Abstract
BackgroundMechanical thrombectomy has been widely performed for large vessel occlusion stroke. The present study aimed to determine whether cumulative experience could improve thrombectomy outcomes.MethodsIn this retrospective single-center analysis, patients who underwent mechanical thrombectomy with the Solitaire stent in 3 years from 25 April 2015 were enrolled in the current study. Patients’ characteristics, durations of admission and treatment, recanalization rates, clinical outcomes, and hemorrhage transformation rates were compared among the 3 years. Logistic analysis was used to analyze the independent correlation of the years and procedural outcomes.ResultsA total of 222 patients underwent mechanical thrombectomy in the 3 years: 50 in the first year, 68 in the second year, and 104 in the third year. Door-to-puncture time (P < 0.001) and puncture-to-recanalization time (P = 0.033) decreased significantly among the 3 years, while successful recanalization rates increased (P = 0.001). Logistic regression analysis showed an independent increase in the successful recanalization rates in the second year and third year (P = 0.020, P = 0.001) as compared to that in the first year.ConclusionsCumulative experience might improve the procedures of mechanical thrombectomy. The current findings suggested a potential benefit for centralization in the treatment of large vessel occlusion stroke.
Highlights
Mechanical thrombectomy has been widely performed for large vessel occlusion stroke
The recanalization status was measured by the modified thrombolysis in cerebral infarction scale and successful recanalization was defined as a score of 2b or 3 [10]
The discrepancies were detected among groups with respect to the history of stroke (8% vs. 19.1% vs. 24.0%, P = 0.021), serum creatinine [77 (64–102) vs. 77 (63–96) vs. 69 (58–85) μmol/L, P = 0.036], onset-to-door time [91 (38–180) vs. 145 (65– 206) vs. 149 (77–283) min, P = 0.009], recruited beyond 6 h (2% vs. 2.9% vs. 7.3%, P = 0.001) and prior intravenous thrombolysis (56.0% vs. 64.7% vs. 40.4%, P = 0.021), while other variables were similar between different years
Summary
Mechanical thrombectomy has been widely performed for large vessel occlusion stroke. The present study aimed to determine whether cumulative experience could improve thrombectomy outcomes. Since the landmark trials were sequentially published from 2015, mechanical thrombectomy has become the key treatment for acute large vessel occlusion stroke [1, 2]. A retrospective analysis on a national database found less mortality rates after thrombectomy in patients transferred to the. The first procedure of mechanical thrombectomy was performed in 2015 following the updated guidelines on endovascular treatment [1]. The group consisted of three senior neuroradiologists with prior experience of interventional procedures, such as carotid artery stenting and intra-artery thrombolysis but not mechanical thrombectomy. We investigated the thrombectomy procedures of three consecutive years from the first case and explored whether there is a continuous improvement trend
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