PRELIMINARY RESULTS OF ENDOVASCULAR INTERVENTION IN ACUTE ISCHEMIC STROKE AT THONG NHAT DONG NAI GENERAL HOSPITAL
DOI:
https://doi.org/10.59294/HIUJS20250128Keywords:
acute ischemic stroke, endovascular intervention, mechanical thrombectomy, TICIAbstract
Background: Endovascular intervention has become the standard treatment for acute ischemic stroke caused by large vessel occlusion, offering rapid reperfusion and improved clinical outcomes.
Objectives: To evaluate recanalization outcomes, complications, and associated factors in patients with acute ischemic stroke treated with endovascular intervention. Materials and methods: A retrospective cross-sectional study was conducted on 36 patients with large vessel occlusion who underwent mechanical thrombectomy, with or without intravenous rt-PA, at Thong Nhat Dong Nai General Hospital from October 2024 to October 2025.Results: The mean age was 63.4 ± 13.2 years; 52.8% were male. The most common occlusion sites were the M1 segment (44.4%) and the internal carotid artery (33.3%). The rate of successful reperfusion (TICI 2B-3) was 86.1%, with complete reperfusion (TICI 3) in 83.3% of cases. The mean procedure time was 66.1 minutes. Symptomatic intracranial hemorrhage occurred in 16.6% of patients. The NIHSS score decreased by an average of 4.3 points after 24 hours. Atrial fibrillation (p = 0.042) and procedure time ≤ 60 minutes (p = 0.003) were significantly associated with good recanalization. Conclusions: Endovascular intervention for acute ischemic stroke at Thong Nhat Dong Nai General Hospital achieved a high rate of successful reperfusion with acceptable complication rates, demonstrating feasibility and safety in the initial phase of implementation.
References
[1] WHO MONICA Project Principal Investigators, “The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration,” J. Clin. Epidemiol., vol. 41, no. 2, pp. 105-114, 1988, doi: 10.1016/0895-4356(88)90084-4.
DOI: https://doi.org/10.1016/0895-4356(88)90084-4[2] N. H. Ngọc và D. V. Phương, “Kết quả điều trị lấy huyết khối bằng dụng cụ cơ học ở 138 bệnh nhân thiếu máu não cấp do tắc nhánh lớn động mạch nội sọ,” Tạp chí Y dược lâm sàng 108, vol. 12, pp. 66-71, 2017.
[3] V. Đ. Lưu, “Kết quả ban đầu điều trị nhồi máu não tối cấp bằng dụng cụ lấy huyết khối Solitaire kết hợp tiêu sợi huyết đường động mạch: nhân 2 trường hợp,” Tạp chí Điện quang Việt Nam, vol. 8, pp. 254-260, 2012.
[4] V. V. Lanh, Nghiên cứu kết quả điều trị đột quỵ nhồi máu não cấp do tắc động mạch lớn trong 6 giờ đầu bằng dụng cụ stent Solitaire, Luận án tiến sĩ Trường Đại học Y Hà Nội, 2019.
[5] M. Paciaroni, V. Caso, and G. Agnelli, “The concept of ischemic penumbra in acute stroke and therapeutic opportunities,” Eur. Neurol., vol. 61, no. 6, pp. 321-330, 2009, doi: 10.1159/000210544.
DOI: https://doi.org/10.1159/000210544[6] P. Khatri et al., “Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke: an analysis of data from the IMS III phase 3 trial,” Lancet Neurol., vol. 13, no. 6, pp. 567-574, 2014.
DOI: https://doi.org/10.1016/S1474-4422(14)70066-3[7] D. T. Mai, V. P. Dao, V. C. Nguyen et al., “Low-dose vs. standard-dose intravenous alteplase in bridging therapy among patients with acute ischemic stroke: Experience from a stroke center in Vietnam,” Front. Neurol., vol. 12, p. 466, 2021, doi: 10.3389/fneur.2021.653820.
DOI: https://doi.org/10.3389/fneur.2021.653820[8] P. J. Mitchell et al., “Endovascular thrombectomy versus standard bridging thrombolytic with endovascular thrombectomy within 4.5 h of stroke onset: an open-label, blinded-endpoint, randomized non-inferiority trial,” Lancet, vol. 400, no. 10346, pp. 116-125, 2022, doi: 10.1016/S0140-6736(22)01234-X.
