Constantino Glenn Anthony A, Señga Miguela Marie A, Soliven Jo Ann R, Jocson Victor Erwin D
Department of Neurology, Institute of the Neurological Sciences, The Medical City, Pasig City, Metro Manila, Philippines.
Section of Vascular and Interventional Radiology, Department of Radiology, The Medical City, Pasig City, Metro Manila, Philippines.
Acta Med Philipp. 2023 May 29;57(5):44-50. doi: 10.47895/amp.vi0.5113. eCollection 2023.
Stroke has remained one of the primary causes of significant morbidity and mortality. Among the therapeutic options for acute stroke management, endovascular thrombectomy is intended to remove the thrombi within the intracerebral vasculature and restore adequate perfusion to the surrounding penumbra. It is recommended up to 24 hours from onset of neurologic symptom. In the Philippines, only a few tertiary healthcare institutions are able to offer and perform endovascular thrombectomies. The aim was to describe the profile and discharge outcomes of endovascular thrombectomy for acute ischemic stroke at a tertiary hospital in our country.
We conducted a retrospective records review among 924 patients admitted for acute ischemic stroke from October 2018 to August 2021 who underwent mechanical thrombectomy. Clinical and functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Score (mRS).
Among 31 patients included in the study, 29 subjects (93.5%) had moderate to severe disability (mRS 3-5), and 25 (80.6%) had moderate stroke (NIHSS 6-21) on admission. The identified site of the cerebrovascular thrombi was within the M1 segment of the middle cerebral artery (41.9%, n=13). The stent retriever approach was performed in 19 participants (61.2%). Upon discharge, only 7 (22.6%) had favorable functional outcomes (MRS 0-2), and 9 (29.0%) resulted in mortality. Successful reperfusion was achieved in 92.3% of the patients.
Overall, endovascular thrombectomy is a possible treatment option for large vessel acute ischemic stroke in developing countries.
中风一直是导致严重发病和死亡的主要原因之一。在急性中风治疗方案中，血管内血栓切除术旨在清除脑内血管中的血栓，并恢复对周围半暗带的充分灌注。建议在神经症状出现后24小时内进行。在菲律宾，只有少数几家三级医疗机构能够提供并实施血管内血栓切除术。本研究旨在描述我国一家三级医院急性缺血性中风血管内血栓切除术的患者情况及出院结局。
我们对2018年10月至2021年8月期间因急性缺血性中风入院并接受机械取栓术的924例患者进行了回顾性病历审查。使用美国国立卫生研究院卒中量表（NIHSS）和改良Rankin量表（mRS）来衡量临床和功能结局。
在纳入研究的31例患者中，29例（93.5%）入院时存在中度至重度残疾（mRS 3 - 5），25例（80.6%）为中度中风（NIHSS 6 - 21）。脑血管血栓的确定部位在大脑中动脉M1段（41.9%，n = 13）。19名参与者（61.2%）采用了支架取栓方法。出院时，只有7例（22.6%）获得了良好的功能结局（MRS 0 - 2），9例（29.0%）死亡。92.3%的患者实现了成功再灌注。
总体而言，血管内血栓切除术是发展中国家治疗大血管急性缺血性中风的一种可行治疗选择。
