RESUMO
OBJECTIVES: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b-TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0-2 - in 31.4% and mRS of 6 in 22% of cases. CONCLUSION: Our results can help harmonize standards for MT in Poland according to international guidelines.
Assuntos
Acidente Vascular Cerebral/cirurgia , Trombectomia/métodos , Humanos , Polônia , Estudos RetrospectivosRESUMO
Since the last decade, the use of external pacing systems became very popular and this means more frequent need for lead extraction or exchange. The extraction of "old", indwelling pacemaker or defibrillator leads is a standard procedure, done in many electrophysiology labs using many modern techniques. However, when a lead is torn off, and stays intravenous --its extraction is difficult. First, it must be caught endovascular, withdrawn out of a body and then extracted. Below, we present the case of successful extraction of torn off lead in a 25-year-old male by means of interventional radiology endovascular techniques.
