Outcomes of Endovascular Mechanical Thrombectomy and Intravenous Tissue Plasminogen Activator for the Treatment of Vertebrobasilar Stroke
Journal of Clinical Neurology
; : 17-23, 2014.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-117829
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND AND PURPOSE:
Aggressive treatment of posterior-circulation occlusions is important due to the high rates of morbidity and mortality associated with these infarctions. A large administrative database was evaluated to determine the outcomes of mechanical thrombectomy and intravenous tissue plasminogen activator (IV-tPA) for the treatment of posterior-circulation (vertebrobasilar) strokes. Outcomes were compared across age groups.METHODS:
The United States Nationwide Inpatient Sample was used to evaluate the outcomes of patients treated for posterior-circulation acute ischemic stroke between 2006 and 2010. Patients who underwent endovascular mechanical thrombectomy and IV-tPA were selected. Primary outcomes were discharge status and mortality; secondary outcomes were length of stay, rate of intracranial hemorrhage, tracheostomy, and percutaneous endoscopic gastrostomy/jejunostomy tube placement. Outcomes were grouped according to age (i.e., or =65 years). Chi-squared test and Student's t-test were used for comparisons of categorical and continuous variables, respectively.RESULTS:
During 2006-2010 there were 36,675 patients who had discharge International Classification of Diseases (9th edition) codes indicating posterior-circulation strokes. Of these, 631 (1.7%) underwent mechanical thrombectomy and 1554 (4.2%) underwent IV-tPA. The in-hospital mortality rate for mechanical thrombectomy patients was significantly lower for those aged or =65 years (30.4% versus 43.0%, p or =65 years (p=0.92).CONCLUSIONS:
Patients requiring IV-tPA and/or mechanical thrombectomy for the treatment of posterior-circulation strokes suffer from high mortality rates. Increased age is associated with significantly higher mortality rates among posterior-circulation stroke patients who require mechanical thrombectomy.
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
/
Doença Cerebrovascular
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Estados Unidos
/
Traqueostomia
/
Classificação Internacional de Doenças
/
Incidência
/
Mortalidade
/
Mortalidade Hospitalar
/
Ativador de Plasminogênio Tecidual
/
Trombectomia
/
Acidente Vascular Cerebral
/
Infarto Encefálico
Tipo de estudo:
Estudo de incidência
/
Estudo prognóstico
Limite:
Humanos
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
Journal of Clinical Neurology
Ano de publicação:
2014
Tipo de documento:
Artigo