Mizowaki Takashi, Nakahara Masahiro, Fujita Atsushi, Sakagami Yoshio, Kohmura Eiji
Department of Neurosurgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo, Japan.
Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
J Neuroendovasc Ther. 2020;14(4):126-132. doi: 10.5797/jnet.oa.2019-0087. Epub 2020 Feb 28.
We retrospectively analyzed the current status of treatment for anterior circulation large vessel occlusion (LVO) in island areas with a high population aging rate.
We investigated 62 consecutive patients with ischemic stroke due to acute anterior circulation LVO between October 1, 2017 and June 30, 2019.
In all, 26 (41.1%) patients underwent endovascular treatment (EVT). The successful recanalization rate of EVT was 88.5% (23/26). There was a significant difference in the age (median, 75.5 years vs. 81 years, respectively, P = 0.0411) and the rate of intravenous tissue plasminogen activator (tPA) therapy (53.5% vs. 11.1%, respectively, P <0.001) between the EVT group and the non-EVT group. Patients in the EVT group achieved a favorable outcome more frequently than those in the non-EVT group (50% vs. 11.1%, respectively, P = 0.0012). In the analysis based on the place of onset among the three cities comprising Awaji Island and the four groups with in-hospital onset, there was no significant difference in the rate of EVT, and the outcome of the in-hospital onset group was poor. Among the EVT group, there was a significant difference in the pre-treatment National Institutes of Health Stroke Scale score (median, 15 vs. 19, respectively, P = 0.0237) and time from onset to recanalization (O2R; median, 240 min vs. 323 min, respectively, P = 0.0128) between the favorable outcome group and the unfavorable outcome group.
Even in an island area, it is possible to complete the treatment of ischemic stroke due to LVO within the regional medical area.
我们回顾性分析了人口老龄化率高的岛屿地区前循环大血管闭塞（LVO）的治疗现状。
我们调查了2017年10月1日至2019年6月30日期间连续62例因急性前循环LVO导致缺血性卒中的患者。
共有26例（41.1%）患者接受了血管内治疗（EVT）。EVT的成功再通率为88.5%（23/26）。EVT组和非EVT组在年龄（中位数分别为75.5岁和81岁，P = 0.0411）和静脉注射组织纤溶酶原激活剂（tPA）治疗率（分别为53.5%和11.1%，P <0.001）方面存在显著差异。EVT组患者比非EVT组患者更频繁地获得良好预后（分别为50%和11.1%，P = 0.0012）。在对包括淡路岛在内的三个城市以及四组院内发病患者的发病地点进行分析时，EVT率没有显著差异，且院内发病组的预后较差。在EVT组中，良好预后组和不良预后组在治疗前的美国国立卫生研究院卒中量表评分（中位数分别为15和19，P = 0.0237）以及从发病到再通的时间（O2R；中位数分别为240分钟和323分钟，P = 0.0128）方面存在显著差异。
即使在岛屿地区，也有可能在区域医疗范围内完成因LVO导致的缺血性卒中的治疗。
