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Tesi etd-10102019-184042


Thesis type
Tesi di specializzazione (4 anni)
Author
BOCCUZZI, ANTONIO
URN
etd-10102019-184042
Title
Endovascular treatment of hyper acute stroke
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Supervisors
relatore Prof. Caramella, Davide
relatore Prof. Cosottini, Mirco
Parole chiave
  • endovascular
  • stroke
Data inizio appello
02/11/2019;
Consultabilità
Secretata d'ufficio
Data di rilascio
02/11/2089
Riassunto analitico
Purpose
To retrospectively evaluate the clinical outcome of patients with acute stroke treated with mechanical thrombectomy in a single center and to find significant variables as predictors of outcome.
Material and Methods
Between January 2018 and July 2019, at the OU of Neuroradiology of the Pisa University Hospital (HUB Center of the North West of Tuscany), 180 patients with hyperacute ischemic stroke underwent to mechanical thrombectomy.
We conducted a retrospective analysis on a restricted cohort of 87 patients by selecting them based on the completeness of the clinical and neuroradiological data.
Results
Mortality at 90 days was 17,24% (n=15), favorable outcome at 90 days (mRS90d 0-2) was 62,07% (n=54), bad outcome (mRS90d 3-6) was 37,93 (n=33). Patients with good outcome differ from patients with poor outcome for pre-procedural variables: mRS (status quo ante) (p: 0,005*)and the presence of collateral circulation (p: 0,012*) IV rtPA therapies (p: 0,006*) and for procedural variable as TICI score.
By using a multivariate analysis TICI (p: 0,025*) and IV rtPA (p: 0,011*) are independent predictors of outcome.
Conclusions
Trombectomy is a recognized efficient therapy for patients with hyperacute ischemic stroke. A good recanalization of occluded vessels in combination with iv rtPA therapy allows to obtain a good clinical outcome.
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