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Time from stroke onset to groin puncture affects rate of recanalisation after mechanical thrombectomy: a real-life single centre experience
, 2, 1, 2, 1, 1
Affiliations- Neurology Department, Jagiellonian University, Krakow, Poland
- Neurology Department, Jagiellonian University, Krakow, Poland
open access
Abstract
Aim of the study. We investigated whether the time elapsed between stroke onset and groin puncture (SO-GP) affects the rate of recanalisation as measured by the Thrombolysis in Cerebral Infarction (TICI) scale.
Clinical rationale for the study. There is no doubt that the effectiveness of thrombolysis in acute ischaemic stroke (AIS) is time-dependent. There is growing evidence that there is a correlation between SO-GP time and rate of recanalisation in patients treated by mechanical thrombectomy (MT).
Materials and methods. This study was performed in patients treated in the Comprehensive Stroke Centre in Krakow that covers 3.5 million inhabitants. The following data was collected for this study: demographics, stroke risk factors, transportation (directly from home or via another hospital), admission NIHSS, IV rt-PA administration prior to MT, the number of passes used during MT, and SO-GP time. The favourable outcome measure was TICI 2b or 3.
Results. 223 patients (48.4% females; mean age: 66.0 ± 16.6 years) with anterior circulation strokes were treated by MT; 64.6% arrived directly from home. Mean admission NIHSS was 15.6 ± 5.3. IV rtPA was administered in 68.6% of patients. At least two thrombectomy passes were required in 20.6% of cases. Median SO-GP time was 240 minutes (IQR range: 180–305 minutes). Grade 3 or 2b TICI scores were obtained in 70.4% of patients. Univariate logistic regression showed that among all studied parameters, only NIHSS affected the rate of recanalisation, but in a multivariate logistic regression model, the only parameter that affected the rate of recanalisation was the SO-GP time (OR = 0.76; 95% CI: 0.60-0.98, p = 0.03).
Conclusions and clinical implications. We suggest that SO-GP time affects the rate of recanalisation in patients with MT.
Abstract
Aim of the study. We investigated whether the time elapsed between stroke onset and groin puncture (SO-GP) affects the rate of recanalisation as measured by the Thrombolysis in Cerebral Infarction (TICI) scale.
Clinical rationale for the study. There is no doubt that the effectiveness of thrombolysis in acute ischaemic stroke (AIS) is time-dependent. There is growing evidence that there is a correlation between SO-GP time and rate of recanalisation in patients treated by mechanical thrombectomy (MT).
Materials and methods. This study was performed in patients treated in the Comprehensive Stroke Centre in Krakow that covers 3.5 million inhabitants. The following data was collected for this study: demographics, stroke risk factors, transportation (directly from home or via another hospital), admission NIHSS, IV rt-PA administration prior to MT, the number of passes used during MT, and SO-GP time. The favourable outcome measure was TICI 2b or 3.
Results. 223 patients (48.4% females; mean age: 66.0 ± 16.6 years) with anterior circulation strokes were treated by MT; 64.6% arrived directly from home. Mean admission NIHSS was 15.6 ± 5.3. IV rtPA was administered in 68.6% of patients. At least two thrombectomy passes were required in 20.6% of cases. Median SO-GP time was 240 minutes (IQR range: 180–305 minutes). Grade 3 or 2b TICI scores were obtained in 70.4% of patients. Univariate logistic regression showed that among all studied parameters, only NIHSS affected the rate of recanalisation, but in a multivariate logistic regression model, the only parameter that affected the rate of recanalisation was the SO-GP time (OR = 0.76; 95% CI: 0.60-0.98, p = 0.03).
Conclusions and clinical implications. We suggest that SO-GP time affects the rate of recanalisation in patients with MT.
Keywords
stroke, thrombectomy, ischaemic stroke, time, recanalisation, groin puncture
About this articleTitle
Time from stroke onset to groin puncture affects rate of recanalisation after mechanical thrombectomy: a real-life single centre experience
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
156-160
Published online
2020-04-03
Page views
1513
Article views/downloads
555
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2020;54(2):156-160.
Keywords
stroke
thrombectomy
ischaemic stroke
time
recanalisation
groin puncture
Authors
Klaudia Nowak
Justyna Derbisz
Jeremiasz Jagiełła
Roman Pułyk
Tadeusz Popiela
Agnieszka Słowik
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