min; mean door-to-vascular access time was 64 min; mean time between cath lab activation and its operational readiness was 13 min. In all cases, access to supra-aortic vessels was achieved. Mean time between femoral arterial puncture and lesion crossing was 26 min. Stent implantation for extracranial stenosis or dissection was performed in 14 (20%) cases. Thrombectomy of intracranial occlusions was done with a stent retriever (n = 64, 91%) or an aspiration system (n = 14, 20%). In 20 (28%) cases, a combination of techniques was used. Recanalization was technically successful (Thrombolysis In Cerebral Infarction flow grade 2b or 3) in 65 (93%) patients. The 30-day mortality was 18% (n = 13). Favorable clinical outcome, defined as a modified Rankin Scale score of 0 to 2, was achieved in 61% at 3-month follow-up.CONCLUSIONS:
Acute stroke interventions can be performed safely and with high technical and clinical success by experienced interventional cardiologists.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Terapia Trombolítica
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Isquemia Encefálica
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Trombectomia
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Acidente Vascular Cerebral
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Atenção à Saúde
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Procedimentos Endovasculares
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Fibrinolíticos
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Cardiologistas
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article