Ces radiol. 2022, 76(1):14-17 | DOI: 10.55095/CesRadiol2022/002

Mechanical thrombectomy technique in the treatment of large cerebral artery occlusion in the Czech Republic in 2021Original article

Antonín Krajina¹, Filip Cihlář², Petr Duras³, Jakub Hustý⁴, Miroslav Chochola⁵, Ladislava Janoušková⁶, Tomáš Jonszta⁷, Boris Kožnar⁸, Martin Köcher⁹, Jiří Lacman¹⁰, Michal Polovinčák¹¹, Jindřich Sova¹², Miroslav Šercl¹³, Martin Válka¹⁴, Jiří Vaniček¹⁵

¹ Radiologická klinika LF UK a FN, Hradec Králové

² Radiologická klinika FZS UJEP, Krajská zdravotní a.s. - Masarykova nemocnice o.z., Ústí nad Labem

³ Klinika zobrazovacích metod LF UK a FN, Plzeň

⁴ Klinika radiologie a nukleární medicíny LF MU a FN, Brno

⁵ II. interní klinika kardiológie a angiologie 1. LF UK a VFN, Praha

⁶ Radiodiagnostické oddělení, Nemocnice Na Homolce, Praha

⁷ Radiodiagnostický ústav FN, Ostrava

⁸ III. interní klinika LF UK a FNKV, Praha

⁹ Radiologická klinika LF UP a FN, Olomouc

¹⁰ Radiodiagnostické oddělení ÚVN, Praha

¹¹ Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha

¹² Radiologické oddělení, Nemocnice České Budějovice

¹³ Radiologické oddělení, Krajská nemocnice Liberec a.s.

¹⁴ Iktové centrum, Vítkovická nemocnice Ostrava

¹⁵ Klinika zobrazovacích metod FN u sv. Anny a LF MU, Brno

Aim: Based on an annual questionnaire, an analysis of the techniques used in endovascular recanalization of large cerebral artery occlusions in the treatment of acute ischemic stroke (AIS) in 2021 was performed.

Method: In 2022, all centres of highly specialised cerebrovascular care and 2 primary centres in the Czech Republic were surveyed. The structured questionnaire in the section on endovascular procedures for AIS focused on the number of patients thrombectomized, the proportion of procedures where technically only a stent retriever was used versus a combination of stent retriever and aspiration catheter, and the number of procedures where only an aspiration catheter was used. The numbers of acutely implanted extra- and intracranial stents in these procedures and the percentage of balloon guiding catheters used were also queried.

Results: Mechanical thrombectomy was performed in 1439 patients in 2021, of whom between 70 and 147 patients were treated in 13 comprehensive cerebrovascular centres, and 41 and 49 patients were treated in two ict centres. The ratio of stentretriever : stentretriever + aspiration catheter : aspiration catheter combination techniques used was approximately 0,8 : 1 : 0,6. A total of 114 extracranial stents (per centre ranging from 0-19) and 19 intracranial stents (per centre ranging from 0-6) were implanted acutely. Overall, a stent was acutely implanted in 11.8% of patients. Balloon catheters were used in 55% of the procedures.

Conclusion: The surveyed parameters show that the number of patients treated endovascularly for iCMP in the Czech Republic in 2021 slightly decreased (to 99.3% in 2020), the number of procedures in complex centres differed by up to two times. The stent were acutely implanted in 11.8% procedures. The technique of flow arrest in the access artery was used in about 55% of procedures.

Keywords: interventional neuroradiology, carotid angioplasty, stroke, mechanical thrombectomy, aspiration thrombectomy, stentretriever

Grants and funding:

Práce byla podpořena výborem České společnosti intervenční radiologie.

Accepted: March 18, 2022; Published: March 1, 2022  Show citation