22. European Stroke Conference 304 © 2013 S. Karger AG, Basel Scientific Programme 51 Acute stroke: new treatment concepts Multimodal endovascular treatment of acute large vessel ischemic strokes A.V. Khripun1, M.V. Malevannyi2, Ya.V. Kulikovskikh3 Regional vascular center, Rostov-on-Don, RUSSIAN FEDERATION1, Regional vascular center, Rostov-on-Don, RUSSIAN FEDERATION2, Regional vascular center, Rostov-on-Don, RUSSIAN FEDERATION3 Background: Large vessel ischemic strokes are associated with poor prognosis in conventional treat-ment. We evaluated the safety and efficacy of the combined use of different endovascular techniques in treating acute stroke. Methods: The prospective analysis of endovascular treatment of 14 patients with acute ischemic stroke was performed. The neurological outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale. Results: The mean patient age was 59.6+/-7.4 years, 12 (85.7%) were males. At admission the me-dian NIHSS score was 17 with a range of 14 to 29. Eight (57.1%) patients had extracranial internal carotid artery occlusion, 4 (28.7%) – occlusion of intracranial ICA, 1 (7.1%) - tandem occlusion of intracranial vertebral and basilar arteries and 1 (7.1%) patient had subtotal stenosis of basilar ar-tery. Five (35.7%) patients underwent intravenous thrombolysis with no clinical effect. Intra-arte-rial thrombolysis was performed in 13 (92.9%) patients, thrombectomy and thrombaspiration – in 8 (57.1%), stenting – in 13 (92.9%). Thirteen (92.9%) patients underwent multimodal intervention. Proximal cerebral protection during endovascular management was used in 12 (85.7%) cases. The mean time from symptom onset to recanalization was 324.3+/-78.6 minutes. The mean procedure time was 54.7+/-32.8 minutes. Recanalization rate with TICI-3 flow was archived in 92.9% of pa-tients. The median NIHSS scores were 10 (range: 6-16) at 24 hours, 6 (range: 0-12) at 1 month, 4 (range: 0-10) at 3 month and 4 (range: 0-8) at 12 months. At 12 months, 71.4% of the patients had a modified Rankin Scale score </= 2. The mortality rate was 7.1%. Conclusions: Multimodal endovascular treatment of acute large vessel ischemic stroke is safe and effective. Combining of different endovascular techniques demonstrated high recanalization rates and was associated with high rate of good outcomes in patients with severe neurologic deficit.
Karger_ESC London_2013
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