title: Mechanical thrombectomy for ischaemic stroke: the first UK case series.
abstract: OBJECTIVE
  Endovascular treatments have the potential to accelerate reperfusion in acute ischaemic stroke with large vessel occlusion. In the UK only a few stroke centres offer this interventional option. The University Hospital of North Staffordshire (UHNS) has treated the largest number of cases in the UK. Results of the first 106 endovascular treatments (EVT) are presented here.
  
  
  METHODS
  All patients treated with EVT (intra-arterial thrombolysis (IAT), mechanical thrombectomy (MT) or both, or an attempt at intervention) for acute stroke at UHNS, Stoke-on-Trent, UK, were entered into a prospective register. Baseline demographic and clinical data, the National Institutes for Health Stroke Scale (NIHSS), imaging results including Thrombolysis in Cerebral Infarction (TICI) score, and complications were recorded. Mortality, and modified Rankin score (mRS) were assessed at 90 days.
  
  
  RESULTS
  From December 2009 to January 2013 106 patients (mean age 64 years, median baseline NIHSS 18) were treated with EVT (thrombectomy ± IAT 83%, IAT alone 13%, neither 4%). Seventy-eight per cent of occlusions were in the anterior circulation. Intravenous bridging thrombolysis was performed in 81%. Revascularization was successful (TICI 2b/3) in 84%. The median time from stroke onset to the end of the procedure was 6 h 03 min. A good outcome (mRS ≤ 2) at 90 days was achieved in 48% with a mortality of 15%. Fatal or nonfatal symptomatic intracranial haemorrhage (sICH) within 10 days occurred in 9%. The median length of stay was 14 days (31% discharged home ≤ 7 days).
  
  
  CONCLUSIONS
  EVT led to good clinical outcomes in almost 50% of patients with severe strokes.
authors.affiliation: University Hospital of North Staffordshire, Stoke-on-Trent, United Kingdom.
authors.forename: Nasar
authors.initials: N
authors.lastname: Ahmad
authors.affiliation: Department of Interventional Neuroradiology, University Hospital of North Staffordshire, Stoke-on-Trent, United Kingdom.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Nayak
authors.affiliation: Department of Interventional Neuroradiology, University Hospital of North Staffordshire, Stoke-on-Trent, United Kingdom.
authors.forename: Changez
authors.initials: C
authors.lastname: Jadun
authors.affiliation: University Hospital of North Staffordshire, Stoke-on-Trent, United Kingdom.
authors.forename: Indira
authors.initials: I
authors.lastname: Natarajan
authors.affiliation: School of Medicine, Keele University, Keele, United Kingdom.
authors.forename: Palbha
authors.initials: P
authors.lastname: Jain
authors.affiliation: Institute for Science and Technology in Medicine, Keele University, Keele, United Kingdom ; North Staffordshire Combined Healthcare Trust, Stoke-on-Trent, United Kingdom.
authors.forename: Christine
authors.initials: C
authors.lastname: Roffe
mesh_terms: D000368:Aged; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects* / Q000401:mortality; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome; D006113:United Kingdom