Effective cerebrovascular thrombectomy requires well-organized structures : Real world experiences of a regional stroke network between 2012-2015

Abstract

Background: The objective of this study was to analyse the Neurothrombectomy Network registry of the Neuromed Campus (NMC) of the Kepler University Hospital in Linz (Austria). The data were compared to the results of recently published thrombectomy trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, REVASCAT and THRACE).

Methods: We retrospectively studied 246 patients with acute ischemic stroke who underwent thrombectomy between January 2012 and December 2015 at the NMC in Upper Austria. The main outcome measures were modified Rankin scale (mRS) score 0-2 at 90 days, all-cause mortality and stroke or thrombectomy-related mortality at discharge, as well as 90 days postdischarge.

Results: The median age was 70.4 years (IQR 59.9-76.9) and the median NIHSS at admission 16 (IQR 13-20). The thrombolysis in cerebral infarction (TICI) scale 2b-3 recanalization was achieved in 87.4%, 11.0% of the patients died in hospital and an additional 6.1% within 90 days after discharge. After 90 days, 56.5% had a mRS score 0-2.

Conclusions: These data suggest that the positive results of thrombectomy reported in several randomized controlled studies can be achieved in routine clinical practice; therefore, the setting of an organized, regional stroke network proved an effective and appropriate method for delivering regional thrombectomy stroke treatment.

Keywords: Endovascular treatment; Interventional neuroradiology; Ischemic stroke; Stroke network; Thrombectomy.