Direct catheter-based thrombectomy in acute ischaemic stroke performed collaboratively by cardiologists, neurologists and radiologists: the single-centre pilot experience (PRAGUE-16 study)
Abstract
Aims: To assess the feasibility of direct catheter-based thrombectomy (d-CBT) performed jointly by cardiologists, neurologists and radiologists. Methods and results: Computed tomography (CT) was completed within <6 hours from onset of acute ischaemic stroke and excluded bleeding or developed ischaemia in 23 patients who fulfilled pre-specified entry criteria.
The mean NIHSS was 17 (8-24). Mechanical recanalisation was successful in 19/23 patients (83%).
The mean symptom onset - CT time was 81 min, CT - sheath insertion 47 min, sheath - reperfusion 46 mm. Three patients died within 30 days, two others within 90 days (overall three-month mortality 22%).
The mean mRs at 90 days for the entire group was 3.19, among survivors 2.31 and among survivors treated within <120 minutes 1.17. Favourable functional outcome (mRs <= 2) was achieved in 48% of patients.
Five patients (22%) had full (mRs=0) or nearly full (mRs=1) neurologic recovery. Seven patients were able to be discharged from neurology ICU directly home after a short (<7 days) hospital stay.
Two patients had symptomatic intracranial haemorrhage. Conclusions: Acute stroke treatment by d-CBT jointly by neurologists, cardiologists and radiologists provided promising results especially in patients reaching the cathlab within <2 hours from stroke onset.