缩小差距：澳大利亚北昆士兰地区和农村地区新的血管内取栓服务的早期经验。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-07-05 DOI:10.1016/j.jstrokecerebrovasdis.2025.108390

Muhammad Usman Manzoor , Abdul Shaik , Awais Farid , Ramon Luis Navarro Balbuena , Ravindra Urkude , Yasir Khattak , Nerida Myers , Lori Mackay , Firas Alnidawi , Rufus Corkill

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引用次数: 0

摘要

背景：血管内血块回收术是大血管闭塞引起的急性缺血性脑卒中的标准治疗方法。然而，在农村和地区，机械取栓的机会仍然有限，那里的患者往往需要转移到城市中心。这些延迟与较差的临床结果直接相关。为了解决这一差距，在澳大利亚北昆士兰的一家地区三级医院建立了机械取栓服务。本研究旨在评估区域性机械取栓的安全性和临床结果。方法：回顾性分析2022年3月至2024年2月在澳大利亚昆士兰州汤斯维尔大学医院（Townsville University Hospital， TUH）连续行机械取栓术的所有患者。根据患者最初的表现，将患者分为两组-本地（TUH）和医院间转院。评估临床结果、手术成功率和并发症。结果：共120例患者，平均年龄71岁；51%男性)行机械取栓术。其中48例（40%）在当地就诊，72例（60%）在医院间转诊。56例患者（47%）获得了良好的功能预后（90天mRS 0-2）。106例（88%）患者手术成功（mTICI评分为2b-3）， 14例（12%）患者出现手术相关并发症。结论：TUH机械取栓服务的建立显著改善了北昆士兰地区和农村人口中风干预的可及性。我们的早期经验表明，临床结果与大型多中心取栓试验报告的结果相当，证实了在区域环境中提供这项服务的可行性和安全性。

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Closing the gap: Early experience from a new Endovascular Thrombectomy service in regional and rural North Queensland, Australia

Background

Endovascular clot retrieval is the standard of care for acute ischemic stroke caused by large vessel occlusion. However, access to mechanical thrombectomy remains limited in rural and regional areas, where patients often require transfer to urban centres. These delays are directly associated with poorer clinical outcomes. To address this disparity, a mechanical thrombectomy service was established at a regional tertiary hospital in North Queensland, Australia. This study aims to evaluate the safety and clinical outcomes of mechanical thrombectomy in a regional setting.

Methods

A retrospective analysis was conducted on all consecutive patients who underwent mechanical thrombectomy at Townsville University Hospital (TUH), Queensland, Australia, between March 2022 and February 2024. Patients were categorized into two groups—local (TUH) and interhospital transfer—based on their initial presentation. Clinical outcomes, procedural success, and complications were assessed.

Results

A total of 120 patients (mean age: 71 years; 51 % male) underwent mechanical thrombectomy. Of these, 48 (40 %) presented locally, while 72 (60 %) were interhospital transfers. A good functional outcome (mRS 0–2 at 90 days) was achieved in 56 patients (47 %). Procedural success (mTICI score 2b–3) was observed in 106 patients (88 %), while 14 patients (12 %) experienced procedure-related complications.

Conclusion

The establishment of a mechanical thrombectomy service at TUH has significantly improved access to stroke intervention for regional and rural populations in North Queensland. Our early experience demonstrates clinical outcomes comparable to those reported in large multicentre thrombectomy trials, confirming the feasibility and safety of delivering this service in a regional setting.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.