Purpose
The aim of study is to evaluate the effectiveness of cerebrovascular occlusion treatment with the use of invasive radiological techniques ,
targeted thrombolysis and mechanical thrombectomy.
This study was conducted to demonstrate which of the endovascular aforementioned methods is more effective.
It shows the impact of endovascular treatment of cerebral vascular obstructionaffects the clinical status of patients and which are the most frequently occluded arteries.
Methods and Materials
Materials:
This retrospective study involved a group of 29 patients hospitalized in SP CSK im.
prof.
K.
Gibińskiego SUM in Katowice,
who in 2005-2012 were treated with targeted thrombolysis and mechanical thrombectomy.
The average age of patients with obstruction of cerebral arteries was 56,72 years (with a range of 26-84 years) (Table 1).
Neurological examination (assessed using the National Institutes of Health Stroke Scale [NIHSS]) was performed before and after surgery and at discharge from the ward.
Qualifications protocol:
In order to exclude patients with...
Results
In the period from 2005 to 2012,
29 cases with cerebrovascular occlusion were treated.
38 endovascular procedures were performed: 24 targeted thrombolysis and 14 mechanical thrombectomy.
Mechanical thrombectomy was performed using 7 Penumbra sets,
5 Solitaire FR sets and twice using the microcatheter and microguidewire.
The combination therapy (targeted thrombolysis and mechanical thrombectomy) was used 4 times (Table 3).
The 7 times during thrombolysis was used ReoPro (Abciximab),
16 times the rt-PA.
In 7 cases of the vascular spasm papaverine was applied.
Obstruction occurred most...
Conclusion
The research performed has shown that endovascular techniques are effective and safe in the treatment of cerebral vascular obstruction.
Targeted thrombolysis is more effective than mechanical thrombectomy.
Patients who were treated endovasculary improved significantly.
The middle cerebral artery was the most common site of obstruction.
References
1.
Jan Baron i Joanna Pilch-Kowalczyk,
Wprowadzenie do diagnostyki obrazowej,
Wydanie: II,ISBN: 978-83-7509-173-1
2.
Castro-Afonso LH,Abud TG,Pontes-Neto OM,Monsignore LM,Nakiri GS,Cougo-Pinto PT,Oliveira Ld,Santos DD,Dias FA,Fábio SC,Coletto FA,Abud DG,
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population,
Clinics (Sao Paulo).2012 Dec;67(12):1379-86.
[PubMed]
3.
Bae GS,Kwon HJ,Kang CW,Choi SW,Kim SH,Koh HS,
Mechanical thrombectomy using a solitaire stent in acute ischemic stroke; initial experience in 40 patients,
J Cerebrovasc Endovasc Neurosurg.2012 Sep;14(3):164-9.
[PubMed]
4.
Piotr Sobolewski,
Review of invasive endovascular methods of treatment...
Personal Information
Daniel Knap,
PhD,Medical University of Silesia,
Katowice,
Poland;
Maciej Honkowicz,student,
Medical University of Silesia,
Katowice,
Poland;
[email protected]
Tomasz Kirmes,
student,
Medical University of Silesia,
Katowice,
Poland;
[email protected]
Marcin Koroński,student,
Medical University of Silesia,
Katowice,
Poland;
Marzena Kysiak,student,
Medical University of Silesia,
Katowice,
Poland;
Mateusz Bukański,student,
Medical University of Silesia,
Katowice,
Poland;
Jan Baron,
PhD,Medical University of Silesia,
Katowice,
Poland;