title: Patient eligibility for thrombectomy after acute stroke: Northern French Alps database analysis.
abstract: BACKGROUND
  Since 2015, the emergence of mechanical thrombectomy as standard care in acute stroke has involved organizational changes not only for stroke centers, but also for entire emergency regional networks. The aim of our study was to assess the proportion of ischemic stroke patients, admitted to stroke units in the Northern French Alps within the first 6h of onset, eligible for thrombectomy.
  
  
  METHODS
  This study retrospectively analyzed the clinical and radiological data of all acute stroke patients hospitalized at three stroke units of the Northern French Alps Emergency Network (RENAU) in 2014. Eligible patients had proximal arterial occlusions of the anterior and posterior cerebral circulation, as confirmed by brain imaging, which could be treated by thrombectomy within 6h of symptom onset.
  
  
  RESULTS
  Of the 435 cases of acute ischemic stroke, 152 patients were treated by intravenous thrombolysis (IV rtPA). Of these patients, 83 (55%) had intracranial occlusions and were eligible for combined thrombectomy. Of the 283 patients not treatable by IV rtPA, 32 patients (11%) were eligible for primary thrombectomy.
  
  
  CONCLUSIONS
  Thrombectomy could be performed in 26% of our acute ischemic stroke patients (n=115/435), and a large increase in endovascular procedures is expected over the next few years that will require close collaboration among all partners in the emergency networks. Using our RENAU stroke database, it will be possible to compare various factors contributing to effective activity.
authors.affiliation: Department of neurology, stroke unit, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France. Electronic address: JPapassin@chu-grenoble.fr.
authors.forename: J
authors.initials: J
authors.lastname: Papassin
authors.affiliation: Department of neurology, stroke unit, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: I M
authors.initials: IM
authors.lastname: Favre-Wiki
authors.affiliation: Department of neurology, stroke unit, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: T
authors.initials: T
authors.lastname: Atroun
authors.affiliation: Department of radiology, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: F
authors.initials: F
authors.lastname: Tahon
authors.affiliation: Department of radiology, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: K
authors.initials: K
authors.lastname: Boubagra
authors.affiliation: Department of neurology, Stroke Unit, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: G
authors.initials: G
authors.lastname: Rodier
authors.affiliation: Department of radiology, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: F
authors.initials: F
authors.lastname: Bing
authors.affiliation: Department of neurology, stroke unit, centre hospitalier Métropole Savoie, 73000 Chambéry, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: S
authors.initials: S
authors.lastname: Marcel
authors.affiliation: RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: C
authors.initials: C
authors.lastname: Vallot
authors.affiliation: RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
authors.forename: L
authors.initials: L
authors.lastname: Belle
authors.affiliation: Department of neurology, stroke unit, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France; Université Grenoble-Alpes, 38400 Saint-Martin-d'Hères, France.
authors.forename: M
authors.initials: M
authors.lastname: Hommel
authors.affiliation: Department of neurology, stroke unit, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France; Université Grenoble-Alpes, 38400 Saint-Martin-d'Hères, France.
authors.forename: O
authors.initials: O
authors.lastname: Detante
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy; D002560:Cerebrovascular Circulation; D016208:Databases, Factual; D004608:Eligibility Determination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005602:France / Q000453:epidemiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D017131:Thrombectomy / Q000706:statistics & numerical data*; D015912:Thrombolytic Therapy; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Endovascular recanalization; Epidemiology; Stroke; Stroke registry; Thrombectomy; Thrombolysis