Management Of Acute Ischemic Strokes In A Tertiary Health Facility: The Role For Mechanical Thrombectomy

Abstract

Introduction: Ischemic strokes are a major source of morbidity and mortality and account for more than half of all the stroke cases in Kenya. It has a high mortality and morbidity. However, mechanical thrombectomy has emerged as an effective treatment method in select patients. We present our outcomes as the region’s only stroke center that offers mechanical thrombectomy. Methods: We retrospectively reviewed 29 files of patients who had anterior circulation ischemic strokes with a large vessel cut-off from July 2016 to Dec 2021. Our primary outcome was the Modified Rankin Score at 6 months post discharge. An MRS score of 2 or less was considered a favorable outcome.  Results: 90% (n=26) of all thrombectomy patients survived to discharge and 68% (n=20) of them remained functionally independent at 6 months. While 6.8% of the patients had asymptomatic hemorrhagic transformation, neurological deterioration post thrombectomy was significantly associated with poor outcomes and occurred in 27% (n=8) of patients. Conclusion: Mechanical thrombectomy is available in the region and it significantly improves functional outcomes may be particularly important in agrarian societies such as ours where manual labor remains the main source of income.