Endovascular therapy for acute stroke is a safe and efficient evolving method: a single-center retrospective analysis.
OBJECTIVE
To determine the clinical outcome in patients undergoing endovascular therapy for acute stroke.


METHODS
During the period 2009-2012, 134 patients with acute stroke and normal computed tomography (CT) findings were treated with endovascular therapy at a single center. Based on CT perfusion and CT angiography findings, all patients had large vessel occlusions. Intravenous thrombolysis was used in eligible patients. The recanalization rate, time to recanalization, periprocedural complications, and clinical outcome at discharge from the hospital (National Institutes of Health score, modified Rankin Scale [mRS]) were analyzed.


RESULTS
The recanalization rate during the study interval increased from 70% (2008-2009) to 94% (2011-2012) (P ≤ .01). The procedure time was reduced from 124 minutes (2009) to 43 minutes (2012) (P ≤ .01), and the periprocedural complication rate decreased from 21% (2009) to 2% (2012) (P ≤ .01). Patients in 2009-2010 had a 2.21 times greater probability for an mRS score ≥ 2 after the procedure compared with patients in 2011-2012 (95% confidence interval, 1.0-5.0). If the procedure lasted 15 minutes longer, the prospect for an mRS score ≥2 after the procedure was 1.30 times greater (P = .02).


CONCLUSIONS
High recanalization rates, low procedural complications, and improved clinical outcomes were achieved using endovascular therapy in selected patients with acute stroke during a 4-year period. Endovascular therapy is an evolving safe and effective treatment for intracranial large vessel occlusion.
Departments of Radiology, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.
Miran
M
Jeromel
Departments of Radiology, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.
Zoran
Z
Miloševicˇ
Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.
Marjan
M
Zaletel
Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.
Bojana
B
Žvan
Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.
Viktor
V
Švigelj
Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.. Electronic address: janja.pretnar@kclj.si.
Janja Pretnar
JP
Oblak
D000046:Academic Medical Centers; D000368:Aged; D002560:Cerebrovascular Circulation; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D055420:Perfusion Imaging / Q000379:methods; D012189:Retrospective Studies; D017524:Slovenia; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D062606:Tertiary Care Centers; D015912:Thrombolytic Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents