Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study
Özet
Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neurointerventional therapy in Turkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0-2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 +/- 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 +/- 6; hospital stay, 24 +/- 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 +/- 13 years; NIHSS: 14.1 +/- 6.5; length of hospital stay, 33 +/- 31 days), 19% in those who received combined treatment (age: 66 +/- 14 years; NIHSS: 15.6 +/- 5.4; length of hospital stay, 26 +/- 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 +/- 13 years; NIHSS: 7.6 +/- 7.2; length of hospital stay, 21 +/- 28 days). The symptom-to-door time was 87 +/- 53 minutes in the IV treatment group and 200 +/- 26 minutes in the neurointerventional group. The average door-to-needle time was 66 +/- 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 +/- 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0-2 was 41%, while the rate of mRS 0-1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0-2 was 31% and mRS 0-1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 +/- 107 and 95 +/- 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Turkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the "Directive on Health Services to be Provided to Patients with Acute Stroke."
Atıf için künye
TOPÇUOĞLU, M. A., ÖZDEMİR, A. Ö., ARSAVA, E. M., Gunes, A., AYKAÇ, Ö., Gencer, E. S., Cabalar, M., Yayla, V., Erdogan, H. A., Erdogan, M., Acar, Z. O., GİRAY, S., KABLAN, Y., Tanriverdi, Z., Tekan, U. Y., Asil, T., Akpinar, C. K., YÜREKLİ, V. A., Acar, B., … ÖZTÜRK, Ş. (2023). Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study. TURKISH JOURNAL OF NEUROLOGY, 29(4), 249–255. https://doi.org/10.4274/tnd.2023.70292
BibTeX
@article{topcuoglu2023-229061,
author = {TOPÇUOĞLU, MEHMET AKİF and ÖZDEMİR, ATİLLA ÖZCAN and ARSAVA, ETHEM MURAT and Gunes, Aygul and AYKAÇ, ÖZLEM and Gencer, Elif Sarionder and Cabalar, Murat and Yayla, Vildan and Erdogan, Haci Ali and Erdogan, Mucahid and Acar, Zeynep Ozdemir and GİRAY, SEMİH and KABLAN, YÜKSEL and Tanriverdi, Zeynep and Tekan, Ulgen Yalaz and Asil, Talip and Akpinar, Cetin Kursad and YÜREKLİ, Vedat Ali and Acar, Bilgehan and ŞİRİN, HADİYE and GÜLER, AYŞE and BAYDEMİR, RECEP and Akcakoyunlu, Merve and Ocek, Levent and ÇETİNER, MUSTAFA and NAZLIEL, BİJEN and BATUR ÇAĞLAYAN, HALE ZEYNEP and Ongun, Nedim and Eren, Alper and Arlier, Zulfikar and Cenikli, Utku and GÖKÇE, MUSTAFA and Bavli, Songul and YAKA, ERDEM and ÖZKUL, AYÇA and Degirmenci, Bahar and Aluclu, Ufuk and TOGAY IŞIKAY, CANAN and Aslanbaba, Eda and SORGUN, MİNE HAYRİYE and AYTAÇ, EMRAH and AY, HALİL and Kunt, Refik and Senadim, Songul and Unsal, Yaprak Ozum and Eskut, Neslihan and ALİOĞLU, ZEKERİYA and Yilmaz, Arda and Genc, Hamit and Yilmaz, Ayse and Milanoglu, Aysel and Gurkas, Erdem and Degirmenci, Eylem and Bektas, Hesna and Ilgezdi, Irem and BİLGİÇ, ADNAN BURAK and Akyol, Senol and Gungor, Levent and Kale, Nilufer and Coban, Eda and YEŞİLOT, Nilüfer and EKİZOĞLU TURGUT, Esme and Kizek, Ozgu and Kursun, Oguzhan and KAYIM YILDIZ, ÖZLEM and BOLAYIR, ASLI and Kisabay, Aysin and Bastan, Birguel and Acar, Zeynep and Niflioglu, Buket and Guven, Bulent and KAYA, Dilaver and AFSAR, NAZİRE and Yazici, Duran and Toplutas, Eren and Ozkan, Esra and Ilik, Faik and Ince, Fatma Birsen and Buyukserbetci, Gulseren and Onder, Halil and KARADELİ, HASAN HÜSEYİN and KOZAK, HASAN HÜSEYİN and Demirbas, Hayri and MİDİ, İPEK and Aydin, Isa and Epceliden, M. Tuncay and Atmaca, Murat Mert and BAKAR, HACI MUSTAFA and Sen, Mustafa and TURGUT, NİLDA and Keskin, Onur and Akdogan, Ozlem and Emre, Ufuk and Bilgili, Ozlem and Sirinocak, Pinar Bekdik and Yevgi, Recep and Akkas, Sinem Yazici and Yoldas, Tahir and Duman, Taskin and Ozel, Tugba and ÜNAL, ALİ and DORA, BABÜR and Atasoy, Tugrul and ÇİNAR, BİLGE PİRİ and Demir, Tulin and DEMİR, TURGAY and Can, Ufuk and Aslan, Yildiz and Bas, Demet Funda and Sener, Ufuk and Yilmaz, Zahide and Bozdogan, Zehra and ÖZDEMİR, GÖKHAN and Krespi, Yakup and ÖZTÜRK, ŞEREFNUR},
title = {Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study},
journal = {TURKISH JOURNAL OF NEUROLOGY},
year = {2023},
volume = {29},
number = {4},
pages = {249--255},
issn = {1301-062X},
doi = {10.4274/tnd.2023.70292},
url = {https://akademik.atauni.edu.tr/yayinlar/229061-acute-stroke-management-in-turkiye-intravenous-tissue-plasminogen-activator-and}
}