Mechanical Thrombectomy for Acute Ischemic Stroke in Czech Republic: Technical Results from the Year 2016

Köcher, Martin; Šaňák, Daniel; Zapletalová, Jana; Cihlář, Filip; Czerný, Daniel; Černík, David; Duras, Petr; Endrych, Ladislav; Herzig, Roman; Lacman, J.; Lojík, Miroslav; Ostrý, Svatopluk; Pádr, Radek; Rohan, Vladimír; Škorňa, Miroslav; Šrámek, Martin; Štěrba, Luděk; Václavík, Daniel; Vaníček, Jiří; Volný, Ondřej; Tomek, Aleš

doi:10.1007/s00270-018-2068-z

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…In 2005, results from a third population-based stroke registry in Estonia indicated a decline in stroke incidence and 28-day case fatality rates starting from the preceding decade [12]. The Czech Republic was also very consistent in the development of a national stroke plan [14,15], stroke prevention [15,16], case registering [17,18], and effective stroke management [19][20][21][22][23][24]. A noticeable stroke burden decline was also found in Slovenia and Hungary [25,26].…”

Section: Discussionmentioning

confidence: 99%

Trends in Stroke Burden in Central and Eastern Europe from 1990–2019

Докова

Feigin

2022

Neuroepidemiology

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Introduction: There has been wide recognition of the health divide between Western Europe and the former socialist countries from Central and Eastern Europe. However, these have not been assessed in terms of burden of disease, and the effect of stroke has not been fully elucidated, especially in terms of time trends. Methods: The West-Eastern European stroke burden was analysed using data from the Global Burden of Stroke (GBD) Study 2019 in terms of disability-adjusted life years lost (DALYs) and years of life lost (YLL) over the period 1990–2019 by gender. Data were extracted on a regional (West, Central, and East Europe) and country level for the twenty former socialist countries from Central and East Europe according to GBD regional definitions. We focused on the trends of age-standardized stroke DALY rates across the three decades and compared them with the average rates for West Europe. Main Findings: All Central and East European countries experienced a decline in all-cause disease burden between 1990 and 2019, and a gap was confirmed between the East, the Central, and the West European region for men but not for women. The age-standardized stroke DALY rates declined in the three European regions and in all twenty Central and East European countries but at a different pace. The stroke DALY rates among women exhibited the greatest decline in the West −59% (95% UI [−60; −57]) followed by the Central European region −48% (95% UI [−53; −42]) and lowest among women in East Europe −37% (95% UI [−43; −29]). The decline in men was even higher than among women −61% (95% UI [−63; −60]), while in Central Europe it was −43% (95% UI [−50; −37]) and in the East −25% (95% UI [−34; −14]), leading to widening of the gap between East, Central, and West Europe in relation to stroke burden. YLL represented more than 70% of stroke DALYs and more than 90% of DALYs for men in East European countries. Conclusions: The burden of stroke contributes to the European health gap through preventable premature stroke deaths. There are some very successful countries in stroke burden management from both Central (Slovenia, Czech Republic, and Hungary) and East Europe (Estonia), suggesting that closing the health gap between East and West is a realistic aim.

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Section: Discussionmentioning

confidence: 99%

Trends in Stroke Burden in Central and Eastern Europe from 1990–2019

Докова

Feigin

2022

Neuroepidemiology

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“…Several other registries on EVT for ischemic stroke can be compared with our data. 6,26,27 In general, baseline characteristics, workflow times, intravenous thrombolysis administration rates, reperfusion rates, and outcomes are similar. However, no trends over time have been reported in these studies.…”

Section: Discussionmentioning

confidence: 93%

Improvements in Endovascular Treatment for Acute Ischemic Stroke: A Longitudinal Study in the MR CLEAN Registry

Compagne

Kappelhof

Hinsenveld

et al. 2022

Stroke

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Background: We evaluated data from all patients in the Netherlands who underwent endovascular treatment for acute ischemic stroke in the past 3.5 years, to identify nationwide trends in time to treatment and procedural success, and assess their effect on clinical outcomes. Methods: We included patients with proximal occlusions of the anterior circulation from the second and first cohorts of the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry (March 2014 to June 2016; June 2016 to November 2017, respectively). We compared workflow times and rates of successful reperfusion (defined as an extended thrombolysis in cerebral infarction score of 2B-3) between cohorts and chronological quartiles (all included patients stratified in chronological quartiles of intervention dates to create equally sized groups over the study period). Multivariable ordinal logistic regression was used to assess differences in the primary outcome (ordinal modified Rankin Scale at 90 days). Results: Baseline characteristics were similar between cohorts (second cohort n=1692, first cohort n=1488) except for higher age, poorer collaterals, and less signs of early ischemia on computed tomography in the second cohort. Time from stroke onset to groin puncture and reperfusion were shorter in the second cohort (median 185 versus 210 minutes; P <0.001 and 236 versus 270 minutes; P <0.001, respectively). Successful reperfusion was achieved more often in the second than in the first cohort (72% versus 66%; P <0.001). Functional outcome significantly improved (adjusted common odds ratio 1.23 [95% CI, 1.07–1.40]). This effect was attenuated by adjustment for time from onset to reperfusion (adjusted common odds ratio, 1.12 [95% CI, 0.98–1.28]) and successful reperfusion (adjusted common odds ratio, 1.13 [95% CI, 0.99–1.30]). Outcomes were consistent in the analysis per chronological quartile. Conclusions: Clinical outcomes after endovascular treatment for acute ischemic stroke in routine clinical practice have improved over the past years, likely resulting from improved workflow times and higher successful reperfusion rates.

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“…Interventional radiologists have been partners with neurointerventional radiologists, endovascular neurosurgeons, and interventional neurologists in acute intervention for stroke (AIS) since the inception of EVT. Vascular/IR physicians who were not trained in formal neurointerventional fellowships have historically provided and continue to provide EVT in substantial numbers with good outcomes, comparable to those achieved by neurointerventional physicians during similar years (29)(30)(31)(32)(33)(34)(35). A recent survey of the Joint Commission (JC) PSCs found that 60% of the responding PSCs performed EVT, and, of these, 41% relied on IR physicians to provide this care (26).…”

Section: Evt Training Backgroundmentioning

confidence: 99%

Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment

Sacks

AbuAwad

Ahn

et al. 2019

Journal of Vascular and Interventional Radiology

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Mechanical Thrombectomy for Acute Ischemic Stroke in Czech Republic: Technical Results from the Year 2016

Abstract: Despite achieved good overall results, a great variability in some of the analyzed key time intervals among individual centers performing MT warrants further quality improvement.

Cited by 7 publications

References 20 publications

Trends in Stroke Burden in Central and Eastern Europe from 1990–2019

Trends in Stroke Burden in Central and Eastern Europe from 1990–2019

Improvements in Endovascular Treatment for Acute Ischemic Stroke: A Longitudinal Study in the MR CLEAN Registry

Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment

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