EXPERIENCE OF USE OF MODERN THERAPEUTIC METHODS OF ISCHEMIC STROKE IN THE REGIONAL CENTER OF CEREBROVASCULAR DISEASE №2 IN NOVOKUZNETSK
Main Article Content
Abstract
Objective – demonstration of the effective using of modern techniques in the treatment of ischemic stroke by the work of the regional center of cerebrovascular disease in Novokuznetsk.
Methods. There is an analysis of the use of intravenous thrombolytic therapy and thromboextraction in patients with verified ischemic stroke. Thrombolytic therapy was carried out with «Actilyse». The dose was calculated of 0.9 mg per 1 kg of patient's weight. Thromboextraction was performed using stent retrievers «Solitaire» or suction system «Penumbra».
Results. For the period from 2011 to 2021, there were performed 445 procedures of intravenous thrombolytic therapy at the regional center of cerebrovascular disease N 2. The proportion of patients with TLT procedure ranges from 10.1 % to 12.3 % in different years. The severity of neurological deficit according to the NIHSS scale before the IV TLT procedure averaged 15.6 ± 7.3 points, and at discharge it was 8.1 ± 6.4 points. It was possible to reduce the mortality rate among patients undergoing TLT from 15.5 % to 4.5 % due to more careful selection of patients in recent years. Also in 2019 the procedure of mechanical recanalization (thrombextraction) was performed in 15 patients, 2020 – 17 patients, 2021 – 8 patients. The use of this method made it possible to reduce the severity of neurological deficit from an average of 18.1 ± 6.3 points to 6.5 ± 4.2 points.
Conclusions. When used in practical medicine, TLT and TE have shown high efficiency in the treatment of stroke. The growth in the use of these techniques is due to a number of reasons: 1) transportation of the patient to the nearest vascular center for specialized care; 2) the arrival of young specialists who are ready to apply modern methods of treatment to the department; 3) close cooperation with ambulance workers; 4) use of a special telephone connection from the patient's bed; 5) continuity in the work of medical services – laboratory, radiation, endovascular surgery, neurosurgery; 6) raising awareness of the population about the symptoms of stroke.
Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Samorodskaia IV, Zairat’yants OV, Perkhov VI, Andreev EM, Vaĭsman DSh. Trends in stroke mortality rates in Russia and the USA over a 15-year period. Arkhiv Patologii. 2018; 80(2): 30-37. Russian (Самородская И.В., Зайратьянц О.В., Перхов В.И., Андреев Е.М., Вайсман Д.Ш. Динамика показателей смертности населения от острого нарушения мозгового кровообращения в России и США за 15-летний период //Архив патологии. 2018. Т. 80, № 2. С. 30-37)
Peganova MA, Chechenin AG, Vereshchagin MA, Peganov AI, Pisareva IA, Bondarenk NA. Successful experience of thrombectomy in postpartum period. Far Eastern Medical Journal. 2019; 1: 91-93. Russian (Пеганова М.А., Чеченин А.Г., Верещагин М.А., Пеганов А.И., Писарева И.А., Бондаренко Н.А. Успешный опыт тромбэктомии при окклюзии левой позвоночной артерии у женщины в послеродовом периоде //Дальневосточный медицинский журнал. 2019. № 1. С. 91-93)
Khasanova DR. Staged thrombolysis. Advantages and difficulties. International Congress dedicated to World Stroke Day: Mater. congress. M: OOO Buki-Vedi, 2017. P. 409. Russian (Хасанова Д.Р. Этапный тромболизис. Преимущества и сложности //Международный конгресс, посвященный Всемирному дню инсульта: Матер. конгресса. М.: ООО «Буки-Веди», 2017. С. 409)
Report on the state of disability in the Russian Federation. M., 2020. 174 p. (Доклад о состоянии инвалидности в Российской Федерации. М., 2020. 174 с.)
Skvortsova VI, Shetova IM, Kakorina EP, Kamkin EG, Boyko EL, Dashyan VG, Krylov VV. Healthcare system for patients with stroke in Russia. Results of 10-years implementation of the measures aimed at improvement of medical care for patients with acute cerebrovascular events. Annals of clinical and experimental neurology. 2018; 12(3): 5-12. Russian (Скворцова В.И., Шетова И.М., Какорина Е.П., Камкин Е.Г., Бойко Е.Л., Дашьян В.Г., Крылов В.В. Организация помощи пациентам с инсультом в России. Итоги 10 лет реализации Комплекса мероприятий по соdершенствованию медицинской помощи пациентам с острыми нарушениями мозгового кровообращения. //Анналы клинической и экспериментальной неврологии. 2018. Т. 12, № 3. С. 5-12)
Resolution of the Government of the Kemerovo Region - Kuzbass of June 27, 2019 N 384 «On approval of the regional program «Management of cardiovascular diseases for 2019-2024» (as amended on May 31, 2021) (as amended by the decrees of the Government of the Kemerovo region – Kuzbass dated 09/27/2019 N 560, dated 01/24/2020 N 28, dated 05/31/2021 N 283). 173 p. Russian (Постановление Правительство Кемеровской Области – Кузбасса от 27 июня 2019 года N 384 «Об утверждении региональной программы «Борьба с сердечно-сосудистыми заболеваниями на 2019-2024 годы» (с изменениями на 31 мая 2021 года) (в ред. постановлений Правительства Кемеровской области – Кузбасса от 27.09.2019 N 560, от 24.01.2020 N 28, от 31.05.2021 N 283. 173 с.)
Ahmed N, Hermansson K, Bluhmki E, et al. The SITS-UTMOST: A registry-based prospective study in Europe investigating the impact of regulatory approval of intravenous Actilyse in the extended time window (3-4.5 h) in acute ischaemic stroke. European Stroke Journal. 2016; 1(3): 213-221