Endovascular Treatment of Acute Stroke with Major Vessel Occlusion before Approval of Mechanical Thrombectomy Devices in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) and JR-NET 2
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概要
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The aim of this study was to clarify the general status and historical transition of endovascular therapy (EVT) of acute stroke with major vessel occlusion before approval of mechanical thrombectomy devices in Japan from January 2005 to December 2009. We extracted 1,409 acute ischemic stroke patients receiving EVT (513 women, 69.8 ± 11.8 years) from two nationwide registry studies, the Japanese Registry of Neuroendovascular Therapy (JR-NET) and JR-NET 2. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 18, and 81.3% of the patients received EVT within 6 hours after symptom onset. The culprit occluded arteries were the internal carotid artery (ICA) in 21.2%, middle cerebral artery (MCA) in 53.0%, and basilar artery (BA) in 20.6%. Intravenous thrombolysis was administered to 6.7% of the patients, and EVT mainly consisted of intra-arterial thrombolysis and percutaneous balloon angioplasty/balloon clot disruption. The final recanalization rate was 82.5%, and the clinical outcome was favorable in 35.8% and fatal in 11.6% at 30 days after onset or at discharge. There was no significant change in neurological severity at baseline throughout the study period, but the onset-to-treatment time became longer and the proportion of ICA or BA occlusion increased annually. Although the final recanalization rate was similar throughout the study period, the incidence of a favorable outcome tended to decreased annually from 41.0% to 29.0%. These results could be considered as baseline data that can be used to validate the beneficial effects of novel EVT devices in Japan.
- 社団法人 日本脳神経外科学会の論文
著者
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Matsumaru Yuji
Department Of Endovascular Neurosurgery Toranomon Hospital
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Toyoda Kazunori
Department Of Cerebrovascular Disease And Clinical Research Institute National Kyushu Medical Center
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Yamagami Hiroshi
Department Of Neurology Stroke Center Kobe City Medical Center General Hospital
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Hayakawa Mikito
Department Of Endovascular Neurosurgery Toranomon Hospital
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Sakai Nobuyuki
Department Of Applied Chemistry Faculty Of Engineering The University Of Tokyo
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Yoshimura Shinichi
Department of Molecular Life science (Cell Biology Division), Tokai University School of Medicine
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YOSHIMURA Shinichi
Department of Neurosurgery, Gifu University
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HAYAKAWA Mikito
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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