Journal de colonne vertébrale et de neurochirurgie

Endovascular Treatment of Acute Ischemic Stroke beyond 6 Hours after Symptoms Onset: A Single Centre Experience

Orazio Buonomo, Antonio Armando Caragliano, Rosario Papa, Antonio Pitrone, Mariano Velo, Cristina Dell’Aera, Angela Alibrandi, Serena Giovanna Martorana, Agostino Tessitore, Marcello Longo and Sergio Lucio Vinci

Background: Ischemic stroke is characterized by the sudden onset of neurologic symptoms related to the occlusion of cerebral vessels. Recently, some randomized clinical trials have demonstrated the effectiveness of mechanical arterial revascularization within 6 hours after the symptoms onset, getting through patient’s selection and the new endovascular devices. Purpose: Our aim is to characterize the factors that may influence the endovascular treatment, in order to extent the therapeutic time window. Results: 69 patients were treated beyond 6 hours from symptoms onset. The median time to treatment was 8.3 hours. Successful recanalization was achieved in the 85%. At discharge the median NIHSS score was 12. At 3 months the modified Ranking score 0-2 was achieved in the 33.3%, with a mortality rate of 26%. Conclusion: Our experience evaluates the role of endovascular therapy beyond 6 h after stroke onset secondary to a strict imaging guided selection of the patients, which is essential to achieve good clinical results.

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