Martin Köcher1, Daniel Šaňák2, Jana Zapletalová3, Filip Cihlář4, Daniel Czerný5, David Černík6, Petr Duras7, Ladislav Endrych8, Roman Herzig9, Jiří Lacman10, Miroslav Lojík11, Svatopluk Ostrý12, Radek Pádr13, Vladimír Rohan14, Miroslav Škorňa15, Martin Šrámek16, Luděk Štěrba17, Daniel Václavík18, Jiří Vaníček19, Ondřej Volný20, Aleš Tomek21. 1. Department of Radiology, Comprehensive Stroke Center, Palacký University Medical School and Hospital, Olomouc, Czech Republic. 2. Department of Neurology, Comprehensive Stroke Center, Palacký University Medical School and Hospital, I. P. Pavlova 6, Olomouc, 77520, Czech Republic. daniel.sanak@centrum.cz. 3. Department of Medical Biophysics and Statistics, Palacký University Medical School, Olomouc, Czech Republic. 4. Department of Radiology, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic. 5. Department of Radiology, University of Ostrava Faculty of Medicine and University Hospital, Ostrava, Czech Republic. 6. Department of Neurology, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic. 7. Department of Radiology, Charles University Faculty of Medicine University Hospital Plzen, Plzeň, Czech Republic. 8. Department of Radiology, Hospital Liberec, Liberec, Czech Republic. 9. Department of Neurology, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic. 10. Department of Radiology, Central Military University Hospital Prague, Prague, Czech Republic. 11. Department of Radiology, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic. 12. Department of Neurology, Hospital České Budějovice, České Budějovice, Czech Republic. 13. Department of Radiology, Charles University 2nd Faculty of Medicine University Hospital Motol Prague, Prague, Czech Republic. 14. Department of Neurology, Charles University Faculty of Medicine University Hospital Plzen, Plzeň, Czech Republic. 15. Department of Neurology, Masaryk University Faculty of Medicine, University Hospital Brno, Brno, Czech Republic. 16. Department of Neurology, Central Military University Hospital Prague, Prague, Czech Republic. 17. Department of Radiology, Hospital České Budějovice, České Budějovice, Czech Republic. 18. Department of Neurology, AGEL Research and Training Institute, Ostrava Vítkovice Hospital, Ostrava, Czech Republic. 19. Department of Diagnostic Imaging, Masaryk University Faculty of Medicine and St. Anne's Hospital Brno and International Clinical Research Center, Brno, Czech Republic. 20. Department of Neurology, Masaryk University Faculty of Medicine and St. Anne's Hospital Brno and International Clinical Research Center, Brno, Czech Republic. 21. Department of Neurology, Charles University 2nd Faculty of Medicine University Hospital Motol Prague, Prague, Czech Republic.
Abstract
BACKGROUND AND PURPOSE: Experienced multidisciplinary stroke team and well-organized hospital management are considered necessary to achieve good results after mechanical thrombectomy (MT) in acute ischemic stroke patients. We analyzed the technical results of MT performed in the Czech Republic in the year 2016 to provide relevant data for further quality improvement. MATERIAL AND METHODS: All centers performing MT in the CR were called for detailed technical and clinical data from year 2016, which were anonymously analyzed and relevant technical key time intervals were compared. Clinical outcomes were assessed according to the HERMES meta-analysis. RESULTS: In the 2016, 1053 MTs were performed in the CR. Of 15 dedicated centers, the data from 12 centers and from 886 (84%) patients (49.2% males, mean age 69.8 ± 12.3 years) were analyzed. The overall median of time from hospital arrival to groin puncture (GP) was 77 min with a range from 40 to 109 min among individual hospitals, from GP to first passage of stent retriever 20 (15-40) min and from GP to maximal reached recanalization 42 (33-80) min. The median of recanalization time was 240 (219-320) min. The recanalization (TICI 2b-3) was achieved in 81.7% of patients, 44.1% of patients had a good 3-month clinical outcome and 6.3% suffered from symptomatic intracerebral hemorrhage. Peri-procedural complications were recorded in 89 (10%) patients. CONCLUSION: Despite achieved good overall results, a great variability in some of the analyzed key time intervals among individual centers performing MT warrants further quality improvement.
BACKGROUND AND PURPOSE: Experienced multidisciplinary stroke team and well-organized hospital management are considered necessary to achieve good results after mechanical thrombectomy (MT) in acute ischemic strokepatients. We analyzed the technical results of MT performed in the Czech Republic in the year 2016 to provide relevant data for further quality improvement. MATERIAL AND METHODS: All centers performing MT in the CR were called for detailed technical and clinical data from year 2016, which were anonymously analyzed and relevant technical key time intervals were compared. Clinical outcomes were assessed according to the HERMES meta-analysis. RESULTS: In the 2016, 1053 MTs were performed in the CR. Of 15 dedicated centers, the data from 12 centers and from 886 (84%) patients (49.2% males, mean age 69.8 ± 12.3 years) were analyzed. The overall median of time from hospital arrival to groin puncture (GP) was 77 min with a range from 40 to 109 min among individual hospitals, from GP to first passage of stent retriever 20 (15-40) min and from GP to maximal reached recanalization 42 (33-80) min. The median of recanalization time was 240 (219-320) min. The recanalization (TICI 2b-3) was achieved in 81.7% of patients, 44.1% of patients had a good 3-month clinical outcome and 6.3% suffered from symptomatic intracerebral hemorrhage. Peri-procedural complications were recorded in 89 (10%) patients. CONCLUSION: Despite achieved good overall results, a great variability in some of the analyzed key time intervals among individual centers performing MT warrants further quality improvement.
Authors: Kars C J Compagne; Manon Kappelhof; Wouter H Hinsenveld; Josje Brouwer; Robert-Jan B Goldhoorn; Maarten Uyttenboogaart; Reinoud P H Bokkers; Wouter J Schonewille; Jasper M Martens; Jeannette Hofmeijer; H Bart van der Worp; Rob T H Lo; Koos Keizer; Lonneke S F Yo; Geert J Lycklama À Nijeholt; Heleen M den Hertog; Emiel J C Sturm; Paul J A M Brouwers; Marianne A A van Walderveen; Marieke J H Wermer; Sebastiaan F de Bruijn; Lukas C van Dijk; Hieronymus D Boogaarts; Ewout J van Dijk; Julia H van Tuijl; Jo P P Peluso; Paul L M de Kort; Boudewijn A A M van Hasselt; Puck S Fransen; Tobien H C M L Schreuder; Roel J J Heijboer; Sjoerd F M Jenniskens; Marieke E S Sprengers; Elias Ghariq; Ido R van den Wijngaard; Stefan D Roosendaal; Anton F J A Meijer; Ludo F M Beenen; Alida A Postma; René van den Berg; Albert J Yoo; Pieter Jan van Doormaal; Marc P van Proosdij; Menno G M Krietemeijer; Dick G Gerrits; Sebastiaan Hammer; Jan Albert Vos; Jelis Boiten; Jonathan M Coutinho; Bart J Emmer; Ad C G M van Es; Bob Roozenbeek; Yvo B W E M Roos; Wim H van Zwam; Robert J van Oostenbrugge; Charles B L M Majoie; Diederik W J Dippel; Aad van der Lugt Journal: Stroke Date: 2022-02-09 Impact factor: 10.170