Direct catheter-based thrombectomy in acute ischaemic stroke performed collaboratively by cardiologists, neurologists and radiologists: the single-centre pilot experience (PRAGUE-16 study).
OBJECTIVE
To assess the feasibility of direct catheter-based thrombectomy (d-CBT) performed jointly by cardiologists, neurologists and radiologists.


RESULTS
Computed tomography (CT) was completed within <6 hours from onset of acute ischaemic stroke and excluded bleeding or developed ischaemia in 23 patients who fulfilled pre-specified entry criteria. The mean NIHSS was 17 (8-24). Mechanical recanalisation was successful in 19/23 patients (83%). The mean symptom onset – CT time was 81 min, CT – sheath insertion 47 min, sheath – reperfusion 46 min. Three patients died within 30 days, two others within 90 days (overall three-month mortality 22%). The mean mRs at 90 days for the entire group was 3.19, among survivors 2.31 and among survivors treated within <120 minutes 1.17. Favourable functional outcome (mRs ≤2) was achieved in 48% of patients. Five patients (22%) had full (mRs=0) or nearly full (mRs=1) neurologic recovery. Seven patients were able to be discharged from neurology ICU directly home after a short (<7 days) hospital stay. Two patients had symptomatic intracranial haemorrhage.


CONCLUSIONS
Acute stroke treatment by d-CBT jointly by neurologists, cardiologists and radiologists provided promising results especially in patients reaching the cathlab within <2 hours from stroke onset.
Department of Cardiology, University Hospital Kralovske Vinohrady and the Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Petr
P
Widimsky
Boris
B
Koznar
Tomas
T
Peisker
Peter
P
Vasko
Jana
J
Vavrova
Ivana
I
Stetkarova
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D002545:Brain Ischemia / Q000601:surgery*; D006328:Cardiac Catheterization; D057785:Catheters; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015641:Radiography, Interventional; D015607:Stents; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed