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Endovascular Acute Stroke Treatment Performed by Vascular Interventional Radiologists: Is It Safe and Efficacious?

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Abstract

Purpose

To evaluate the safety and efficacy of neurointerventional procedures in acute stroke patients performed by a team of vascular interventional radiologists in close cooperation with diagnostic neuroradiologists and stroke neurologists and to compare the results with those of previous reports from centres with specialised interventional neuroradiologists.

Material and Methods

A total of 39 patients with acute ischemic stroke due to large-vessel occlusion not responding to or not eligible for intravenous thrombolysis were treated with either intra-arterial thrombolysis or mechanical thrombectomy (Penumbra System or solitaire FR thrombectomy system, respectively) and included in our prospective study. Outcomes were measured using the modified Rankin scale after 90 days, and recanalization was assessed by thrombolysis using the myocardial infarction score.

Results

Mean patient age was 68.3 ± 14.2 years; the average National Institutes of Health Stroke Scale score at hospital admission was 17.2 (SD = 6.2 [n = 38]). Successful recanalization was achieved in 74.4 % of patients. Median time from clinical onset to recanalization was 5 h 11 min. Procedure-related complications occurred in 5 % of patients, and 7.5 % had a symptomatic intracerebral hemorrhage. Of the patients, 22.5 % died within the first 90 postprocedural days, 5 % of these from cerebral causes. Patients who were successfully recanalized had a clinical better outcome at follow-up than those in whom treatment failed. Of the patients, 35.9 % had an mRS score ≤2 after 90 days.

Conclusion

Our results are in line with those in the published literature and show that a treatment strategy with general interventional radiologists performing neurointerventional procedures in acute stroke patients with large vessel occlusions can be achieved to the benefit of patients.

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Conflict of interest

Jan Petter Larsen reports board membership for Lundbeck Pharma and receiving payment for lectures from Lundbeck Pharma. Martin W. Kurz reports receiving payment for lectures from Boehringer Ingelheim and Pfizer.

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Authors and Affiliations

  1. Department of Radiology, Stavanger University Hospital, 4068, Stavanger, Norway

    Lars Fjetland, Sumit Roy & Kathinka D. Kurz

  2. The Norwegian Centre for Movement Disorders, Stavanger University Hospital, 4068, Stavanger, Norway

    Lars Fjetland, Jan Petter Larsen & Martin W. Kurz

  3. Department of Neurology, Stavanger University Hospital, 4068, Stavanger, Norway

    Jan Petter Larsen & Martin W. Kurz

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  1. Lars Fjetland
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  2. Sumit Roy
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  3. Kathinka D. Kurz
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Correspondence to Lars Fjetland.

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Fjetland, L., Roy, S., Kurz, K.D. et al. Endovascular Acute Stroke Treatment Performed by Vascular Interventional Radiologists: Is It Safe and Efficacious?. Cardiovasc Intervent Radiol 35, 1029–1035 (2012). https://doi.org/10.1007/s00270-012-0438-5

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  • DOI: https://doi.org/10.1007/s00270-012-0438-5

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