A Registry of Mechanical Recanalization Procedures in Acute Stroke - Pilot Results from a Multicentre Registry
Abstract
Background: Acute cerebral artery occlusion is the most common cause of ischemic stroke. Early recanalization is associated with a significantly higher chance of achieving patient self-sufficiency and reducing mortality.
Over the recent years, pharmacological recanalization methods were joined by mechanical methods. The aim of the registry is to map geographic availability and to assess safety and efficacy of mechanical recanalization techniques in routine clinical practice.
Methods: All consecutive acute ischemic stroke patients treated with mechanical recanalization techniques in selected comprehensive cerebrovascular and stroke centers in the Czech Republic have been prospectively registered. Demographic data, stroke severity, grade of recanalization, patient clinical outcome and frequency of symptomatic intracranial hemorrhage (SICH) were analyzed in the pilot study and are presented.
Results: A total of 353 patients (210 men, mean age 66.0 +/- 13.1 years) with acute ischemic stroke and acute occlusion of the carotid or intracranial artery, treated using mechanical technique were consecutively registered to a multicentre registry between January 1, 2006 and September 21, 2014. The median of baseline NIHSS score was 16 points.
Recanalization (TICI 2b-3) was achieved in 58.6% and self-sufficiency after three months (modified Rankin Scale, mRS 0-2) in 45.3% patients. SICH occurred in 4.2% patients and 3-month mortality was 26.1%.
Conclusion:The organization of care for ischemic stroke patients in the Czech Republic is at a good level with availability of intravenous thrombolysis as well as mechanical recanalization methods. Endovascular procedures appear to be safe and highly effective with respect to arterial recanalization.