Endovascular Treatment for Acute Ischaemic Stroke due to Large-vessel Occlusion: Single-centre Experience

Abstract

Objectives: To evaluate the effectiveness of endovascular treatment (EVT) for acute ischaemic stroke in terms of angiographic results and clinical outcomes. Methods: Patients who presented with symptoms of acute ischaemic stroke and who underwent EVT including mechanical thrombectomy and/or intra-arterial thrombolysis (IAT) at an acute-care public hospital between January 2013 and October 2016 were recruited. Digital angiographic images were reviewed by an independent neuroradiologist, who assigned a Thrombolysis in Cerebral Infarction (TICI) grade to each patient. Medical records were reviewed to retrieve the National Institutes of Health Stroke Scale score, modified Rankin scale (mRS) score at 90 days, and clinical outcomes. Results: Records of a total of 38 patients were reviewed (mean age, 65.6 years). In all, 19 patients were treated with aspiration thrombectomy alone, 11 with both stent retriever and aspiration thrombectomy, six with stent-retriever thrombectomy alone, one with aspiration thrombectomy and IAT, and one with IAT alone. Revascularisation was successful (TICI grade 2b/3) in 76% of patients. The median time to reperfusion from the start of the procedure was 1 hour 3 minutes. Post-procedural symptomatic intracranial haemorrhage occurred in 11% of patients. Outcome was good (mRS score ≤ 2) and fair (mRS score ≤ 3) at 90 days in 27% and 43% of patients, respectively. The mean length of hospital stay for patients with successful and unsuccessful revascularisation was 35.7 and 62.3 days, respectively. The mortality rate within 90 days of EVT was 8%. Conclusion: Our study shows that EVT has a high success rate for recanalisation, overall patient clinical outcomes are acceptable, and the procedure-related complication and mortality rates are low.