Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen.
Department of Neurology, Aarhus University Hospital, Aarhus.
Eur J Neurol. 2019 Aug;26(8):1044-1050. doi: 10.1111/ene.13931. Epub 2019 Mar 19.
Acute endovascular reperfusion treatment (aERT) of stroke patients with large-vessel occlusions is efficacious and safe according to several clinical trials. Data on outcome and safety of aERT in daily clinical routine are warranted and, in this study, we present national data from Denmark during 2011-2017.
National data for Denmark from 2011 to 2017 on all aERT procedures in patients with acute ischaemic stroke and computed tomography angiography/magnetic resonance angiography-verified large-vessel occlusion were derived from the Danish Stroke Registry, a national clinical quality registry to which reporting is mandatory for all hospitals treating stroke patients. Outcome (modified Rankin Scale score) after 3 months, including time of death, was assessed prospectively based on clinical examination or the Danish Civil Registration System.
During the 7 years of observation, a total of 1720 patients were treated with aERT. The annual number of procedures increased from 128 in 2011 to 409 in 2017. The median age was 70 years, 58% were males and median National Institutes of Health Stroke Scale score at baseline was 16. Median time from symptom onset to groin puncture was 238 min with a decreasing trend during the years. Successful recanalization was reported in 1306 (76%) patients. At 3-month follow-up, an modified Rankin Scale score of 0-2 was reported in 46% of patients, whereas 14% of patients had died.
Routine data on aERT in acute ischaemic stroke in Denmark from 2011 to 2017 suggest that the procedure is safe and efficacious.
根据几项临床试验,急性血管内再灌注治疗(aERT)对大血管闭塞的脑卒中患者是有效且安全的。需要有关于日常临床实践中 aERT 的结果和安全性的数据,本研究报告了丹麦 2011 年至 2017 年期间的全国数据。
从丹麦国家卒中登记处获取了丹麦 2011 年至 2017 年期间所有急性缺血性脑卒中且计算机断层血管造影/磁共振血管造影证实的大血管闭塞的接受 aERT 治疗的患者的全国数据。该登记处是一个国家临床质量登记处,所有治疗卒中患者的医院都有义务进行报告。根据临床检查或丹麦民事登记系统,前瞻性地评估 3 个月后的结局(改良 Rankin 量表评分),包括死亡时间。
在 7 年的观察期间,共有 1720 名患者接受了 aERT 治疗。每年的治疗例数从 2011 年的 128 例增加到 2017 年的 409 例。中位年龄为 70 岁,58%为男性,基线时的美国国立卫生研究院卒中量表评分中位数为 16 分。从发病到腹股沟穿刺的中位数时间为 238 分钟,呈逐年下降趋势。1306 名(76%)患者报告了成功再通。在 3 个月的随访中,46%的患者报告改良 Rankin 量表评分为 0-2,14%的患者死亡。
2011 年至 2017 年丹麦急性缺血性卒中 aERT 的常规数据表明,该治疗方法是安全有效的。