Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno

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. Materi...

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Autores principales:	Reyes S.,Pablo, Badilla O.,Lautaro, Andreu,Daniel, Besa,Valentina, Rivera,Rodrigo, Sordo,Gabriel, Bustamante,Gonzalo, Pasten,Juan A., Vargas,Gabriel, Silva,Paula, Guerrero,Rodrigo, Feuerhake,Walter
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Reperfusion Stroke Thrombolytic Therapy
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000600708
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spelling	oai:scielo:S0034-988720180006007082018-08-24Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chilenoReyes S.,PabloBadilla O.,LautaroAndreu,DanielBesa,ValentinaRivera,RodrigoSordo,GabrielBustamante,GonzaloPasten,Juan A.Vargas,GabrielSilva,PaulaGuerrero,RodrigoFeuerhake,Walter Reperfusion Stroke Thrombolytic Therapy 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 and Methods: 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.6 20182018-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000600708es10.4067/s0034-98872018000600708
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Reperfusion Stroke Thrombolytic Therapy
spellingShingle	Reperfusion Stroke Thrombolytic Therapy Reyes S.,Pablo Badilla O.,Lautaro Andreu,Daniel Besa,Valentina Rivera,Rodrigo Sordo,Gabriel Bustamante,Gonzalo Pasten,Juan A. Vargas,Gabriel Silva,Paula Guerrero,Rodrigo Feuerhake,Walter Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
description	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 and Methods: 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.
author	Reyes S.,Pablo Badilla O.,Lautaro Andreu,Daniel Besa,Valentina Rivera,Rodrigo Sordo,Gabriel Bustamante,Gonzalo Pasten,Juan A. Vargas,Gabriel Silva,Paula Guerrero,Rodrigo Feuerhake,Walter
author_facet	Reyes S.,Pablo Badilla O.,Lautaro Andreu,Daniel Besa,Valentina Rivera,Rodrigo Sordo,Gabriel Bustamante,Gonzalo Pasten,Juan A. Vargas,Gabriel Silva,Paula Guerrero,Rodrigo Feuerhake,Walter
author_sort	Reyes S.,Pablo
title	Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
title_short	Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
title_full	Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
title_fullStr	Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
title_full_unstemmed	Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
title_sort	experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000600708
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Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno

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