Prise en charge de l'AVC ischémique à la phase aiguë en Basse-Normandie : étude descriptive et analyse des facteurs limitant l'accès à la thrombectomie mécanique

Abstract : Introduction: since the advent of mechanical thrombectomy (MT), the AVC pathway has been profoundly reworked. The aim of this work is to describe the management of patients during the acute phase of an ischemic stroke in Lower Normandy and to investigate the factors limiting access to MT. Method: we carried out a retrospective multicenter study on patients thrombolyzed for cerebral infarction, from January 2016 to September 2017, at the University Hospital of Caen, in the peripheral UNVs and tele-thrombolysis centers. Results: among the 297 patients included, 63.5% benefited from a pre-hospital regulation, which improved the Door To Needle (DTN) significantly (p <0.01). The median DTN was 80 minutes; it was longer in the tele-thrombolysis centers (p <0.01). Only 16.4% of patients had a DTN <60 minutes. The radiological diagnosis error rate was 25.1% .168 patients (56.6%) had an indication of MT, 72 (42.8%) benefited from the procedure. Patients were more frequently thrombectomized when managed at the CHU than in the peripheral UNVs (p <0.01). The main factors limiting access to MT were the non-evocation of the indication (36% of cases) and the radiological diagnosis error (32% of cases). Conclusion: this work is the first to compile all the data of patient's management during the acute phase of a cerebral infarction in Lower Normandy. It demonstrates the need to improve the training of personnel involved in the care of these patients, in order to optimize the access time to thrombolysis and to improve the rate of MT.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [53 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02103851
Contributor : Ufr Santé Unicaen <>
Submitted on : Thursday, April 18, 2019 - 6:18:43 PM
Last modification on : Tuesday, May 21, 2019 - 1:37:54 AM

File

Braud Florent.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02103851, version 1

Citation

Florent Braud. Prise en charge de l'AVC ischémique à la phase aiguë en Basse-Normandie : étude descriptive et analyse des facteurs limitant l'accès à la thrombectomie mécanique. Médecine humaine et pathologie. 2018. ⟨dumas-02103851⟩

Share

Metrics

Record views

9

Files downloads

45