Publication details

Mechanical thrombectomy performs similarly in real world practice: a 2016 nationwide study from the Czech Republic

Authors	VOLNÝ Ondřej KRAJINA Antonin BELASKOVA Silvie BAR Michal CIMFLOVÁ Petra HERZIG Roman SANAK Daniel TOMEK Ales KOCHER Martin ROCEK Miroslav PADR Radek CIHLAR Filip NEVSIMALOVA Miroslava JURAK Lubomir HAVLICEK Roman KOVAR Martin SEVCIK Petr ROHAN Vladimir FIKSA Jan MENON Bijoy K. MIKULÍK Robert
Year of publication	2018
Type	Article in Periodical
Magazine / Source	Journal of NeuroInterventional Surgery
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1136/neurintsurg-2017-013534
Keywords	mechanical thrombectomy
Description	Background Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. Methods A vailable nationwide data for the CR from 2016 from the Safe Implementation of Treatments in Stroke-Thrombectomy (SITS-TBY) registry for patients with terminal internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusions were compared with data from HERMES. CR and HERMES patients were comparable in age, sex, and baseline National Institutes of Health Stroke Scale scores. Results From a total of 1053 MTs performed in the CR, 845 (80%) were reported in the SITS-TBY. From these, 604 (72%) were included in this study. Occlusion locations were as follows (CR vs HERMES): ICA 22% versus 21% (P=0.16), M1 MCA 62% versus 69% (P=0.004), and M2 MCA 16% versus 8% (P<0.0001). Intravenous thrombolysis was given to 76% versus 83% of patients, respectively (P=0.003). Median onset to reperfusion times were comparable: 232 versus 285 min, respectively (P=0.66). A modified Thrombolysis in Cerebral Infarction score of 2b/3 was achieved in 74% (433/584) versus 71% (390/549) of patients, respectively (OR 1.17, 95% CI 0.90-1.5, P=0.24). There was no statistically significant difference in the percentage of parenchymalhematoma type 2 (OR 1.12, 95% CI 0.66-1.90, P=0.68). A modified Rankin Scale score of 0-2 at 3 months was achieved in 48% (184/268) versus 46% (291/633) of patients, respectively (OR 0.92, 95% CI 0.71-1.18, P=0.48).