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MECHANICAL THROMBECTOMY FOR ACUTE ISCHEMIC STROKE. DESCRIPTIVE ANALYSIS OF CASES SINCE 2015 IN A STROKE CENTER IN BUENOS AIRES, ARGENTINA

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Presented at

11th World Stroke Congress

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Abstract

Introduction Ischemic stroke is a leading cause of morbidity worldwide. Reperfusion therapies with intravenous tissue plasminogen activator (IV-tPA) and mechanical thrombectomy (MT) are proven effective in the acute stage. In our country there are difficulties to achieve the implementation of both practices. Objective To report the experience of a Stroke Center in the use of MT in acute stroke. Patients and methods Retrospective and descriptive analysis of consecutive patients from January 2015 to June 2018, who received reperfusion treatment with MT. We assessed demographic data, treatment times, use of tPA, site of obstruction, recanalization, severity and disability at three months after stroke. Results 922 patients were admitted with acute stroke during this period, 87 received IV-tPA (9.5%) and 24 were treated with MT (2.6%). In the MT group, the mean age was 66±16 years. Median NIHSS before MT was 20 (range 14-24). 17 (71%) presented occlusion at M1 level. The most frequent etiology was cardioembolism (58%). Prior to MT, 15 patients (63%) received IV-tPA. Average window-time 184±42 minutes and door-to-needle time for IV-tPA 42±16 minutes. Mean time to onset of symptoms-recanalization 308±147 minutes. In 19 patients (79%) successful recanalization was achieved (TICI 2B/3). At three-month follow-up, the median NIHSS was 5 and mRS 3. Conclusion Proper logistics made possible the use of MT in a substantial number of cases. The use of protocols and the training of a multidisciplinary team are fundamental to achieve optimal times. We obtained high recanalization rate and good recovery at three-months. Our results were similar to actual series reported in Latin America.

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© Copyright 2019 Morressier GmbH.
All rights reserved.