Thrombectomy-Capable Stroke Centre—A Key to Acute Stroke Care System Improvement? Retrospective Analysis of Safety and Efficacy of Endovascular Treatment in Cardiac Cathlab

Pawłowski, Krzysztof; Dziadkiewicz, Artur; Podlasek, Anna; Klaudel, Jacek; Mączkowiak, Alicja; Szołkiewicz, Marek

Abstract

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.

• Journal Article Type: Article
• Acceptance Date: Jan 24, 2023
• Online Publication Date: Jan 26, 2023
• Publication Date: 2023-02
• Deposit Date: Apr 16, 2023
• Publicly Available Date: Apr 18, 2023
• Journal: International Journal of Environmental Research and Public Health
• Print ISSN: 1661-7827
• Electronic ISSN: 1660-4601
• Publisher: MDPI AG
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Issue: 3
• Article Number: 2232
• DOI: https://doi.org/10.3390/ijerph20032232
• Keywords: Acute ischaemic stroke, mechanical thrombectomy, thrombectomy-capable stroke centre, endovascular stroke treatment
• Public URL: https://nottingham-repository.worktribe.com/output/17934333
• Publisher URL: https://www.mdpi.com/1660-4601/20/3/2232
• Additional Information: Pawłowski, K.; Dziadkiewicz, A.; Podlasek, A.; Klaudel, J.; Mączkowiak, A.; Szołkiewicz, M. Thrombectomy-Capable Stroke Centre—A Key to Acute Stroke Care System Improvement? Retrospective Analysis of Safety and Efficacy of Endovascular Treatment in Cardiac Cathlab. Int. J. Environ. Res. Public Health 2023, 20, 2232. https://doi.org/10.3390/ijerph20032232