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The related main theme: A. Stroke and Cerebral vascular disorders

中國醫藥大學附設安南醫院急性腦中風動脈取栓術一年經驗分享

One year experience of Intra-arterial thrombectomy for acute ischemic stroke in An Nan hospital, China Medical University

Authers:

蔡銘駿, PhD, MD 1, 2, 3 , 張哲肇, MD 3 , 
Ming-Jun  Tsai, PhD, MD 1, 2, 3 , Che-Chao   Chang, MD 3 , 
1 中國醫藥大學附設醫院神經部
2 中國醫藥大學醫學院醫學系
3 中國醫藥大學附設安南醫院
1 Department of Neurology, China Medical University Hospital, Taichung, Taiwan
2 School of medicine, Medical College, China Meidcal Univeristy, Taichung, Taiwan
3 An Nan Hospital, China Medical University
Corresponding Author:

蔡銘駿
Ming-Jun  Tsai , PhD, MD
中國醫藥大學附設醫院神經部
Department of Neurology, China Medical University Hospital, Taichung, Taiwan

keywords: stroke, intra-arterial thrombectomy, TICI, ASPECTS
Abstract for original article

OBJECTIVES /BACKGROUND:
As soon as possible restoration of cerebral blood flow using reperfusion therapy is now the most effective maneuver for salvaging penumbra of ischemic brain tissue. Since 2015, mechanical thrombectomy (IA) has been suggested by AHA/ASA for patients with acute ischemic stroke secondary to a large artery occlusion within 24 hours of last normal time, regardless of whether receiving intravenous alteplase for the same ischemic stroke event. An Nan Hospital, China Medical University has set up 24 hour mechanical thrombectomy for acute ischemic stroke since 2019.10. Here, we analysis one year data of all patients receiving mechanical thrombectomy.

MATERIAL and METHOD:
All patients receiving mechanical thrombectomy were included in An Nan Hospital, China Medical University. Stroke pattern, initial NIHSS, ASPECTS before IA, perfusion scan (CBV/Tmax), onset to needle time, TICI and significant side effect (e.g: symptomatic hemorrhage) were evaluated.

RESULT:
Total 21 patients receiving mechanical thrombectomy since 2019.10 to 2020.9 and two patient received rTPA before IA. The average age is 74.7 y/o (range from 48 y/o to 96 y/o). 24% (5/21) is ICA occlusion, 71% (15/21) is MCA infarct and 5% (1/21) is BA occlusion. Average initial NIHSS is 22 (range from 8 to 32). Median ASPECTS before IA is 2 (range from 0 to 10). Presented significant penumbras in infracted area shown as CBV/Tmax mismatch are 72% (13/18), and three patients don’t receive perfusion CT. Mean onset to needle time is 383 minutes (range from 211 to 784 minutes). Re-canalization rate (TICI=2b or 3) is 76% (16/21). Symptomatic hemorrhage is 14% (3/21).

DISCUSSION:
24 hour endovascular treatment for acute ischemic stroke has been established for one year in An Nan Hospital, China Medical University. In a local hospital, we got re-canalization rate up to 76% and mean onset to needle time is 383 minutes.


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