Stroke: After analyzing 200,000 people, what is the general situation of mechanical thrombus removal after stroke?

Since the end of 2014, several randomized clinical trials have proved that mechanical thrombectomy can help restore cerebral perfusion in patients with acute ischemic stroke with cerebral vascular occlusion and prevent disability .

However, thrombectomy requires procedural expertise, and not all hospitals have personnel to perform such interventions

In this way, Hooman Kamel of Cornell University and others used population data from 11 states to try to solve the following problems:

(1) What percentage of stroke patients in the United States can undergo thrombectomy?

If an institution has undergone mechanical thrombectomy, it is classified as a hub; if it is transferred to a patient who ultimately undergoes mechanical thrombectomy, the institution is classified as a gateway; otherwise, it is classified as a gap ( gap)

They found that among the 205 681 patients with ischemic stroke, 100 139 (48.

Patients who were initially treated in the gateway were much less likely to undergo thrombectomy than those who were initially treated in the hub (OR=0.

For 93.

The results of the study did not change in the model adjusted for demographics and comorbidities, and remained the same in multiple sensitivity analyses, including analyses that adjusted for estimated stroke severity

The important significance of this study lies in the discovery: Even considering the transfer between hospitals, a considerable number of patients with ischemic stroke in the United States lack thrombectomy, and the stroke treatment system in the United States needs to be further developed to optimize the use of thrombectomy

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