open access

Vol 51, No 5 (2017)
Original research articles
Submitted: 2017-05-08
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Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Agnieszka Słowik, Marcin Wnuk, Paweł Brzegowy, Joanna Chrzanowska-Waśko, Aleksandra Golenia, Bartłomiej Łasocha, Dorota Włoch-Kopeć, Antoni Ferens, Wojciech Serednicki, Piotr Jarocki, Halina Bartosik-Psujek, Rafał Kaczorowski, Edward Filip, Monika Grzegorzak, Jarosław Homa, Janusz Darocha, Daniel Dudek, Wiesław Guz, Konrad Rejdak, Piotr Luchowski, Joanna Wojczal, Michał Sojka, Michał Górnik, Sylwia Stachowicz, Jacek Jaworski, Kinga Buraczyńska, Remigiusz Ficek, Anna Szczepańska-Szerej, Tomasz Jargiełło, Małgorzata Szczerbo-Trojanowska, Anetta Lasek-Bal, Przemysław Puz, Aldona Warsz-Wianecka, Arkadiusz Stęposz, Krzysztof Ziaja, Wacław Kuczmik, Tomasz Urbanek, Damian Ziaja, Witold Tomalski, Adam Kobayashi, Przemysław Richter, Andrzej Płoński, Marcin Kotkowski, Wojciech Czepiel, Iwona Kurkowska-Jastrzębska, Halina Sienkiewicz-Jarosz, Anna Członkowska, Beata BłażejewskaHyżorek, Danuta Ryglewicz, Magdalena Konopko, Edyta Brelak, Jacek Antecki, Igor Szydłowski, Maciej Włosek, Adam Stępień, Krzysztof Brzozowski, Jacek Staszewski, Piotr Piasecki, Piotr Zięcina, Izabela Wołoszyńska, Norbert Kolmaga, Jerzy Narloch, Tomasz Hasiec, Jacek Gawłowicz, Monika Pędracka, Jacek Porębiak, Bogumił Grzechnik, Vadym Matsibora, Michał Frąszczak, Marcin Leus, Maciej Mazgaj, Violetta Palacz-Duda, Grzegorz Meder, Wojciech Skura, Piotr Płeszka, Milena Świtońska, Krzysztof Słomiński, Józef Kościelniak, Paulina Sobieszak-Skura, Magdalena Konieczna-Brazis, Olgierd Rowiński, Andrzej Opuchlik, Anatol Mickielewicz, Beata Szyluk, Piotr Szczudlik, Anna Kostera-Pruszczyk, Maciej Jaworski, Rafał Maciąg, Jarosław Żyłkowski, Bożena Adamkiewicz, Wojciech Szubert, Jarosław Chrząstek, Marek Raźniewski, Agnieszka Pawelec, Paweł Wilimborek, Ryszard Wagner, Paweł Pilarski, Paweł Gierach, Jan Baron, Wojciech Gruszka, Stanisław Ochudło, Agnieszka Krzak-Kubica, Monika Rudzińska-Bar, Miłosz Zbroszczyk, Kamila Smulska, Michał Arkuszewski, Dorota Różański, Dariusz Koziorowski, Izabela Meisner-Kramarz, Stanisław Szlufik, Artur Zaczyński, Krzysztof Kądziołka, Kazimierz Kordecki, Michał Zawadzki, Mirosław Ząbek, Bartosz Karaszewski, Dariusz Gąsecki, Paweł Łowiec, Waldemar Dorniak, Tomasz Gorycki, Edyta Szurowska, Ewa Wierzchowska-Cioch, Tomasz Smyk, Beata Szajnoga, Marcin Bachta, Kajetan Mazurek, Magdalena Piwowarska, Wojciech Kociemba, Artur Drużdż, Adrian Dąbrowski, Michał Glonek, Małgorzata Wawrzyniak, Radosław Kaźmierski, Robert Juszkat, Adam Heliosz, Adam Ryszczyk, Jacek Zwiernik, Grzegorz Wasilewski, Andrzej Tutaj, Grzegorz Dałek, Krzysztof Nosek, Sławomir Bereza, Katarzyna Lubkowska, Jerzy Kamienowski, Piotr Sobolewski, Adam Bielecki, Maciej Miś, Marcin Miś, Maria Krużewska-Orłowska, Jan Kochanowicz, Zenon Mariak, Marta Jakoniuk, Grzegorz Turek, Urszula Łebkowska, Andrzej Lewszuk, Tomasz Dziedzic, Tadeusz Popiela
DOI: 10.1016/j.pjnns.2017.05.004
·
Neurol Neurochir Pol 2017;51(5):339-346.

open access

Vol 51, No 5 (2017)
Original research articles
Submitted: 2017-05-08

Abstract

Objectives

Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland.

Methods and results

We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures.

Results

Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases.

Conclusion

Our results can help harmonize standards for MT in Poland according to international guidelines.

Abstract

Objectives

Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland.

Methods and results

We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures.

Results

Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases.

Conclusion

Our results can help harmonize standards for MT in Poland according to international guidelines.

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Keywords

Acute stroke, Treatment, Mechanical thrombectomy

About this article
Title

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 5 (2017)

Pages

339-346

DOI

10.1016/j.pjnns.2017.05.004

Bibliographic record

Neurol Neurochir Pol 2017;51(5):339-346.

Keywords

Acute stroke
Treatment
Mechanical thrombectomy

Authors

Agnieszka Słowik
Marcin Wnuk
Paweł Brzegowy
Joanna Chrzanowska-Waśko
Aleksandra Golenia
Bartłomiej Łasocha
Dorota Włoch-Kopeć
Antoni Ferens
Wojciech Serednicki
Piotr Jarocki
Halina Bartosik-Psujek
Rafał Kaczorowski
Edward Filip
Monika Grzegorzak
Jarosław Homa
Janusz Darocha
Daniel Dudek
Wiesław Guz
Konrad Rejdak
Piotr Luchowski
Joanna Wojczal
Michał Sojka
Michał Górnik
Sylwia Stachowicz
Jacek Jaworski
Kinga Buraczyńska
Remigiusz Ficek
Anna Szczepańska-Szerej
Tomasz Jargiełło
Małgorzata Szczerbo-Trojanowska
Anetta Lasek-Bal
Przemysław Puz
Aldona Warsz-Wianecka
Arkadiusz Stęposz
Krzysztof Ziaja
Wacław Kuczmik
Tomasz Urbanek
Damian Ziaja
Witold Tomalski
Adam Kobayashi
Przemysław Richter
Andrzej Płoński
Marcin Kotkowski
Wojciech Czepiel
Iwona Kurkowska-Jastrzębska
Halina Sienkiewicz-Jarosz
Anna Członkowska
Beata BłażejewskaHyżorek
Danuta Ryglewicz
Magdalena Konopko
Edyta Brelak
Jacek Antecki
Igor Szydłowski
Maciej Włosek
Adam Stępień
Krzysztof Brzozowski
Jacek Staszewski
Piotr Piasecki
Piotr Zięcina
Izabela Wołoszyńska
Norbert Kolmaga
Jerzy Narloch
Tomasz Hasiec
Jacek Gawłowicz
Monika Pędracka
Jacek Porębiak
Bogumił Grzechnik
Vadym Matsibora
Michał Frąszczak
Marcin Leus
Maciej Mazgaj
Violetta Palacz-Duda
Grzegorz Meder
Wojciech Skura
Piotr Płeszka
Milena Świtońska
Krzysztof Słomiński
Józef Kościelniak
Paulina Sobieszak-Skura
Magdalena Konieczna-Brazis
Olgierd Rowiński
Andrzej Opuchlik
Anatol Mickielewicz
Beata Szyluk
Piotr Szczudlik
Anna Kostera-Pruszczyk
Maciej Jaworski
Rafał Maciąg
Jarosław Żyłkowski
Bożena Adamkiewicz
Wojciech Szubert
Jarosław Chrząstek
Marek Raźniewski
Agnieszka Pawelec
Paweł Wilimborek
Ryszard Wagner
Paweł Pilarski
Paweł Gierach
Jan Baron
Wojciech Gruszka
Stanisław Ochudło
Agnieszka Krzak-Kubica
Monika Rudzińska-Bar
Miłosz Zbroszczyk
Kamila Smulska
Michał Arkuszewski
Dorota Różański
Dariusz Koziorowski
Izabela Meisner-Kramarz
Stanisław Szlufik
Artur Zaczyński
Krzysztof Kądziołka
Kazimierz Kordecki
Michał Zawadzki
Mirosław Ząbek
Bartosz Karaszewski
Dariusz Gąsecki
Paweł Łowiec
Waldemar Dorniak
Tomasz Gorycki
Edyta Szurowska
Ewa Wierzchowska-Cioch
Tomasz Smyk
Beata Szajnoga
Marcin Bachta
Kajetan Mazurek
Magdalena Piwowarska
Wojciech Kociemba
Artur Drużdż
Adrian Dąbrowski
Michał Glonek
Małgorzata Wawrzyniak
Radosław Kaźmierski
Robert Juszkat
Adam Heliosz
Adam Ryszczyk
Jacek Zwiernik
Grzegorz Wasilewski
Andrzej Tutaj
Grzegorz Dałek
Krzysztof Nosek
Sławomir Bereza
Katarzyna Lubkowska
Jerzy Kamienowski
Piotr Sobolewski
Adam Bielecki
Maciej Miś
Marcin Miś
Maria Krużewska-Orłowska
Jan Kochanowicz
Zenon Mariak
Marta Jakoniuk
Grzegorz Turek
Urszula Łebkowska
Andrzej Lewszuk
Tomasz Dziedzic
Tadeusz Popiela

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