MECHANICAL THROMBECTOMY IN STROKE - OUR TEN MONTHS EXPERIENCE

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.