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Endovascular recanalization therapy in acute ischemic stroke
Jae H Choi1, Brian T Bateman, Sundeep Mangla
1Stroke Center, The Neurological Institute, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY 10032, USA. jchoi@neuro.columbia.edu
Stroke
|December 24, 2005
Summary
Endovascular recanalization therapy (ERT) is a safe and effective alternative for acute ischemic stroke patients ineligible for thrombolysis. Nationwide data show increasing ERT use, with reasonable outcomes despite varied patient profiles.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Stroke Medicine
Background:
- Acute ischemic stroke patients often miss the window for systemic thrombolysis.
- Endovascular recanalization therapy (ERT) offers an alternative for these patients.
Purpose of the Study:
- To evaluate ERT outcomes in acute ischemic stroke patients ineligible for systemic thrombolysis.
- To determine the nationwide usage and outcomes of ERT in acute ischemic stroke.
Main Methods:
- Retrospective analysis of 31 patients treated with ERT at CUMC (2001-2004).
- Analysis of Nationwide Inpatient Sample (NIS) data (1999-2002) for US nationwide ERT usage.
Main Results:
- CUMC cohort: 32% good outcomes (mRS 0-2), 29% mortality, 19% fatal intracerebral hemorrhage.
- NIS cohort: 15% mortality, ~50% discharged home/rehab, 6% intracerebral hemorrhage.
- ERT was often initiated beyond 3 hours, with patients on anticoagulants or post-surgery.
Conclusions:
- ERT is a relatively safe and effective treatment for acute ischemic stroke patients ineligible for IV thrombolysis.
- Nationwide use of ERT for stroke is increasing, demonstrating its growing importance.