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Recent trials have extended the therapeutic time window for MT to within 24 h. However, MT treatment remains low in remote areas. Nagasaki Prefecture, Japan has many inhabited islands with no neurointerventionalists. Our hospital on the mainland is a regional hub for eight island hospitals. We evaluated clinical outcomes of MT for patients with AIS on these islands versus on the mainland. Methods: During 2014–2019, we reviewed consecutive patients with AIS who received MT at our hospital. Patients comprised the Islands group and Mainland group. Patient characteristics and clinical outcomes were compared between groups. Results: We included 91 patients (Islands group: 15 patients, Mainland group: 76 patients). Seven patients (46.7%) in the Islands group versus 43 (56.6%) in the Mainland group achieved favorable outcomes. Successful recanalization was obtained in 11 patients (73.3%) on the islands and 67 (88.2%) on the mainland. The median OTP time in the Islands was 365 min. 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Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy
http://hdl.handle.net/10069/00040494
http://hdl.handle.net/10069/000404945d24582a-1394-445f-89d1-9cd9cee2dce0
名前 / ファイル | ライセンス | アクション |
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PLoS16_0245082.pdf (733.7 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2021-02-03 | |||||
タイトル | ||||||
タイトル | Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Hiu, Takeshi
× Hiu, Takeshi× Morimoto, Shimpei× Matsuo, Ayaka× Satoh, Kei× Otsuka, Hiroaki× Kutsuna, Fumiya× Ozono, Keisuke× Hirayama, Kosuke× Nakamichi, Chikaaki× Yamasaki, Kazumi× Ogawa, Yuka× Shiozaki, Eri× Morofuji, Yoichi× Kawahara, Ichiro× Horie, Nobutaka× Tateishi, Yohei× Ono, Tomonori× Haraguchi, Wataru× Izumo, Tsuyoshi× Tsujino, Akira× Matsuo, Takayuki× Tsutsumi, Keisuke |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Mechanical thrombectomy (MT) is standard treatment for acute ischemic stroke (AIS) with large-vessel occlusion within 6 h of symptom onset to treatment initiation (OTP). Recent trials have extended the therapeutic time window for MT to within 24 h. However, MT treatment remains low in remote areas. Nagasaki Prefecture, Japan has many inhabited islands with no neurointerventionalists. Our hospital on the mainland is a regional hub for eight island hospitals. We evaluated clinical outcomes of MT for patients with AIS on these islands versus on the mainland. Methods: During 2014–2019, we reviewed consecutive patients with AIS who received MT at our hospital. Patients comprised the Islands group and Mainland group. Patient characteristics and clinical outcomes were compared between groups. Results: We included 91 patients (Islands group: 15 patients, Mainland group: 76 patients). Seven patients (46.7%) in the Islands group versus 43 (56.6%) in the Mainland group achieved favorable outcomes. Successful recanalization was obtained in 11 patients (73.3%) on the islands and 67 (88.2%) on the mainland. The median OTP time in the Islands was 365 min. In both the Islands and Mainland groups, the OTP time and successful recanalization were associated with functional outcome. The modified Rankin Scale (mRS) score at 90 days ≤2 was obtained in two patients and mRS = 3 in four patients among eight patients with OTP time >6 h. Conclusions: Few patients with AIS on remote islands have received MT. Although patients who underwent MT on the islands had longer OTP, the clinical outcomes were acceptable. OTP time on remote islands must be shortened, as this is related to functional outcome. In some cases with successful recanalization, a favorable outcome can still be obtained even after 6 h. Even if OTP exceeds 6 h, it is desirable to appropriately select patients and actively perform MT. | |||||
書誌情報 |
PLOS ONE 巻 16, 号 1, p. e0245082, 発行日 2021-01-19 |
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出版者 | ||||||
出版者 | Public Library of Science | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1932-6203 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1371/journal.pone.0245082 | |||||
権利 | ||||||
権利情報 | © 2021 Hiu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | PLOS ONE, 16(1), e0245082; 2021 |