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London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 291 27 Acute stroke: current treatment Systemic cerebral thrombolysis in patients aged more than 80 in the three rural hospitals in Poland – an observational study. P. Sobolewski1, W. Brola2, J. Stoinski3, W. Szczuchniak4, M. Fudala5, R. Hatalska-Zerebiec6 Department of Neurology and Stroke Unit of Hospital in Sandomierz, Sandomierz, POLAND1, Department of Neurology and Stroke Unit of Hospital in Końskie, , POLAND2, Department of Neurology and Stroke Unit of Hospital in Skarżysko-Kamienna, Skarżysko-Kamienna, POLAND3, Department of Neurology and Stroke Unit of Hospital in Sandomierz, Sandomierz, POLAND4, De-partment of Neurology and Stroke Unit of Hospital inKońskie, Końskie, POLAND5, Department of Neurology and Stroke Unit of Hospital in Sandomierz, Sandomierz, POLAND6 Background: The majority of strokes occurring in older people. Patients over 80 years of age are in-creasingly receiving intravenous thrombolysis for acute ischaemic stroke (AIS). The recent results of The Third IST Trial (IST 3) raised additional questions about the effectiveness on rt-PA use in ex-tended time window and in elderly patients. The aim of our study was to evaluate the effectiveness and safety systemic cerebral thrombolysis (SCT) in this group of patients from the rural regions. Methods. We have retrospectively evaluated data of 274 patients with ischaemic stroke (IS) who were consecutively treated with SCT in 3 rural hospitals in Poland. Results. In analysed group there were 69(25.18%) patients over 80 years old including 6 nonagenarians patients (≥90 years old). In this group were longer: onset to door time (105min. vs. 85min., p=0.026), door to needle time (80min. vs. 60min., p<0.0001) and onset to needle time (180min. vs. 150min., p<0.0001) and higher stroke severity (National Institutes of Health Stroke Scale , NIHSS 13 vs. 11, p=0.046). At 3 months after stroke onset in patients over 80 we found less patients with good outcome (mRS 0-2) (39.1% vs. 50.0%, p=0.004) and more patients died (34.8% vs. 14.2%, p=0.002). In this group was also more Haemorrhagic Transformation (HT) (30.9% vs. 15.1%, p=0.004) and Symptomatic Intra-ce-rebral Haemorrhage (SICH) according to National Institute of Neurological Disorders and Stroke (NINDS) definition (13.0% vs. 3.9%, p=0.015). A multivariate analysis showed impact of higher NI-HSS at admission on the unfavourable outcome (mRS 3-6) in older patients (p=0.0006). Conclusion. Older age significantly effected on the prolongation of times of pre- and in-hospital procedures in patients with IS. Older patients can gain less benefit from SCT especially patients presenting more sever baseline stroke . 28 Acute stroke: current treatment Mechanical Thrombectomy in Acute Ischemic Stroke - comparison with standard treatement I. Šarbochová1, O. Chudomel2, H. Magerová3, J. Schwalbová4, A. Tomek5 Neurology Departemen 2nd Faculty of Medicine Charles University and Faculty Hospital Motol, Prague, Prague, CZECH REPUBLIC1, Neurology Departemen 2nd Faculty of Medicine Charles University and Faculty Hospital Motol, Prague, Prague, CZECH REPUBLIC2, Neurolo-gy Departemen 2nd Faculty of Medicine Charles University and Faculty Hospital Motol, Prague, Prague, CZECH REPUBLIC3, Neurology Departemen 2nd Faculty of Medicine Charles Universi-ty and Faculty Hospital Motol, Prague, Prague, CZECH REPUBLIC4, Neurology Departemen 2nd Faculty of Medicine Charles University and Faculty Hospital Motol, Prague, Prague, CZECH RE-PUBLIC5 Background and Purpose: Stent–based recanalization techniques are being increasingly used in routine clinical practice in stroke patients with large vessel occlusion despite insufficient evi-dence- based data. The purpose of this study was to evaluate the safety and feasibility of thrombec-tomy device Solitaire (ev3 Inc) and compare the outcome with matched control group of patients treated in our department before thrombectomy programme started who would be otherwise indicat-ed for thrombectomy. Methods: Retrospective, monocentric study, two cohorts of acute stroke patients with large vessel occlusion: 1. Standard treatment – with or without i.v. thrombolysis (admitted between January and December 2011); 2. Mechanical thrombectomy (Solitaire device) - with or without i.v. thrombolysis (March to October 2012). Patients were scored NIHSS on admission; clinical outcome was assessed as mRS at 90 days. Recanalization was evaluated using the Trombolysis In Cerebral Infarction score. Results: There were no significant differences between cohorts in age and comorbidities. Cohort 1. 20 patients, 13 men, mean age 66,2 (44-81) years. Mean admission NIHSS 16 (8-24). Good out-come (mRS 0-2) 2 (10%) patients, bad outcome (mRS 3-6) in 18 (90%) patients, including 3 deaths (mRS 6). Cohort 2. 19 patients (11 men), mean age 58,3 (17-78) years. Mean NIHSS 14 (8-25), good out-come 6 (31.7%) patients, bad outcome 13 (68.3%), including 3 (15.7 %) deaths. Recanalization was successful in 17(90.1%) cases. Conclusion: Mechanical thrombectomy with Solitaire device demonstrated to be safe and effective in our stroke centre as was shown elsewhere. Outcome of cohort treated with endovascular treat-ment was superior to standard treatment group. We find this method to be effective, feasible and ap-plicable in our clinical practice.


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