Complicaciones vasculares durante la trombectomía mecánica en el ictus agudo, una experiencia multicéntrica en España

Resumen

Objetivo Determinar la frecuencia de las complicaciones observadas durante la trombectomía en el ictus isquémico agudo.

Materiales y Métodos Se revisó de forma retrospectiva las trombectomías realizadas en nuestra institución cuando los ictus isquémicos tuvieron una indicación de tratamiento endovascular. Se registraron los diferentes dispositivos utilizados en ese periodo de tiempo y si presentaron relación con el desarrollo de las complicaciones inmediatas mediante arteriografía.

Resultados De un total de 228 casos, se registraron complicaciones en el 16,6% de los casos. Se identificaron embolias (n = 31), hemorragias subaracnoideas (n = 2), hemorragia gangliobasal (n = 1), vasoespasmo (n = 1), disección (n = 1) y peusoaneurismas (n = 2). La embolia a nuevos territorios se presentó solo en 5 casos.

Discusión El tratamiento endovascular ha demostrado ser efectivo para la recanalización en oclusión de gran vaso. El uso de dispositivos presume un riesgo por la manipulación de los vasos.

Conclusión La embolia fue la complicación más frecuente. El tratamiento endovascular en el ictus genera un desenlace clínico favorable de los pacientes, al mismo tiempo, el bajo porcentaje de complicaciones que encontramos no suponen una afectación negativa en el desenlace final.

Abstract

Purpose To determine the complications we observed during thrombectomy in acute ischemic stroke.

Materials and Methods We reviewed retrospectively thrombectomies performed in our institution when endovascular treatment for stroke was done. The different devices used in this period of time were recorded and we determined if these were related to the development of immediate complications during the procedure visualized in arteriography.

Results We had 228 cases, complications were found in 16.6% of the cases. Embolisms (n = 31), subarachnoid hemorrhages (n = 2), gangliobasal hemorrhage (n = 1), vasospasm (n = 1), dissection (n = 1) and peusoaneurysms (n = 2) were identified. 5 embolisms happened to new territories during thrombectomy.

Discussion Endovascular treatment has been shown to be effective for recanalization in large vessel occlusion. The use of devices presumes a risk for the manipulation of the vessels.

Conclusion Embolism was the most frequent complication. The endovascular treatment in the acute stroke produces a favorable clinical outcome of the patients and we found a low percentage of complications that would not suppose a negative affectation in the final outcome.

Palabras Clave

accidente cerebrovascular - trombectomía - embolia - hemorragia cerebral

Keywords

stroke - thrombectomy - embolism - cerebral hemorrhage

Responsabilidades Éticas

Protección de personas y animales. Los autores declaran que para esta investigación no se han realizado experimentos en seres humanos ni en animales.

Confidencialidad de los datos. Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicación de datos de pacientes.

Derecho a la privacidad y consentimiento informado. Los autores declaran que en este artículo no aparecen datos de pacientes.

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