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Extended Time Window Mechanical Thrombectomy for Acute Stroke in Brazil.
Beckhauser, Mayara Thays; Castro-Afonso, Luis Henrique; Dias, Francisco Antunes; Nakiri, Guilherme Seizem; Monsignore, Lucas Moretti; Martins Filho, Rui Kleber; Camilo, Millene Rodrigues; Aléssio Alves, Frederico Fernandes; Libardi, Milena; Rodrigues, Guilherme Riccioppo; Pontes-Neto, Octavio Marques; Abud, Daniel Giansante.
Afiliación
  • Beckhauser MT; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: mayara.beck@hotmail.com.
  • Castro-Afonso LH; Interventional Neuroradiology Division, Department of Radiology, Hematology and Oncology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: ikeafonso@yahoo.com.br.
  • Dias FA; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: chicodias.neuro@gmail.com.
  • Nakiri GS; Interventional Neuroradiology Division, Department of Radiology, Hematology and Oncology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: gsnakiri@yahoo.com.br.
  • Monsignore LM; Interventional Neuroradiology Division, Department of Radiology, Hematology and Oncology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: lucasmonsignore@gmail.com.
  • Martins Filho RK; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: ruikleber@gmail.com.
  • Camilo MR; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: millene_camilo@yahoo.com.br.
  • Aléssio Alves FF; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: f.f.a.alves@gmail.com.
  • Libardi M; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: milenalibardi@gmail.com.
  • Rodrigues GR; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: ggrr.md@gmail.com.
  • Pontes-Neto OM; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: opontesneto@fmrp.usp.br.
  • Abud DG; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: dgabud@gmail.com.
J Stroke Cerebrovasc Dis ; 29(10): 105134, 2020 Oct.
Article en En | MEDLINE | ID: mdl-32912530
BACKGROUND: Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) caused by large vessel occlusion of the anterior circulation within 6 hours of symptoms onset and can be performed with an extended window up to 24 hours in selected patients. Nevertheless, the outcomes of MT with extended window are unknown in developing countries. OBJECTIVE: Explore the safety and efficacy of MT for AIS performed beyond 6 hours from symptoms onset in Brazil. METHODS: We reviewed data from AIS patients treated with MT beyond 6 hours of stroke onset, from 2015 to 2018 in a Brazilian public hospital. Patients had an occlusion of the intracranial internal carotid artery and/or proximal segment of the middle cerebral artery. CT Perfusion mismatch was evaluated using the RAPID® software. We evaluated the modified Rankin scale (mRS) and mortality at 90 days, and rate of symptomatic intracranial hemorrhage (sICH). RESULTS: Fifty-four patients were included, with a mean age of 65.6 ± 16.1 years, 55.6% were male, and the median NIHSS score at presentation was 17. Successful recanalization (TICI 2b to 3) was obtained in 92.6% of patients and sICH rate was 11.1%. Overall, 34% of the patients had a good outcome (mRS ≤2) at 90 days and the mortality rate was 20.3%. CONCLUSION: Our study, the first series of MT for AIS treated with extended window reported in Latin America, shows that MT can be performed with safety and lead to adequate functional outcomes in this context. Further studies should explore the barriers to broad implementation of MT for AIS in Latin America.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteria Carótida Interna / Circulación Cerebrovascular / Estenosis Carotídea / Trombectomía / Arteria Cerebral Media / Infarto de la Arteria Cerebral Media / Tiempo de Tratamiento Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteria Carótida Interna / Circulación Cerebrovascular / Estenosis Carotídea / Trombectomía / Arteria Cerebral Media / Infarto de la Arteria Cerebral Media / Tiempo de Tratamiento Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos