Endovascular Thrombectomy in Treatment of Patients with Acute Ischemic Stroke - Pauls Stradins Clinical University Hospital Experience
Introduction. 15 mlj people suffer from stroke each year (World Health Organization 2005). That is one of the main causes of mortality, dementia and disability. (5;7) Inability after stroke is much more important problem than mortality, since it forms substantial additional costs in the health and social budget, and often isolate patients from the social life.
Aim of the study. The aim of our study is to evaluate the safety and effectiveness of mechanical thrombectomy and cerebrovascular revascularization for patients with acute ischemic stroke.
Materials and methods. This study was retrospective and all included patients (n=37) were hospitalized in Department of Neurology at Pauls Stradins Clinical University hospital with acute ischemic stroke. Patients with carotid artery, middle cerebral artery and basilar artery occlusions were included in the thrombectomy group.
Results. Our results suggest that endovascular revascularization for patients with acute ischemic stroke in case of large artery occlusion is relatively safe and effective. This method is a method of choice for ischemic stroke patients with middle cerebral, basilar artery, and carotid artery occlusion.
Conclusions. Endovascular revascularization is relatively safe and effective method of stroke treatment.
Alexandrov AV, Grotta JC. Arterial reocclusion in stroke patients treated with intravenous tissue plasminogen activator// Neurology, 2002; 59: 862-67
del Zoppo GJ, Poeck K, Pessin MS, et al. Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke// Ann Neurol, 1992; 32:78-86
Grotta JC, Welch KM, Fagan SC, et al. Clinical deterioration following improvement in the NINDS rtPA Stroke Trial// Stroke, 2001; 32:661-68
Kaufmann AM, Firlik AD, Fukui MB, et al. Ischemic core and penumbra in human stroke// Stroke, 1999; 30:93-99
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data// Lancet, 2006; 367: 1747-1757
Miglane E, Eniņa G, Tilgale B. Risk factors and some clinical factors in various subtypes of cerebral infarction// Atherosclerosis Supplements, 2004; 5/4: 35
Murray CJL, Lopez AD. Global mortality, disability and the contribution of risk factors: Global burden of disease study// Lancet, 1997; 349:1436-1442
Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis// Stroke, 2007; 38: 967-973
Sarti C, Rastenyte D, Cepaitis Z, Tuomilehto J. International trends in mortality from Stroke, 1968 to 1994// Stroke, 2000; 31:1588-1601
Smith WS, Sung G, Starkman S, et al. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial// Stroke, 2005; 36: 1432-1438
Smith WS. Intra-arterial thrombolytic therapy for acute basilar occlusion: pro// Stroke, 2007; 38: 701-703
Smith WS. Safety of mechanical thrombectomy and intravenous tissue plasminogen activator in acute ischemic stroke. Results of the Multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I// AJNR Am J Neuroradiol, 2006; 27: 1177-1182
Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rtPA Stroke Study Group// N Engl J Med, 1995; 333:1581-87