Endovascular thrombectomy for acute ischemic stroke: A single-center experience in Taiwan
Journal
Journal of the Formosan Medical Association
Journal Volume
117
Journal Issue
9
Pages
806-813
Date Issued
2018
Author(s)
Abstract
Background/purpose: Endovascular thrombectomy has been strongly recommended for treatment of acute ischemic stroke (AIS) with large vessel occlusion. This study aimed to evaluate its efficacy and safety in an Asian population from a single center in Taiwan. Methods: Patients who experienced AIS and received endovascular thrombectomy during the period of September 2014 to September 2016 at National Taiwan University Hospital were included. Factors related to favorable outcome, defined as modified Rankin scale 0–2 at 90 days after stroke, were analyzed. Results: During the study period, 65 patients (mean age, 71.9 ± 12.4 years; 44.6% females) received endovascular thrombectomy, including 33 who received intravenous thrombolysis before the endovascular treatment. A significant trend of increasing thrombectomy therapy was observed. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 19 (interquartile range, 15–26). The sites of vessel occlusion were middle cerebral artery in 47 (72.3%) patients, intracranial internal carotid artery in 8 (12.4%), anterior cerebral artery in 1 (1.5%), and basilar artery in 9 (13.8%). The median times from stroke onset to groin puncture and from groin puncture to recanalization time were 200 and 29.5 min, respectively. Successful revascularization was achieved in 41 (63.1%) patients. Two (3.1%) patients had symptomatic hemorrhagic transformation. At 90 days, 25 (38.5%) patients achieved favorable outcome. A shorter time from onset to puncture, and successful recanalization were independent predictors of favorable outcome. Conclusion: This study demonstrated the therapeutic promise of endovascular thrombectomy for treatment of AIS with large vessel occlusion in a clinical setting. ? 2017
SDGs
Other Subjects
aged; anterior cerebral artery; Article; atrial fibrillation; basilar artery; blood clot lysis; brain ischemia; cerebrovascular accident; clinical effectiveness; clinical evaluation; clinical outcome; computer assisted tomography; diabetes mellitus; endovascular surgery; female; heart infarction; human; hyperlipidemia; hypertension; inguinal region; internal carotid artery; major clinical study; male; middle cerebral artery; National Institutes of Health Stroke Scale; neuroimaging; nuclear magnetic resonance imaging; occlusion; patient selection; percutaneous thrombectomy; Rankin scale; recanalization; risk factor; safety; Taiwan; thrombectomy; university hospital; brain ischemia; cerebrovascular accident; computed tomographic angiography; diagnostic imaging; middle aged; multivariate analysis; pathophysiology; severity of illness index; thrombectomy; treatment outcome; very elderly; fibrinolytic agent; tissue plasminogen activator; Aged; Aged, 80 and over; Brain Ischemia; Carotid Artery, Internal; Computed Tomography Angiography; Endovascular Procedures; Female; Fibrinolytic Agents; Humans; Male; Middle Aged; Multivariate Analysis; Severity of Illness Index; Stroke; Taiwan; Thrombectomy; Tissue Plasminogen Activator; Treatment Outcome
Type
journal article