SciELO - Scientific Electronic Library Online

 
vol.146 issue6Clinical features of 63 patients with ataxiaAssociation between FTO (ns9939609) genotype and adiposity markers in Chilean adults author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista médica de Chile

Print version ISSN 0034-9887

Abstract

REYES S., Pablo et al. Emergency endovascular management of ischemic stroke. Experience in 104 patients. Rev. méd. Chile [online]. 2018, vol.146, n.6, pp.708-716. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872018000600708.

Background:

Recently, five randomized controlled trials confirmed the efficacy and safety of endovascular treatment with or without intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion.

Aim:

To report patients with ischemic stroke treated with endovascular methods.

Material and Methods:

Retrospective analysis of 104 patients aged 61 ± 15 years (54% males) with ischemic stroke who received endovascular treatment at a single medical center between 2009 and 2017.

Results:

Sixty one percent were treated with intravenous thrombolysis plus endovascular procedures and 39% with endovascular procedures alone. The median door-to needle time was 61 minutes and door-to femoral puncture was 135 minutes. The median National Institute of Health Stroke Scale (NIHSS) scores on admission, 24 hours later and at discharge were 12,4 and 1 points, respectively. Middle cerebral artery was occluded in 60% of cases. Other frequent localizations where distal carotid artery in 17% and vertebro-basilar artery in 14%. Thrombolysis in cerebral infarction (TICI) scale flow score after the procedure was 3 or 2b in 58% of cases and significantly correlated with NIHSS scores at 24 hours and discharge. Fifty percent of patients had a mRankin score < = 1 and ten patients died (9.6%). Eight percent had a symptomatic intracerebral hemorrhage.

Conclusions:

The clinical improvement of these patients 24 hours after the procedure and at discharge demonstrate the effectiveness of endovascular treatment in ischemic stroke. The presence neurologists able to interpret multimodal images at the emergency room, the use of local guidelines, the availability of an experienced neuro-interventional team engaged with the workflow and the use of stent retrievers are strongly associated with good outcomes.

Keywords : Reperfusion; Stroke; Thrombolytic Therapy.

        · text in Spanish     · Spanish ( pdf )