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Master Thesis

Mise en place de la filière de thrombectomie mécanique pour la prise en charge des accidents vasculaires cérébraux ischémiques sur le centre hospitalier de la côte basque : retour sur les six premiers mois de fonctionnement de la filière

Abstract : Introduction: mechanical thrombectomy (TM) is an effective therapy for the management of some type of strokes. Public access to this technique must be improved and new centers are thus created. Method: this retrospective study focused on patients treated on thrombolysis/thrombectomy alert in the emergency department of Centre Hospitalier de la Côte Basque in Bayonne, over the first six months of operation of our new TM sector, from March to August 2019. The main objective was to compare our practices with the quality and good practice objectives defined by the HAS (IPAQSS). The secondary objectives were to assess our sector in more detail and look for areas for improvement (call center and in emergency department). Results: 244 patients were included, 128 were men (52%), with a median age of 80 years. 45 patients received a TM. None of patients with thrombectomy were able to call rescue themselves. Use of LAMS score in regulation could be relevant. Average picture times were 39 min. for CT (median to 38 min.) and 52 min. for MRI (median to 52 min.). The start time of the signs was known and traced in 95% of the files (233/244), the capillary glycemia carried out in 99% of the cases (242/244) and the NIHSS calculated for 92% of the situations (225/244). The rate of neurovascular expertise for these patients was 97% (236/244). Conclusion: the first six months of activity in our sector show satisfactory and encouraging results for the future. On all the main evaluation criteria retained by the HAS, our performances are higher than the national averages. A more detailed study of emergency care reveals practices comparable to the standards of our reference hospital (Bordeaux) and to national references, while highlighting limits and areas for improvement.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03099872
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, January 6, 2021 - 1:01:27 PM
Last modification on : Friday, January 29, 2021 - 3:10:24 AM
Long-term archiving on: : Wednesday, April 7, 2021 - 7:57:26 PM

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Thomas Charabas. Mise en place de la filière de thrombectomie mécanique pour la prise en charge des accidents vasculaires cérébraux ischémiques sur le centre hospitalier de la côte basque : retour sur les six premiers mois de fonctionnement de la filière. Médecine humaine et pathologie. 2020. ⟨dumas-03099872⟩

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