Experience of reperfusion therapy of ischemic stroke in the Regional Stroke Center

Abstract

Introduction. Modern methods of recanalization — systemic thrombolytic therapy (STT) and mechanical thrombectomy (MT) — allow restoring blood fl ow in the brain tissue in ischemic stroke (IS).Purpose of the study: to analyze the effectiveness of IS reperfusion therapy methods used in the Regional Stroke Center (RSC) of the Tomsk Regional Clinical Hospital from 2017 to 2022.Material and methods. A retrospective evaluation of 666 analyzed cases of specific therapy for IS was performed: 505 cases of STT (67 [59.0; 75.0] years), 126 cases of MT (69 [60.5; 77.5] years), 35 cases a combination of STT followed by MT (69 [63.0; 76.7] years).Results. The severity of neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS) before the intervention was greater in the MT and STT + MT groups (18 [14.0; 25.0] and 18 [14.5; 20.0] points) relative to patients who received STT (11 [8.0; 16.0] and 4 [2.0; 10.0]). Mortality in the MTE group was (64/127, 50.8%) and was higher compared to patients who received STT (104/505, 20.6%, p < 0.001). In the group of patients who underwent combined intervention with STT + MT (9/27, 25.7%), there was a trend towards lower mortality (p = 0.050) compared with isolated MT.Conclusion. A trend towards fewer deaths was found when using a combined intervention in the treatment of IS compared with isolated MT, which may indicate a higher effi ciency of bridging-therapy.