Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno / Emergency endovascular management of ischemic stroke: experience in 104 patients
Rev. méd. Chile
;
146(6): 708-716, jun. 2018. tab, graf
Artículo
en Español
| LILACS
| ID: biblio-961451
ABSTRACT
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 andMethods:
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.
Texto completo:
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Índice:
LILACS (Américas)
Asunto principal:
Terapia Trombolítica
/
Isquemia Encefálica
/
Accidente Cerebrovascular
/
Procedimientos Endovasculares
Tipo de estudio:
Guía de Práctica Clínica
/
Estudio observacional
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Aged80
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Chile
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Clínica Santa María/CL
/
Universidad de Chile/CL
/
Universidad de los Andes/CL
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