AIMS: The aim of this study was to evaluate the role of direct catheter-based thrombectomy (d-CBT, without thrombolysis) and the feasibility and safety of d-CBT performed in an interventional cardiology center. METHODS AND @entity1 : Single center, prospective observational registry based on the prespecified protocol included 3 months follow-up. The decision to perform @entity64 was done by a neurologist based on the clinical and imaging findings. Inclusion criteria were moderate-to-severe acute @entity385 (NIHSS >= 6), <6 hours from symptom onset, no large @entity63 on the admission CT scan and CT evidence for occluded large artery. The primary outcome was functional neurologic recovery (mRs 0-2) at three months. Key secondary outcomes were angiographic recanalisation rate and symptomatic @entity510 . A total of 115 consecutive @entity1 (mean age 66 years) have been enrolled during a period of 4 years, 84 @entity1 underwent d-CBT and 31 @entity1 bridging thrombolysis with immediate catheter intervention (TL-CBT). The annual number of procedures increased from 13 (initial 12 months) to 41 (last 12 months). RESULTS: Angiographic success (TICI flow 2b-3) was 69% after d-CBT and 81% after TL-CBT. It was higher in isolated occlusions of @entity2500 ( @entity2500 , 74% and 100%) or of proximal internal carotid artery (ICA, 80% and 100%), while it was lower in @entity2500 (63% and 70%) and in basilar or @entity432 (57% and 50%). Neurologic recovery (mRS <= 2 after 90 days) was achieved in 40% @entity1 . It was higher (43%) in anterior circulation @entity64 then in posterior circulation @entity64 (25%). Direct CBT lead to neurologic recovery in 36%, while TL-CBT in 52%. Best clinical outcomes (51% and 71% neurologic recovery rates) were achieved among @entity1 with isolated @entity2500 . Any symptomatic @entity510 was present in 3.6% (d-CBT) and 6.5% (TL-CBT).Vessel perforation or major dissection was in 5,2% overall, distal embolization to other territory in 3,5% of @entity1 . CONCLUSIONS: Direct catheter-based thrombectomy may be considered in @entity1 with contraindications for thrombolysis or in @entity1 with very short CT - groin puncture times. A randomized trial is needed to better evaluate the role of direct catheter-based thrombectomy. @entity64 performed in close cooperation of cardiologists, neurologists and radiologists are feasible and safe.

Feasibility and safety of direct catheter-based thrombectomy in the treatment of acute XXXX . Cooperation of cardiologists, neurologists and radiologists. Prospective registry PRAGUE-16.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity64 :: ('MESH:D020521', 'Disease') :: ['acute stroke intervention', 'Acute stroke interventions', 'strokes'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity510 :: ('MESH:D013345', 'Disease') :: ['intracranial bleeding'] @entity2500 :: ('MESH:D020244', 'Disease') :: ['MCA occlusion', 'middle cerebral artery', 'combined ICA+MCA occlusions', 'MCA'] @entity432 :: ('MESH:D001157', 'Disease') :: ['vertebral occlusions'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity385 :: (MESH:D002544,Disease) :: ['ischemic stroke']
