Influence of technically successfull mechanical thrombectomy on the clinical outcome in patients with acute ischemic stroke treated in CHC Rijeka : Bachelor thesis

Moždani udar (MU) je stanje poremećaja cirkulacije u krvnim žilama mozga te predstavlja jedan od najčešćih uzroka smrtnosti i invaliditeta u Europi i svijetu. Poznate su dvije vrste MU, hemoragijski te ishemijski. Ishemijski MU je znatno češći, a posljedica je okluzije cerebralne arterije s posljedičnom pojavom ishemije zbog onemogućene opskrbe mozga kisikom i hranjivim tvarima. Kod sumnje na akutni ishemijski możdani udar (AIMU) provodi se brzi CT protokol pretraga. Ukoliko nalaz potvrdi okluziju krvne žile kao uzrok akutne cerebralne ishemije, bolesnici se podvrgavaju jednoj od dvije metode liječenja AIMU-a, intravenskoj trombolizi ili mehaničkoj trombektomiji. Cilj: Utvrditi povezanost tehnički uspješno izvedenog zahvata mehaničke trombektomije na klinički ishod bolesnika liječenih od akutnog ishemijskog moždanog udara u KBC-u Rijeka. Utvrditi utječe li dob bolesnika na klinički ishod kod provedene mehaničke trombektomije. Materijali: Pretraživanjem bolničkih baza podataka (ISSA i IBIS) retrospektivno su prikupljeni podaci o 131 bolesniku koji su bili podvrgnuti zahvatu mehaničke trombektomije u razdoblju od 1. siječnja 2020. do 31. prosinca 2021. godine, u KBC-u Rijeka. Rezultati: Od ukupno 131 provedenih zahvata MT, njih 50 (38,17 %) nije tehnički uspješno provedeno od kojih je 47 bolesnika (35,88 %) rezultiralo lošim kliničkim ishodom, a 3 bolesnika (2,29 %) dobrim kliničkim ishodom. Kod 81 bolesnika, odnosno 61,83 % slučajeva ostvarena je potpuna rekanalizacija intrakranijskih arterija, a povoljan klinički uspjeh kod tih bolesnika je uočen u 53 slučaja (40,46 %). Podjelom bolesnika prema dobi potvrđene su tvrdnje o učestalosti MU kod osoba starije životne dobi (67,94 %) u odnosu na osobe mlađe životne dobi (32,06 %). Kod osoba starijih od 65 godina uočen je porast nepovoljnih kliničkih ishoda, no nije se pokazao značajnim. Zaključak: Rezultati provedenog istraživanja mogu se komparirati s rezultatima ostalih autora i potvrditi već postavljene i dokazane tvrdnje vezane uz MU i ishod provedene MT. Dokazno je da uspješnost MT utječe na klinički ishod bolesnika liječenih od akutnog ishemijskog moždanog udara te da učestalost MU raste porastom dobi, no sama dob ne utječe na klinički ishod bolesnika.Stroke is a condition described as a circulatory disturbance of the brain vessels and the leading source of mortality and disability in Europe and worldwide. There are two types of strokes, hemorrhagic and ischemic stroke (AIS). Ischemic stroke is much more frequent, and it is caused by the occlusion of the cerebral artery and consequent appearance of ischemia due to disabled brain's supply with oxygen and nutrients. If there is any suspicion on acute ischemic stroke, stroke CT protocol should be performed immediately. When the findings are positive, the patient undergoes one of the following methods of AIS treatment, intravenous thrombolysis or mechanical thrombectomy. Objective: To determine the relationship between a technically successfully performed MT procedure and the clinical outcome of patients treated for AIS at CHC Rijeka. To determine whether the patient's age affects the clinical outcome after MT was performed. Materials: By searching hospital databases (ISSA and IBIS) the data of 131 patients who underwent mechanical thrombectomy at CHC Rijeka, during the period between January 1, 2020, and December 31, 2021, were collected retrospectively. Results: Out of a total of 131 performed MT procedures, 50 of them (38.17 %) were not technically successfully performed, of which 47 patients (35.88 %) resulted in a poor clinical outcome, and 3 patients (2.29 %) in a good clinical outcome. Complete recanalization of intracranial arteries was achieved in 81 patients, i.e., 61.83% of cases, and favorable clinical success in these patients was observed in 53 cases (40.46%). The division of patients according to age confirmed the claims about the frequency of AIS in older people (67.94 %) compared to younger people (32.06 %). An increase in unfavorable clinical outcomes was observed in people over 65 years of age, but it did not prove to be significant. Conclusion: The results of the conducted research can be compared with the results of other authors and confirm the already stated and proved claims related to stroke and MT outcomes. It has been proven that the success of MT affects the clinical outcome of patients treated for AIS and that the frequency of stroke increases with age but does not affect the clinical outcome of patients