Publication details
Systematická evaluace center provádějících mechanické trombektomie u akutního mozkového infarktu v České republice za rok 2016
| Title in English | A Comprehensive Nationwide Evaluation of Stroke Centres in the Czech Republic Performing Mechanical Thrombectomy in Acute Stroke in 2016 |
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| Authors | |
| Year of publication | 2017 |
| Type | Article in Periodical |
| Magazine / Source | Česká a slovenská neurologie a neurochirurgie |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2017-4-4/systematicka-evaluace-center-provadejicich-mechanicke-trombektomie-u-akutniho-mozkoveho-infarktu-v-ceske-republice-za-rok-2016-61403?hl=cs |
| Doi | http://dx.doi.org/10.14735/amcsnn2017445 |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | mechanical thrombectomy; acute stroke; questionnaire; nationwide evaluation |
| Description | Introduction: Mechanical thrombectomy (MT) has been established as a standard of care in acute ischaemic stroke. We systematically evaluated all stroke centres conducting MT in the Czech Republic. Methods: An online questionnaire based on the International Multi-Society Consensus Document was distributed to all such centres to monitor all the procedures in 2016. It includes 64 questions on imaging, logistic and training standards related to MT. Results: Complete data were obtained from all 15 comprehensive stroke centres. Local operating procedures are used in 14 centres. Specialised stroke units are available in all centres, 24/7 CT is available in all centres and 24/7 MRI in 11 centres. Admission imaging in a time window <6 hours includes: CT/CTA in 11, CT/CTA/CTP in 6, MRI/MRA in 2 centres; after 6 hours from the symptoms: CT/CTA is performed in 7, CT/CTA/CTP in 14, MRI/MRA in 5 centres. Early ischaemic changes are evaluated before neuro-intervention in all centres and collaterals are scored in 8 centres. Interventionalists are available 24/7 in all centres. Door-to-groin time <60 min is monitored in 14 and door-to-reperfusion <90 min in 10 centres. Analgosedation is preferred over general anaesthesia in all centres. Fourteen centres enter data into a registry (SITS-TBY). 1,053 MTs (range: 17-136/centre) were performed in 2016. There are 49 neuro-interventional trainees and 64 interventionalists providing MT in 2016. Conclusion: The Czech Republic has a high availability of expertise to perform MT in acute ischaemic stroke. Nevertheless, there is a high variability among the centers. Thus, the next step should be regular quality monitoring and evaluation of patients' data. |