Background:
Endovascular therapy (EVT) is a novel treatment for acute ischemic stroke (AIS) from large vessel occlusion. This study described the application and the outcomes of EVT in southern Taiwan, exploring the incidences and factors related to favorable outcomes.
Methods:
This was a retrospective study of AIS treated by EVT at Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Outcome parameters included National Institute of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and modified treatment in cerebral ischemic scale (mTICI) scores. Intracranial hemorrhage (ICH) and mortality at 90 days were analyzed.
Results:
Sixty-three patients received EVT from February 2016 to May 2018. The median time from onset to ER, to groin needle and recanalization was 172, 310 and 330 minutes respectively. The median NIHSS was 19, and 34.9% treated by IV rt-PA before EVT. Forty-three patients (68.3%) achieved mTICI  2b and 12 (19.0%) had mRS 0-2 at 90 days. Thirty-three patients (52.4%) were transferred from surrounding hospitals with a prolonged time from onset to groin puncture. Overall, 41.3% of the patients had hemorrhagic transformation and 15.9% had symptomatic ICH without impact to favorable outcomes. Eleven patients died. Dyslipidemia, IV rt-PA pretreatment and time from onset to groin puncture were associated with recanalization.
Conclusion:
The incidence EVT was relative low. The efficacy of inter-hospital transfer could be important for the better outcomes by minimizing the time from onset to groin needle. IV rt-PA pretreatment before EVT was crucial for better recanalization. EVT is feasible to be applied in the study hospital.

Outcomes of Thrombolysis and Intra-arterial Thrombectomy in Acute Ischemic Stroke from a single medical center in Taiwan