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Multicenter Study
. 2023 Mar;128(3):357-361.
doi: 10.1007/s11547-023-01599-5. Epub 2023 Feb 8.

Efficacy of recanalization therapy for ischemic stroke: multicenter hospital network experience

Francesco Briganti  1 , Mario Tortora  1 , Fabio Tortora  1 , Andrea Elefante  1 , Giovanni Loiudice  1 , Mariano Marseglia  1 , Giuseppe Buono  1 , Michele Rizzuti  1 , Rosa Iodice  1 , Fiore Manganelli  1 , Francesco Diurno  2 , Fabio Giuliano Numis  2 , Luigi Ferrara  2 , Carlo Bruno  2 , Alessandro Bresciani  2 , Ferdinando Caranci  3 , Donatella Franco  4 , Carlo Vaiano  5 , Gaetano D'Onofrio  5 , Pasquale Scala  5 , Rosa Raucci  6 , Eufrasia Silvestro  6
Affiliations
Multicenter Study

Efficacy of recanalization therapy for ischemic stroke: multicenter hospital network experience

Francesco Briganti et al. Radiol Med. 2023 Mar.

Abstract

Purpose: Stroke is a leading cause of long-term disability with high mortality rate in the first year after the event. In Campania, mechanical thrombectomy treatment significantly increases in the last 3 years, as well as hospitals delivering acute stroke treatments. The aim of this study is to demonstrate how a full opening of our stroke network improves stroke management and stroked patients' survival in Campania.

Material and methods: In Federico II University Hospital of Naples acting as a HUB center of 7 peripheral SPOKE hospitals in regional territory, 68 patients with acute ischemic stroke were evaluated with NIHSS and m-RS clinical scores and neuroradiological ASPECT scores, from January 1 to December 31, 2021. At hospital discharge, NIHSS score and three months after m-RS score were re-assessed to evaluate the therapeutic effects.

Results: Forty-two of 68 patients (63%) admitted to our hub center had ischemic acute stroke at CT evaluation; 29 patients had ASPECT score > 7 (69%), and 6 a score < 7 (14%). At admission, NIHSS score mean value was 10.75, and m-RS score mean value was 0.74. At discharge, NIHSS score mean value was 7.09. After three months, m-RS score mean value was 0.74.

Discussion: The inter-company agreement between Federico II University and several peripheral hospitals allows an absolute and relative increase in endovascular mechanical thrombectomy and intravenous thrombolysis procedures, with a relative prevalence of mechanical thrombectomy. A regional implementation of the stroke multi-disciplinary care system is hardly needed to ensure the optimum treatment for the largest number of patients, improving patient's outcome.

Keywords: HUB and SPOKE network; Intravenous thrombolysis; Mechanical thrombectomy; Stroke.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Pie chart illustrates the different occlusion sites in stroke cases treated at our institution
Fig. 2
Fig. 2
Diagram shows how suspected stroke cases with ASPECT evaluation and treatment modalities were handled
Fig. 3
Fig. 3
Ratings (mean value, maximum value and minimum value) NIHSS before and after treatment
Fig. 4
Fig. 4
Ratings (mean value, maximum value and minimum value) mRS before and after treatment
See this image and copyright information in PMC

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