BACKGROUND: Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. METHODS: Available nationwide data for the CR from 2016 from the Safe Implementation of Treatments in Stroke-Thrombectomy (SITS-TBY) registry for patients with terminal internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusions were compared with data from HERMES. CR and HERMES patients were comparable in age, sex, and baseline National Institutes of Health Stroke Scale scores. RESULTS: From a total of 1053 MTs performed in the CR, 845 (80%) were reported in the SITS-TBY. From these, 604 (72%) were included in this study. Occlusion locations were as follows (CR vs HERMES): ICA 22% versus 21% (P=0.16), M1 MCA 62% versus 69% (P=0.004), and M2 MCA 16% versus 8% (P<0.0001). Intravenous thrombolysis was given to 76% versus 83% of patients, respectively (P=0.003). Median onset to reperfusion times were comparable: 232 versus 285 min, respectively (P=0.66). A modified Thrombolysis in Cerebral Infarction score of 2b/3 was achieved in 74% (433/584) versus 71% (390/549) of patients, respectively (OR 1.17, 95% CI 0.90-1.5, P=0.24). There was no statistically significant difference in the percentage of parenchymalhematoma type 2 (OR 1.12, 95% CI 0.66-1.90, P=0.68). A modified Rankin Scale score of 0-2 at 3 months was achieved in 48% (184/268) versus 46% (291/633) of patients, respectively (OR 0.92, 95% CI 0.71-1.18, P=0.48). CONCLUSIONS: Data on efficacy, safety, and logistics of MT from the CR were similar to data from the HERMES collaboration.

Department of Medical Imaging St Anne's University Hospital and Faculty of Medicine Masaryk University Brno Czech Republic

Department of Neurology Charles University 1st Faculty of Medicine and General University Hospital Prague Czech Republic

Department of Neurology Charles University 2nd Medical Faculty Prague Czech Republic

Department of Neurology Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Department of Neurology Faculty of Medicine in Pilsen Charles University Prague Pilsen Czech Republic

Department of Neurology Hospital Ceske Budejovice Statutory City Czech Republic

Department of Neurology Military University Hospital Prague Canada

Department of Neurology Na Homolce Hospital Prague Czech Republic

Department of Neurology Palacky University Medical School Olomouc Czech Republic

Department of Neurology St Anne's University Hospital and Faculty of Medicine Masaryk University Brno Czech Republic

Department of Neurology University Hospital Ostrava Faculty of Medicine University Ostrava Ostrava Czech Republic

Department of Radiology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital Usti nad Labem Czech Republic

Department of Radiology Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Department of Radiology Masaryk Hospital Usti nad Labem Czech Republic

Department of Radiology University Hospital and Palacky University Medical School Olomouc Czech Republic

Departments of Clinical Neurosciences Radiology and Community Health Sciences Cumming School of Medicine University of Calgary Calgary Canada

International Clinical Research Centre Stroke Research Program St Anne's University Hospital Brno Czech Republic

Neurocentre Regional Hospital Liberec Liberec Czech Republic

References provided by Crossref.org

Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries

Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke

Urgent Middle Cerebral Artery Embolectomy of Calcified Embolus After Intravenous Thrombolysis: 2-Dimensional Operative Video

Comparison of Mechanical Thrombectomy with Contact Aspiration, Stent Retriever, and Combined Procedures in Patients with Large-Vessel Occlusion in Acute Ischemic Stroke