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Journal of Korean Neurosurgical Society 2011;50(4): 311-316.
doi: https://doi.org/10.3340/jkns.2011.50.4.311
The Comparison of Outcome between Thromboaspiration and Aggressive Mechanical Clot Disruption in Treating Hyperacute Stroke Patients.
Hyun Goo Lee, Jong Kook Rhim, Yoon Hee Kim, Seung Hun Sheen, Sung Han Oh, Bong Sub Chung
1Department of Neurosurgery, Bundang Jesaeng General Hospital, Seongnam, Korea. pedineur@dmc.or.kr
2Department of Neuroradiology, Bundang Jesaeng General Hospital, Seongnam, Korea.
3Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea.
Stroke is the third leading cause of death in the Republic of Korea. Time is the most important factor in hyperacute stroke. Yet, there had been no protocol for mechanical thrombolysis. We have treated patients with hyperacute stroke by mechanical thrombolysis for 3 years. In current study, we analyzed the outcome of mechanical thrombolysis.
From March 2008 to February 2011, 36 patients were treated with mechanical thrombolysis. Initially we treated the patients by aggressive mechanical clot disruption (AMCD) who were admitted within 6 hours after the symptom onset. If revascularization was not achieved, balloon angioplasty was performed, followed by stenting or temporary endovascular bypass was performed. The result in 15 cases was not so successful. Since then, we started using the thromboaspiration method as the first line treatment of the mechanical thrombolysis.
After using the thromboaspiration, we had better results in recanalization rate, modified Rankin Score (mRS) and reperfusion injury compared to AMCD. The recanalization rate was 80.85%, mRS is 2.85, and there was only 0.09% hemorrhagic formation.
Even though thromboaspiration is not statistically significant due to the limited numbers of patients enrolled in this study, we think it is a good way in mechanical thronbolysis for hyperacute stroke.
Key Words: Aspiration; Mechanical; Stroke; Acute; Thrombolysis
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