Analysis of 565 thrombectomies for anterior circulation stroke: A Brazilian registry

Interv Neuroradiol. 2022 Jun;28(3):283-290. doi: 10.1177/15910199211026995. Epub 2021 Jun 18.

Abstract

Introduction: The benefits of mechanical thrombectomy in the treatment of patients with acute stroke due to large vessel occlusions (LVOs) have been extensively demonstrated by randomized trials and registries in developed countries. However, data on thrombectomy outside controlled trials are scarce in developing countries. The aim of this study was to assess the safety and efficacy, and to investigate the predictors for good and poor outcomes of thrombectomy for treatment of AIS due to anterior circulation LVOs in Brazil.

Materials and methods: This was a single center registry of thrombectomy in the treatment of stroke caused by anterior circulation LVOs. Between 2011 and 2019, a total of 565 patients were included.

Results: the mean baseline NIHSS score on admission was 17.2. The average baseline ASPECTS was 8, and 91.0% of patients scored ≥6. Half of the patients received intravenous thrombolysis. The mean time from symptom onset to arterial puncture was 296.4 minutes. The mean procedure time was 61.4 minutes. The rates of the main outcomes were recanalization (TICI 2b-3) 85.6%, symptomatic intracranial hemorrhage (sICH) 8,1%, good clinical outcome (mRS=0-2) 43,5%, and mortality 22.1% at three months.

Conclusions: This study demonstrates the efficacy and safety of mechanical thrombectomy for treatment of patients with AIS of the anterior circulation in real-life conditions under limited facilities and resources. The results of the present study were relatively similar to those of large trials and population registers of developed countries.

Keywords: Acute ischemic stroke; large vessel occlusion; mechanical thrombectomy; stent retrievers.

MeSH terms

  • Brain Ischemia* / surgery
  • Brazil
  • Humans
  • Registries
  • Retrospective Studies
  • Stents
  • Stroke* / surgery
  • Thrombectomy / methods
  • Treatment Outcome