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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

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The effectiveness of systemic and endovascular intra-arterial thrombectomy protocol for decreasing

Su Chel Kim1, Chang-Young Lee1, Chang-Hyun Kim1

  • 1Department of Neurosurgery, Keimyung University, Dong-San Medical Center, Daegu, Korea.

Journal of Cerebrovascular and Endovascular Neurosurgery
|October 26, 2021
PubMed

Insights

Implementing intra-arterial thrombectomy (IAT) protocols significantly reduces door-to-recanalization time in acute stroke patients. This optimized approach improves successful recanalization rates and clinical outcomes for large vessel occlusion (LVO) stroke management.

Area of Science:

  • Neurology
  • Interventional Radiology
  • Emergency Medicine

Background:

  • Acute stroke management requires rapid intervention to minimize brain damage.
  • Variable treatment strategies exist, but optimizing time-dependent protocols is crucial for improving outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of a systemic and endovascular intra-arterial thrombectomy (IAT) protocol.
  • To assess the protocol's impact on reducing door-to-recanalization time and improving recanalization success rates in acute stroke patients.

Main Methods:

  • Retrospective analysis of 267 acute stroke patients with anterior circulation large vessel occlusion (LVO).
  • Comparison of pre-IAT protocol (Sep 2012-Apr 2014) and post-IAT protocol (May 2014-Jul 2018) groups.
  • Statistical analysis included univariate analysis and independent t-tests to compare time durations and outcomes.

Main Results:

  • The post-IAT protocol group showed significantly faster door-to-image, image-to-puncture, and puncture-to-recanalization times compared to the pre-IAT group.
  • Successful recanalization rates improved from 78.0% in the pre-IAT group to 85.3% in the post-IAT group (p<0.05).
  • While not statistically significant, the post-IAT group demonstrated a higher tendency for good clinical outcomes (48.8% vs. 36.0%).

Conclusions:

  • Systemic and endovascular IAT protocols significantly reduce time to recanalization in acute stroke patients with LVO.
  • Well-designed IAT protocols, particularly optimizing puncture-to-recanalization time, are essential for improving clinical outcomes in recanalization therapy.
Abstract

Keywords:
Acute strokeAnterior circulationIntra-arterial mechanical thrombectomyProtocol

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