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Słowik A, Wnuk M, Brzegowy P, Chrzanowska-Waśko J, Golenia A, Łasocha B, Włoch-Kopeć D, Ferens A, Serednicki W, Jarocki P, Bartosik-Psujek H, Kaczorowski R, Filip E, Grzegorzak M, Homa J, Darocha J, Dudek D, Guz W, Rejdak K, Luchowski P, Wojczal J, Sojka M, Górnik M, Stachowicz S, Jaworski J, Buraczyńska K, Ficek R, Szczepańska-Szerej A, Jargiełło T, Szczerbo-Trojanowska M, Lasek-Bal A, Puz P, Warsz-Wianecka A, Stęposz A, Ziaja K, Kuczmik W, Urbanek T, Ziaja D, Tomalski W, Kobayashi A, Richter P, Płoński A, Kotkowski M, Czepiel W, Kurkowska-Jastrzębska I, Sienkiewicz-Jarosz H, Członkowska A, BłażejewskaHyżorek B, Ryglewicz D, Konopko M, Brelak E, Antecki J, Szydłowski I, Włosek M, Stępień A, Brzozowski K, Staszewski J, Piasecki P, Zięcina P, Wołoszyńska I, Kolmaga N, Narloch J, Hasiec T, Gawłowicz J, Pędracka M, Porębiak J, Grzechnik B, Matsibora V, Frąszczak M, Leus M, Mazgaj M, Palacz-Duda V, Meder G, Skura W, Płeszka P, Świtońska M, Słomiński K, Kościelniak J, Sobieszak-Skura P, Konieczna-Brazis M, Rowiński O, Opuchlik A, Mickielewicz A, Szyluk B, Szczudlik P, Kostera-Pruszczyk A, Jaworski M, Maciąg R, Żyłkowski J, Adamkiewicz B, Szubert W, Chrząstek J, Raźniewski M, Pawelec A, Wilimborek P, Wagner R, Pilarski P, Gierach P, Baron J, Gruszka W, Ochudło S, Krzak-Kubica A, Rudzińska-Bar M, Zbroszczyk M, Smulska K, Arkuszewski M, Różański D, Koziorowski D, Meisner-Kramarz I, Szlufik S, Zaczyński A, Kądziołka K, Kordecki K, Zawadzki M, Ząbek M, Karaszewski B, Gąsecki D, Łowiec P, Dorniak W, Gorycki T, Szurowska E, Wierzchowska-Cioch E, Smyk T, Szajnoga B, Bachta M, Mazurek K, Piwowarska M, Kociemba W, Drużdż A, Dąbrowski A, Glonek M, Wawrzyniak M, Kaźmierski R, Juszkat R, Tomalski W, Heliosz A, Ryszczyk A, Zwiernik J, Wasilewski G, Tutaj A, Dałek G, Nosek K, Bereza S, Lubkowska K, Kamienowski J, Sobolewski P, Bielecki A, Miś M, Miś M, Krużewska-Orłowska M, Kochanowicz J, Mariak Z, Jakoniuk M, Turek G, Łebkowska U, Lewszuk A, Kordecki K, Dziedzic T, Popiela T. Mechanical thrombectomy in acute stroke - Five years of experience in Poland. Neurol Neurochir Pol 2017; 51:339-346. [PMID: 28756015 DOI: 10.1016/j.pjnns.2017.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 05/13/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b-TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0-2 - in 31.4% and mRS of 6 in 22% of cases. CONCLUSION Our results can help harmonize standards for MT in Poland according to international guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Edward Filip
- Clinical Voivodeship Hospital, No. 2, Rzeszów, Poland.
| | | | - Jarosław Homa
- Clinical Voivodeship Hospital, No. 2 Rzeszów, Poland.
| | | | - Daniel Dudek
- Clinical Voivodeship Hospital, No. 2 Rzeszów, Poland.
| | - Wiesław Guz
- Medical Faculty University of Rzeszów, Poland.
| | | | | | | | | | - Michał Górnik
- Independent Public Clinical Hospital, Lublin, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adam Kobayashi
- Institute of Psychiatry and Neurology of Warsaw, Poland.
| | | | | | | | | | | | | | | | | | | | | | - Edyta Brelak
- Voivodeship Integrated Hospital in Kielce, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcin Leus
- State Specialistic Hospital in Lublin, Poland.
| | | | - Violetta Palacz-Duda
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Grzegorz Meder
- Department of Interventional Radiology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Wojciech Skura
- Department of Interventional Radiology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Piotr Płeszka
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Milena Świtońska
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Krzysztof Słomiński
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Józef Kościelniak
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Paulina Sobieszak-Skura
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Magdalena Konieczna-Brazis
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | | | | | | | | | | | | | | | | | | | - Bożena Adamkiewicz
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Wojciech Szubert
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Jarosław Chrząstek
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Marek Raźniewski
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Agnieszka Pawelec
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Paweł Wilimborek
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Ryszard Wagner
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Paweł Pilarski
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Paweł Gierach
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Jan Baron
- Medical University of Silesia, Poland.
| | | | | | | | | | - Miłosz Zbroszczyk
- Department of Radiodiagnostic and Invasive Radiology, The University Clinical Centre, Medical University of Silesia, Poland.
| | - Kamila Smulska
- Department of Radiodiagnostic and Invasive Radiology, The University Clinical Centre, Medical University of Silesia, Poland.
| | | | - Dorota Różański
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Poland.
| | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Poland.
| | | | - Stanisław Szlufik
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Poland.
| | - Artur Zaczyński
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Krzysztof Kądziołka
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Kazimierz Kordecki
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Michał Zawadzki
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Mirosław Ząbek
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Bartosz Karaszewski
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Dariusz Gąsecki
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Paweł Łowiec
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Waldemar Dorniak
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Tomasz Gorycki
- Department of Radiology, Medical University of Gdansk, Poland.
| | - Edyta Szurowska
- 2 nd Department of Radiology, Medical University of Gdansk, Poland.
| | | | - Tomasz Smyk
- Voivodeship Public Hospital, Zamość, Poland.
| | | | | | | | | | - Wojciech Kociemba
- Neuroradiology, Department University of Medical Sciences in Poznan, Poland.
| | - Artur Drużdż
- Multidisciplinary Municipal Hospital, Poznań, Poland.
| | | | - Michał Glonek
- Voivodeship Specialistic Neuropsychiatric Complex, Opole, Poland.
| | | | - Radosław Kaźmierski
- Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, Poland.
| | - Robert Juszkat
- Department of General and Interventional Radiology, Poznan University of Medical Sciences, Poland.
| | | | - Adam Heliosz
- Voivodeship Hospital, No 2, Jastrzębie Zdrój, Poland.
| | - Adam Ryszczyk
- Voivodeship Hospital, No 2, Jastrzębie Zdrój, Poland.
| | - Jacek Zwiernik
- University of Warmia and Mazury in Olsztyn, Faculty of Medical Sciences, Department of Neurology and Neurosurgery, Poland.
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