Current Status of Treatment for Acute Large Vessel Occlusion Stroke in Awaji Island Area after the Introduction of Endovascular Treatment

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  • Mizowaki Takashi
    Department of Neurosurgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo, Japan
  • Nakahara Masahiro
    Department of Neurosurgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo, Japan
  • Fujita Atsushi
    Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
  • Sakagami Yoshio
    Department of Neurosurgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo, Japan
  • Kohmura Eiji
    Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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<p>Objective: We retrospectively analyzed the current status of treatment for anterior circulation large vessel occlusion (LVO) in island areas with a high population aging rate.</p><p>Methods: We investigated 62 consecutive patients with ischemic stroke due to acute anterior circulation LVO between October 1, 2017 and June 30, 2019.</p><p>Results: In all, 26 (41.1%) patients underwent endovascular treatment (EVT). The successful recanalization rate of EVT was 88.5% (23/26). There was a significant difference in the age (median, 75.5 years vs. 81 years, respectively, P = 0.0411) and the rate of intravenous tissue plasminogen activator (tPA) therapy (53.5% vs. 11.1%, respectively, P <0.001) between the EVT group and the non-EVT group. Patients in the EVT group achieved a favorable outcome more frequently than those in the non-EVT group (50% vs. 11.1%, respectively, P = 0.0012). In the analysis based on the place of onset among the three cities comprising Awaji Island and the four groups with in-hospital onset, there was no significant difference in the rate of EVT, and the outcome of the in-hospital onset group was poor. Among the EVT group, there was a significant difference in the pre-treatment National Institutes of Health Stroke Scale score (median, 15 vs. 19, respectively, P = 0.0237) and time from onset to recanalization (O2R; median, 240 min vs. 323 min, respectively, P = 0.0128) between the favorable outcome group and the unfavorable outcome group.</p><p>Conclusion: Even in an island area, it is possible to complete the treatment of ischemic stroke due to LVO within the regional medical area.</p>

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 14 (4), 126-132, 2020

    特定非営利活動法人 日本脳神経血管内治療学会

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