title: Treatment Result in the Initial Stage of Kanazawa Mobile Embolectomy Team for Acute Ischemic Stroke.
abstract: Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy. In this article, we report early treatment outcomes and validate the effectiveness of a network between affiliated hospitals and KMET. Between January 2014 and December 2015, 48 patients, aged 45-92 years (mean: 73.0 years), underwent acute reperfusion therapy provided by KMET in 10 affiliated hospitals of Kanazawa University Hospital. The pre-treatment NIHSS scores ranged from 5 to 39 (mean: 19.1). ASPECTS+W ranged from 1 to 11 (mean: 7.3). Successful revascularization, defined as thrombolysis in cerebral infarction (TICI) 2b or 3, was achieved in 38/48 cases (80%), and a good outcome, defined as modified Rankin Scale (mRS) score from 0 to 2 at 90 days after the treatment, was achieved in 24/48 cases (50%). There were two cases of intracranial bleeding (4%). Mean time from onset to recanalization was 297 min. These results, which are similar to those of five previous RCTs, suggest that a collaborative network between affiliated hospitals and KMET is effective for acute reperfusion therapy in local areas wherein experienced neuroendovascular specialists are insufficient.
authors.affiliation: Department of Neurosurgery, Kanazawa University Hospital.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uchiyama
authors.forename: Kouichi
authors.initials: K
authors.lastname: Misaki
authors.forename: Masanao
authors.initials: M
authors.lastname: Mohri
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kamide
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hirota
authors.forename: Ryo
authors.initials: R
authors.lastname: Higashi
authors.forename: Hisato
authors.initials: H
authors.lastname: Minamide
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kohda
authors.forename: Takashi
authors.initials: T
authors.lastname: Asahi
authors.forename: Katsuo
authors.initials: K
authors.lastname: Shoin
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iwato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kita
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Hamada
authors.forename: Yuya
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Nakada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017128:Embolectomy; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome