Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, Poland.
Department of Neurology and Stroke, Pomeranian Hospitals, 84-200 Wejherowo, Poland.
Int J Environ Res Public Health. 2023 Jan 26;20(3):2232. doi: 10.3390/ijerph20032232.
The optimal structure of the acute ischaemic stroke treatment network is unknown and eagerly sought. To make it most effective, different treatment and transportation strategies have been developed and investigated worldwide. Since only a fraction of acute stroke patients with large vessel occlusion are treated, a new entity-thrombectomy-capable stroke centre (TCSC)-was introduced to respond to the growing demand for timely endovascular treatment. The purpose of this study was to present the early experience of the first 70 patients treated by mechanical means in a newly developed cardiac Cathlab-based TCSC. The essential safety and efficacy measures were recorded and compared with those reported in the invasive arm of the HERMES meta-analysis-the largest published dataset on the subject. We found no significant differences in terms of clinical and safety outcomes, such as early neurological recovery, level of functional independence at 90 days, symptomatic intracranial haemorrhage, parenchymal haematoma type 2, and mortality. These encouraging results obtained in the small endovascular centre may be an argument for the introduction of the TCSC into operating stroke networks to increase patient access to timely treatment and to improve clinical outcomes.
急性缺血性脑卒中治疗网络的最佳结构尚不清楚，目前正在积极研究。为了使其最有效，全球范围内已经开发和研究了不同的治疗和转运策略。由于只有一部分大血管闭塞的急性脑卒中患者接受了治疗，因此引入了一个新的实体——血栓切除术能力卒中中心（TCSC），以满足对及时血管内治疗日益增长的需求。本研究旨在介绍在新建立的心导管室 TCSC 中对前 70 名接受机械治疗的患者的早期经验。记录了基本的安全性和疗效措施，并与 HERMES 荟萃分析侵袭性治疗组（最大的主题数据集）报告的数据进行了比较。在早期神经恢复、90 天功能性独立程度、症状性颅内出血、实质血肿 2 型和死亡率等临床和安全性结果方面，我们没有发现显著差异。在这个小型血管内中心获得的令人鼓舞的结果可能是将 TCSC 引入运行中的卒中网络的一个论据，以增加患者获得及时治疗的机会，并改善临床结果。
