Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
International Clinical Research Centre, Stroke Research Program, St Anne's University Hospital, Brno, Czech Republic.
J Neurointerv Surg. 2018 Aug;10(8):741-745. doi: 10.1136/neurintsurg-2017-013534. Epub 2017 Nov 16.
Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis.
Available nationwide data for the CR from 2016 from the Safe Implementation of Treatments in Stroke-Thrombectomy (SITS-TBY) registry for patients with terminal internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusions were compared with data from HERMES. CR and HERMES patients were comparable in age, sex, and baseline National Institutes of Health Stroke Scale scores.
From a total of 1053 MTs performed in the CR, 845 (80%) were reported in the SITS-TBY. From these, 604 (72%) were included in this study. Occlusion locations were as follows (CR vs HERMES): ICA 22% versus 21% (P=0.16), M1 MCA 62% versus 69% (P=0.004), and M2 MCA 16% versus 8% (P<0.0001). Intravenous thrombolysis was given to 76% versus 83% of patients, respectively (P=0.003). Median onset to reperfusion times were comparable: 232 versus 285 min, respectively (P=0.66). A modified Thrombolysis in Cerebral Infarction score of 2b/3 was achieved in 74% (433/584) versus 71% (390/549) of patients, respectively (OR 1.17, 95% CI 0.90-1.5, P=0.24). There was no statistically significant difference in the percentage of parenchymalhematoma type 2 (OR 1.12, 95% CI 0.66-1.90, P=0.68). A modified Rankin Scale score of 0-2 at 3 months was achieved in 48% (184/268) versus 46% (291/633) of patients, respectively (OR 0.92, 95% CI 0.71-1.18, P=0.48).
Data on efficacy, safety, and logistics of MT from the CR were similar to data from the HERMES collaboration.
随机临床试验已经证明机械取栓（MT）在急性中风中是一种非常有效和安全的治疗方法。本研究的目的是比较捷克共和国（CR）的神经血栓切除术数据与 HERMES 荟萃分析的数据。
对 2016 年来自捷克共和国的全国范围内的安全实施卒中溶栓治疗（SITS-TBY）登记处接受终末颈内动脉（ICA）和/或大脑中动脉（MCA）闭塞治疗的患者数据与 HERMES 数据进行比较。CR 和 HERMES 患者在年龄、性别和基线国立卫生研究院中风量表评分方面具有可比性。
在 CR 进行的总共 1053 例 MT 中，845 例（80%）在 SITS-TBY 中报告。其中，604 例（72%）被纳入本研究。闭塞部位如下（CR 与 HERMES）：ICA 22%比 21%（P=0.16），M1 MCA 62%比 69%（P=0.004），M2 MCA 16%比 8%（P<0.0001）。分别给予 76%和 83%的患者静脉溶栓治疗（P=0.003）。中位数发病至再灌注时间相当：分别为 232 分钟和 285 分钟（P=0.66）。改良的脑梗死溶栓评分达到 2b/3 的患者分别为 74%（433/584）和 71%（390/549）（OR 1.17，95%CI 0.90-1.5，P=0.24）。实质血肿类型 2 的比例无统计学差异（OR 1.12，95%CI 0.66-1.90，P=0.68）。3 个月时改良 Rankin 量表评分为 0-2 的患者分别为 48%（184/268）和 46%（291/633）（OR 0.92，95%CI 0.71-1.18，P=0.48）。
来自 CR 的 MT 的疗效、安全性和后勤数据与 HERMES 协作的数据相似。
