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Patient eligibility for thrombectomy after acute stroke: Northern French Alps database analysis.
J Papassin1, I M Favre-Wiki1, T Atroun1
1Department of neurology, stroke unit, CHU Grenoble-Alpes, 38043 Grenoble, France; RENAU network, centre hospitalier d'Annecy-Genevois, 74370 Epagny Metz-Tessy, France.
Revue Neurologique
|April 6, 2017
Summary
Mechanical thrombectomy for acute ischemic stroke is increasingly standard care. In the Northern French Alps, 26% of eligible patients could undergo thrombectomy, highlighting the need for enhanced emergency network collaboration.
Area of Science:
- Neurology
- Emergency Medicine
- Vascular Surgery
Background:
- Mechanical thrombectomy has become standard care for acute stroke since 2015.
- This has necessitated significant organizational changes in stroke centers and emergency networks.
- Assessing patient eligibility for thrombectomy is crucial for network planning.
Purpose of the Study:
- To determine the proportion of acute ischemic stroke patients eligible for mechanical thrombectomy.
- To evaluate eligibility within the first 6 hours of symptom onset in a specific regional network.
- To inform future healthcare planning and resource allocation.
Main Methods:
- Retrospective analysis of clinical and radiological data from stroke units in the Northern French Alps Emergency Network (RENAU).
- Inclusion criteria: acute stroke patients hospitalized in 2014 with proximal arterial occlusions (anterior/posterior circulation) confirmed by imaging.
- Eligibility defined as suitability for thrombectomy within 6 hours of symptom onset.
Main Results:
- Out of 435 acute ischemic stroke cases, 152 received intravenous thrombolysis (IV rtPA).
- Of those receiving IV rtPA, 83 patients (55%) had intracranial occlusions and were eligible for combined thrombectomy.
- Additionally, 32 patients (11%) not eligible for IV rtPA were suitable for primary thrombectomy.
Conclusions:
- Mechanical thrombectomy was feasible in 26% (115/435) of analyzed acute ischemic stroke patients.
- A significant increase in endovascular procedures is anticipated, requiring robust inter-network collaboration.
- The RENAU stroke database can facilitate comparative analysis of factors influencing thrombectomy activity.