Article

Since 2015, the emergence of mechanical thrombectomy as standard care
in acute stroke has involved organizational changes not only for stroke centers,
but also for entire emergency regional networks.
The aim of our study was to
assess the proportion of ischemic stroke patients, admitted to stroke units in
the Northern French Alps within the first 6h of onset, eligible for thrombectomy.
METHODS: This study retrospectively analyzed the clinical and radiological data
of all acute stroke patients hospitalized at three stroke units of the Northern
French Alps Emergency Network (RENAU) in 2014. Eligible patients had proximal
arterial occlusions of the anterior and posterior cerebral circulation, as
confirmed by brain imaging, which could be treated by thrombectomy within 6h of
symptom onset. RESULTS: Of the 435 cases of acute ischemic stroke, 152 patients
were treated by intravenous thrombolysis (IV rtPA). Of these patients, 83 (55%)
had intracranial occlusions and were eligible for combined thrombectomy. Of the
283 patients not treatable by IV rtPA, 32 patients (11%) were eligible for
primary thrombectomy. CONCLUSION: Thrombectomy could be performed in 26% of our
acute ischemic stroke patients (n=115/435), and a large increase in endovascular
procedures is expected over the next few years that will require close
collaboration among all partners in the emergency networks. Using our RENAU
stroke database, it will be possible to compare various factors contributing to
effective activity.
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Langue : ANGLAIS