MECHANICAL THROMBECTOMY IN STROKE - OUR TEN MONTHS EXPERIENCE
Date Issued
2019-10-24
Author(s)
Aliji, Vjolca
Daskalov, Dejan
Bushinvoska, Jasna
Temenugova, Ida
Abstract
Mechanical thrombectomy for stroke patient started in November 2018 in our
country. For ten months we have 21 patient with large vessel occlusion. Our center
is for now single center that provide mechanical thrombectomy for population of
two million people. All stroke patient were with large vessel occlusion on CT
and CTA. First patient was directly evaluated and treated in angiography suite
on the basis of native CT- hyperdense MCA sign and clinical symptoms. Next
patient underwent CT and CTA and one with MR/MRA. Four patient were with T
occlusion, two successful recanalization and two failure. Other 17 were M1/M2
occlusion from witch tree tandem lesions ICA and M1. Patients were on age of 25
to 73 years old. We used stent retriever in all patients (solitaire or embotrap) and
aspiration together and in most of patient intermediate catheter ( sofia/sofia plus)
but we never used balloon guiding catheter. Time window in 18 patient was <6h
and 3 of patients with wake up stroke. All patients were with NIHSS >5. TICI
2b was achieved in 8 patients, TICI 3 in 4 patients, TICI 2a in 3 patients, in one
patient grade 1 and no reperfusion in 5 patients from witch one with worsening.
No major hemorrhage appeared but only 4 patients previously received IV tPA.
Till today no national strategy for stroke patient pathway.
country. For ten months we have 21 patient with large vessel occlusion. Our center
is for now single center that provide mechanical thrombectomy for population of
two million people. All stroke patient were with large vessel occlusion on CT
and CTA. First patient was directly evaluated and treated in angiography suite
on the basis of native CT- hyperdense MCA sign and clinical symptoms. Next
patient underwent CT and CTA and one with MR/MRA. Four patient were with T
occlusion, two successful recanalization and two failure. Other 17 were M1/M2
occlusion from witch tree tandem lesions ICA and M1. Patients were on age of 25
to 73 years old. We used stent retriever in all patients (solitaire or embotrap) and
aspiration together and in most of patient intermediate catheter ( sofia/sofia plus)
but we never used balloon guiding catheter. Time window in 18 patient was <6h
and 3 of patients with wake up stroke. All patients were with NIHSS >5. TICI
2b was achieved in 8 patients, TICI 3 in 4 patients, TICI 2a in 3 patients, in one
patient grade 1 and no reperfusion in 5 patients from witch one with worsening.
No major hemorrhage appeared but only 4 patients previously received IV tPA.
Till today no national strategy for stroke patient pathway.
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MECHANICAL THROMBECTOMY IN STROKE-OUR TEN MONTHS EXPERIENCE
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