Studies of the systems of medical care for patients with acute disorders of brain circulation indicate that well-organized "stroke" service promotes morbidity decrease, lowers neurological deficit expression and restriction of social and daily activities. At the same time, there are essential differences in the scope of the medical care, which a patient can receive in different countries and no consensus on the most optimal system of medical scope for patients with stroke at different stages. The recent statistical reviews confirm that a patient admitted to specialized stroke departments has a less chance to die or to be a handicap. The article analyzes current systems service for patients with acute disorders of brain blood circulation in the United States, Europe and Russia.
We present our results from the first 6 years with mechanical thrombectomy in the treatment of ischemic stroke.
Every patient treated with mechanical thrombectomy for acute ischemic stroke from September 2005 to December 2011 was consecutively included in this retrospective analysis. Baseline and outcome data were retrieved from computerized records at the hospital. National Institute of Health Stroke Scale (NIHSS) score and the modified Rankin Scale (mRS) score were used as outcome parameters. Favorable outcome was defined as a mRS score of 0-2, corresponding to independence in activities of daily living. We also evaluated revascularization and severe adverse events, with focus on symptomatic intracranial hemorrhage.
Good functional outcome (mRS 0-2) was achieved in 50 % (120/240) of all patients. For patients with no neurological deficit prior to stroke onset (i.e., mRS?=?0 before stroke), the proportion with good functional outcome was 54 %. Symptomatic hemorrhages occurred in 4.6 % of the cases (5.7 % in the anterior circulation).
In summary, our results supports that mechanical thrombectomy is a safe and effective method to restore blood flow in selected patients suffering from an acute ischemic stroke.