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The University of Maryland Medical Center Comprehensive Stroke Center provides many acute therapies for patients. The following are outcomes of our patients who received these therapies between January and December 2017.
IV Alteplase is a clot busing medication we provide stroke patients. One of the complications for IV Alteplase is bleeding into the brain, often referred to as a symptomatic hemorrhage.
At UMMC the symptomatic hemorrhage rate is < 3% (24 patients January-December 2017). The national average symptomatic hemorrhage rate after receiving IV Alteplase should be less than 6.4% which is reported in the hallmark IV Alteplase to treat stroke trials.
NINDS Study Group. Tissue Plasminogen Activator for Acute Ischemic Stroke. N Engl J Med; 19953333:1581-1588
Sometimes a large clot in one of the blood vessels in the brain may cause a stroke. Sometimes a stroke patient may have a procedure called a mechanical thrombectomy to remove the clot. The procedure is performed by a specialty trained doctor called an Interventional Neuroradiologst. The procedure involves placing a thin catheter into the brain to remove the clot. Serious complications from this procedure may include having a new stroke or damaging a blood vessel by having it tear during a procedure.
A good outcome for stroke patients who have a mechanical thrombectomy procedure is a TICI grade of 2b or 3. The TICI stands for thrombolysis in cerebral infarction. The TICI grade is used to describe how well the blood flows in the treated blood vessel after having a mechanical thrombectomy procedure.
At UMMC after having a post mechanical thrombectomy the symptomatic hemorrhage rate was 2% (n=98) compared to the reported hemorrhage rate in reported in studies which is 7% (Defuse Trial, Albers et al.).*
The serious complication rate for patients having a mechanical thrombectomy was < 1% (1/98).
The accepted national serious complication rates for patients having a mechanical thrombectomy rate is 2% (Defuse Trial, Albers et al.).*
At UMMC for 4th quarter Oct-December 2017 the 78% (18/23) of the TICI scores were 2b-3 compared to the national accepted rate of 76% reported in clinical trials (Defuse Trial, 2018, Albers et al.).*
G.W. Albers, M.P. Marks, S. Kemp, S. Christensen, J.P. Tsai, S. Ortega‑Gutierrez, for the DEFUSE 3 Investigators et al . Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. NEJM January 24, 2018. DOIL10.1056/NEJMoa1713973