Purpose Mechanical thrombectomy is a promising new modality of interventional stroke treatment. The use of these devices has been steadily increasing over the past 2–3 years.
In recent years, multiple trials have been published establishing the efficacy of mechanical thrombectomy devices in achieving successful vascular recanalization and improved outcomes. We reviewed single institution data analyzing increasing use of mechanical thrombectomy devices and related outcomes in recent years.
Methods Retrospective chart review was performed on 146 consecutive patients who underwent interventional acute stroke treatment from January 2006 to October 2009. Data were analyzed to compare use of mechanical thrombectomy devices (MERCI and Penumbra) and outcomes for each individual year. The primary outcome measures compared were mortality, recanalization rate and modified Ranking Score (mRS).
Results For all patients included, data were analyzed for each year separately. In 2006, all patients (n=11) were treated with IA (intra-arterial) tissue plasminogen activator (tPA) (100%) and none received mechanical thrombectomy, with recanalization rates (TIMI=2/3), mortality and mRS ≤2 of 54%, 18% and 45%, respectively. Total patients treated were 49, 47 and 39 in 2007, 2008 and 2009, respectively. In 2007, 44 were treated with IA tPA (89%) and nine (18%) underwent mechanical thrombectomy with recanalization rates (TIMI=2/3), mortality and mRS ≤2 of 65%, 18% and 53%, respectively. In 2008, 34 were treated with IA tPA (72%) and 21 (44%) underwent mechanical thrombectomy with recanalization rates (TIMI=2/3), mortality and mRS ≤2 of 59%, 25% and 48%, respectively. In 2009, 30 were treated with IA tPA (76%) and 28 (71%) underwent mechanical thrombectomy with recanalization rates (TIMI=2/3), mortality and mRS ≤2 of 71%, 23% and 41%, respectively
Conclusion There is an increasing trend towards using mechanical thrombectomy devices over recent years resulting in better recanalization rates. However, no trend towards improved outcomes or reduced mortality was observed in our single institution series. This could be due to inclusion of patients with older age, higher National Institutes of Health Stroke Scale scores and expanded treatment time windows for interventional stroke therapy in recent years.
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Competing interests None.