title: Mechanical Thrombectomy in Acute Ischemic Stroke: Initial Single-Center Experience and Comparison with Randomized Controlled Trials.
abstract: BACKGROUND
  Until recently, intravenous thrombolysis was the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. However, this treatment option has low recanalization rates in large-vessel occlusions. The search for additional treatments continued until 5 randomized trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) revealed the superiority of mechanical thrombectomy for anterior circulation large-vessel occlusion. After 1 year of performing thrombectomy with stent retrievers in our tertiary hospital, we intended to answer the question: is it possible to achieve similar results in a "real-world" setting?
  
  
  METHODS
  We analyzed data from our prospective observational registry, compared it with the trials aforementioned, and concluded that the answer is affirmative.
  
  
  RESULTS
  Our study population of 77 patients, with a mean age of 68,2 years and 48,1% men, is comparable with these trials in much of selection criteria, baseline characteristics, and rate of previous intravenous thrombolysis (72,7%). Recovery of functional independence at 90 days was achieved in almost two thirds of patients, similarly to the referred trials. We devoted special emphasis on fast recanalization, keeping a simple image selection protocol (based on non-enhanced and computed tomography angiography) and not waiting for clinical response to thrombolysis in patients eligible for mechanical thrombectomy. We emphasize a successful recanalization rate of 87% and only 2,6% symptomatic intracranial hemorrhage.
  
  
  CONCLUSIONS
  In summary, mechanical thrombectomy seems to be a safe and effective treatment option in a "real-world" scenario, with results similar to those of the recent randomized controlled trials.
authors.affiliation: Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Stroke Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Andreia
authors.initials: A
authors.lastname: Carvalho
authors.affiliation: Imagiology Department, Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: André
authors.initials: A
authors.lastname: Cunha
authors.affiliation: Imagiology Department, Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Rodrigues
authors.affiliation: Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Stroke Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Figueiredo
authors.affiliation: Stroke Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Ludovina
authors.initials: L
authors.lastname: Paredes
authors.affiliation: Stroke Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Gregório
authors.affiliation: Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Hugo
authors.initials: H
authors.lastname: Morais
authors.affiliation: Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Pinheiro
authors.affiliation: Neurology Department, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal.
authors.forename: Vítor Tedim
authors.initials: VT
authors.lastname: Cruz
authors.affiliation: Neurology Department, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal.
authors.forename: José Mário
authors.initials: JM
authors.lastname: Roriz
authors.affiliation: Neurology Department, Hospital Escala Braga, Braga, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Pinho
authors.affiliation: Neurology Department, Hospital Escala Braga, Braga, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Ferreira
authors.affiliation: Stroke Unit, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal.
authors.forename: Edgar
authors.initials: E
authors.lastname: Torre
authors.affiliation: Imagiology Department, Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Nunes
authors.affiliation: Imagiology Department, Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Castro
authors.affiliation: Imagiology Department, Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ribeiro
authors.affiliation: Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Stroke Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Veloso
authors.affiliation: Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Stroke Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal. Electronic address: pedrojgbarros@gmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Barros
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D020300:Intracranial Hemorrhages / Q000209:etiology; D008279:Magnetic Resonance Imaging; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D017131:Thrombectomy / Q000379:methods; D016896:Treatment Outcome; D016032:Randomized Controlled Trials as Topic
chemical_list: D005343:Fibrinolytic Agents
keywords: Acute ischemic stroke; endovascular treatment; mechanical thrombectomy; stent retrievers