RESULTS OF THE IMPLEMENTATION OF STROKE NOVEL TREATMENT METHODS IN THE REGIONAL VASCULAR CENTER OF YAKUTIA IN A TEN-YEAR PERIOD

We studied the results of the implementation of stroke novel treatment methods in a ten-year period in the Regional Vascular Center (Yakutsk). Since the Regional Vascular Center opening in 2011, new stroke treatment methods have been introduced, including intravenous thrombolytic therapy and endovascular thrombectomy for ischemic stroke; microsurgical clipping of ruptured cerebral aneurysms in the acute stage of subarachnoid hemorrhage; microcoil embolization for aneurysms with / without balloon or stent assistance; transcranial surgical treatment of intracerebral non-traumatic hemorrhages, including endoscopic methods; decompressive craniotomy for massive cerebral infarctions; continuous intraventricular pressure monitoring; telemedicine consulting. In the period 2018-2020, at the Regional Vascular Center, the reperfusion of ischemic stroke was provided in 4.1% of the patients, including intravenous thrombolytic therapy in 3.0%, endovascular thrombectomy in 1.1%. Surgical treatment was performed in 35.1% hemorrhagic stroke patients in 2017-2019. Microsurgical clipping for cerebral aneurysms in the acute period of subarachnoid hemorrhage was performed in 51.9%. Microspiral embolization for cerebral aneurysms was performed in 18,4%. Transcranial surgical treatment of intracerebral hemorrhage was performed in 18,9%. The implementation of stroke novel treating methods in the Regional Vascular Center has proved effective. Over the ten-year period, the ischemic stroke hospital mortality significantly decreased from 12.5% in 2007-2009 to 6.5% in 2017-2019 (p < 0,0001; χ2 = 37,676; df = 1; OR = 2,044; 95% CI: 1,621-2,577). The hemorrhagic stroke hospital mortality decreased from 30.6% to 19.8% (p <0,001; χ2 = 22,564; df = 1; OR = 1,790; 95% CI: 1,405-2,279) during this period.

Regional Vascular Center, stroke, thrombolytic therapy, endovascular thrombectomy, microsurgical aneurysm clipping, microspiral embolization of aneurysms, ischemic stroke, hemorrhagic stroke

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