Ces radiol. 2025, 79(2):81-91 | DOI: 10.55095/CesRadiol2025/012

Endovascular treatment of acute ischemic stroke - the results of METRICS II study (Mechanical Thrombectomy Quality endicators Study in Czech Stroke Centers II)Original article

Martin Köcher¹, Daniel Šaňák², Jana Zapletalová³, Vít Buriánek⁴, Filip Cihlář⁵, David Černík⁶, Jan Fiksa⁷, Jakub Hustý⁸, Zuzana Eichlová⁹, Martin Kovář¹⁰, Jiří Lacman¹¹, Radek Pádr¹², Johana Horáková¹³, Jan Raupach¹⁴, Martin Reiser¹⁵, Vladimír Rohan¹⁶, Jindřich Sova¹⁷, Miroslav Šercl¹⁸, Miroslav Škorňa¹⁹, Libor Šimůnek²⁰, Alena Šnajdrová²¹, Martin Šrámek²², Aleš Tomek²³

¹ Radiologická klinika LF UP a FN, Olomouc

² Neurologická klinika LF UP a FN, Olomouc

³ Ústav lékařské biofyziky LF UP a FN, Olomouc

⁴ Klinika zobrazovacích metod LF UK a FN, Plzeň

⁵ Radiologická klinika FZS UJEP a Krajské zdravotní a.s., Ústí nad Labem

⁶ Neurologická klinika FZS UJEP a Krajské zdravotní a.s., Ústí nad Labem

⁷ Radiologické oddělení, Nemocnice České Budějovice

⁸ Klinika radiologie a nukleární medicíny LF MU a FN, Brno

⁹ Neurologické oddělení, Krajská nemocnice Liberec a.s.

¹⁰ Neurologické oddělení, Nemocnice Na Homolce, Praha

¹¹ Radiodiagnostické oddělení, Ústřední vojenská nemocnice, Praha

¹² Klinika zobrazovacích metod 2. LF UK a FN, Praha

¹³ 2. interní klinika 1. LF UK a VFN, Praha

¹⁴ Radiologická klinika LF UK a FN, Hradec Králové

¹⁵ Neurologické oddělení, Nemocnice České Budějovice

¹⁶ Neurologická klinika LF UK a FN, Plzeň

¹⁸ Radiodiagnostické oddělení, Krajská nemocnice Liberec a.s.

¹⁹ Neurologická klinika LF MU a FN, Brno

²⁰ Neurologická klinika LF UK a FN, Hradec Králové

²¹ Radiodiagnostické oddělení, Nemocnice Na Homolce, Praha

²² Neurologické oddělení, Ústřední vojenská nemocnice, Praha

²³ Neurologická klinika 2. LF UK a FN, Praha Korespondenční adresa:

Aim: The Czech Republic is among the leading countries in Europe in the number of mechanical thrombectomy (MT) procedures for symptomatic large vessel occlusion (LVO) in patients with acute ischemic stroke per population. The aim of this study was to evaluate the current outcomes of acute ischemic stroke treatment and the development of treatment quality indicators in the Czech Republic based on the analysis of data from the METRICS II study (Mechanical Thrombectomy Quality Indicators Study in Czech Stroke Centres II). The secondary aim of the study was to subanalyze the cohort in terms of the MT technique used and its impact on the success of recanalisation of the LVO.

Methods: The national prospective observational study METRICS II was conducted in the Czech Republic from 1 January 2023 to 31 December 2023. Eleven of the 15 centres performing MT participated in the study. All technical and clinical data were collected prospectively. The results of ischemic stroke treatment were then compared with the recommended values of the individual parameters of the multidisciplinary consensus and the results of the METRICS study ongoing in 2019. Data related to the actual technique of MT in the anterior circulation were subanalyzed and statistically processed for the effect of the technique used on the success of recanalization of the LVO.

Results: Data from 11 centres in which mechanical thrombectomy was performed on a total of 1312 patients (51.1% male) with a mean age of 70.9 years (SD ± 12.7) were analysed. IV thrombolysis prior MT was performed in 894 (68.2%) patients and 426 (32.5%) patients were transferred secondarily for MT from primary stroke centers to dedicated comprehensive centers. Data obtained from the national prospective observational METRICS II study were evaluated as a whole and for individual centers. The concordance of results with the recommendations of multi-society consensus was very high. Seven centers met the parameters of all recommendations. The remaining centers failed to meet only isolated criteria and only marginally. Statistical

Keywords: acute ischemic stroke, mechanical thrombectomy, indicators of quality of care, stent-retriever, aspiration.

Accepted: February 16, 2025; Published: June 6, 2025  Show citation