J Korean Neurosurg Soc.  2011 Oct;50(4):311-316. 10.3340/jkns.2011.50.4.311.

The Comparison of Outcome between Thromboaspiration and Aggressive Mechanical Clot Disruption in Treating Hyperacute Stroke Patients

• Lee HG
• Rhim JK
• Kim YH
• Sheen SH
• Oh SH
• Chung BS

• KMID: 2190388
• DOI: http://doi.org/10.3340/jkns.2011.50.4.311

Abstract

OBJECTIVE
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.

Keyword

Aspiration; Mechanical; Stroke; Acute; Thrombolysis

MeSH Terms

Angioplasty, Balloon
Cause of Death
Humans
Mechanical Thrombolysis
Reperfusion Injury
Republic of Korea
Stents
Stroke