Trombectomía mecánica en pacientes con ataque cerebrovascular isquémico: serie de casos en un centro de referencia colombiano / Mechanical Thrombectomy in patients with isquemic stroke: Case series in a Colombian reference center

RESUMEN OBJETIVO: Este artículo describe las características clínicas, indicaciones y desenlaces de mortalidad, eventos adversos e independencia funcional en pacientes con ataque cerebrovascular isquémico, ACVi, sometidos a trombectomía mecánica con stent Solitaire, TMSS. MATERIALES Y MÉTODOS: Estudio descriptivo, retrospectivo, de corte trasversal llevado a cabo entre abril de 2013 y abril de 2016. RESULTADOS: Durante el periodo de tiempo evaluado, se sometieron un total de 10 pacientes a TMSS. La edad media de los pacientes fue 62 años. Todos los pacientes tenían una buena clase funcional previa al ACVi, definida como una escala modificada de Rankin de 0 a 2. Al momento de la consulta, la escala de Rankin modificada fue 4. Los pacientes se sometieron a estrategia reperfusión combinada que consta de trombolisis intravenosa más trombectomía mecánica. Sin embargo, un 40 % de los pacientes tenía contraindicación para trombolisis. La mortalidad fue de 20 %, al igual que el sangrado cerebral que se presentó en 20 % de los pacientes y el Rankin modificado mejoró a lo largo del seguimiento en el 70 % de los pacientes, con un total de 50 % de pacientes que lograron independencia funcional significativa. CONCLUSIÓN: Parece haber impacto importante en la independencia funcional de pacientes sometidos a estrategia combinada de reperfusión cerebral con el uso de stents recuperadores, sin diferencia en la seguridad y mortalidad comparado con la estrategia estándar.

SUMMARY OBJECTIVE: This paper describes the clinical features, treatment indications, mortality and severity of global disability in the follow up outcomes in isquemic cerebrovascular stroke patients submitted to mechanical thrombectomy. MATERIALS AND METHODS: Retrospective, descriptive, cross-sectional study conducted from April 2013 to April 2016. RESULTS: During the study period, ten patients underwent mechanical thrombectomy. Mean age was 62, median modified Rankin Scale Score at acceptance was 4. Initially, all patients had a combined reperfusion approach, unless there were contraindications. Intravenous thrombolysis was contraindicated in 40% of patients. Mortality Trombectomía mecánica en pacientes con ataque cerebrovascular isquémico: serie de casos en un centro de referencia colombiano rate was 20% as well as intraparenchimal hemorrhage. Modified Rankin Scale improved during follow up in 70% of patients. Of these, functional independence was achieved by 50% of patients. CONCLUSION: it seems to be a functional independence impact on patients submitted to mechanical thrombectomy. There is not difference in safety and mortality outcomes.

Seaweeds early development: detrimental effects of desiccation and attenuation by algal extracts.

The effects of desiccation on the early development stages of Mazzaella laminarioides, Scytosiphon lomentaria and Lessonia nigrescens, algal species with different patterns of distribution across the intertidal zone, were examined in the laboratory. In addition, the protective effect against desiccation was evaluated using algal extracts, including those from Porphyra columbina, a macroalga tolerant to desiccation that lives in the uppermost part of the intertidal zone. Our results showed that M. laminarioides displayed the highest resistance to daily desiccation, followed by S. lomentaria, whereas L. nigrescens was the most susceptible. Spores from L. nigrescens exposed to desiccation, although being able to germinate, ceased further post-germination development. In addition, our results showed that all species exposed to extracts from desiccated P. columbina successfully completed their development and strongly suggest the occurrence of compounds with protective properties that help in attenuating the stress caused by desiccation. Finally, our results indicate that the magnitude of the effects generated by desiccation on the early algal development is related to the position of the species in the intertidal zone, and that the protective effects of P. columbina extracts reveal an exceptional metabolism of this species under desiccation stress.