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Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa
Introduction: Mechanical thrombectomy (MT) is standard of care for acute ischemic stroke from large vessel occlusion following randomized controlled trials performed largely in high-income countries. Limited data exists on its effectiveness in the real-world setting, particularly in low- and middle-...
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| Format: | Thesis |
| Language: | English English |
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Division of General Surgery
2025
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| _version_ | 1867613196135694336 |
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| access_status_str | Open Access |
| author | Kiriinya, Martin |
| author2 | Taylor, Allan |
| author_browse | Kiriinya, Martin Taylor, Allan |
| author_facet | Taylor, Allan Kiriinya, Martin |
| author_sort | Kiriinya, Martin |
| collection | Thesis |
| description | Introduction: Mechanical thrombectomy (MT) is standard of care for acute ischemic stroke from large vessel occlusion following randomized controlled trials performed largely in high-income countries. Limited data exists on its effectiveness in the real-world setting, particularly in low- and middle-income countries. We aimed to evaluate the safety and efficacy of MT in a public hospital in Cape Town, South Africa. Methods: We evaluated acute ischaemic stroke patients presenting consecutively to Groote Schuur Hospital between 01 January 2018 to 01 January 2022 with proximal intracranial occlusion in the anterior circulation treated with MT within 6 hours from onset using CT and CTA imaging-based protocols. Demographic, clinical, radiological and procedural data were obtained from the stroke unit database. Recanalization was evaluated post-procedure by modified Treatment in Cerebral Infarction score (mTICI). We assessed functional independence (modified Rankin scores (mRS) 0-2) and mortality at 90 days. Results: Thrombectomies were performed in 84 patients during the study period. The median age was 56 years and 51% of participants were female. Median National Institute of Health Stroke Score was 18 and median baseline Alberta Stroke Programme Early CT score was 8. Bridging thrombolysis was given to 65% of participants. Median time from symptom onset to reperfusion was 339 minutes. Successful recanalization (mTICI 2b/3) was obtained in 62%. At 90 days, 34 % of participants reached functional independence and mortality was 34% . Conclusions: We achieved similar rates of recanalization and functional independence to that seen in trials in high-income countries using basic imaging despite a higher mortality and longer median time to reperfusion. These data support the effectiveness of MT in a public hospital in south Africa despite the challenges of providing emergent stroke care in a resource-constrained setting. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41710 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:32:17.361Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41710 Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa Kiriinya, Martin Taylor, Allan Bateman, Kathleen Le Feuvre, David Mechanical thrombectomy Groote Schuur Hospital Introduction: Mechanical thrombectomy (MT) is standard of care for acute ischemic stroke from large vessel occlusion following randomized controlled trials performed largely in high-income countries. Limited data exists on its effectiveness in the real-world setting, particularly in low- and middle-income countries. We aimed to evaluate the safety and efficacy of MT in a public hospital in Cape Town, South Africa. Methods: We evaluated acute ischaemic stroke patients presenting consecutively to Groote Schuur Hospital between 01 January 2018 to 01 January 2022 with proximal intracranial occlusion in the anterior circulation treated with MT within 6 hours from onset using CT and CTA imaging-based protocols. Demographic, clinical, radiological and procedural data were obtained from the stroke unit database. Recanalization was evaluated post-procedure by modified Treatment in Cerebral Infarction score (mTICI). We assessed functional independence (modified Rankin scores (mRS) 0-2) and mortality at 90 days. Results: Thrombectomies were performed in 84 patients during the study period. The median age was 56 years and 51% of participants were female. Median National Institute of Health Stroke Score was 18 and median baseline Alberta Stroke Programme Early CT score was 8. Bridging thrombolysis was given to 65% of participants. Median time from symptom onset to reperfusion was 339 minutes. Successful recanalization (mTICI 2b/3) was obtained in 62%. At 90 days, 34 % of participants reached functional independence and mortality was 34% . Conclusions: We achieved similar rates of recanalization and functional independence to that seen in trials in high-income countries using basic imaging despite a higher mortality and longer median time to reperfusion. These data support the effectiveness of MT in a public hospital in south Africa despite the challenges of providing emergent stroke care in a resource-constrained setting. 2025-09-08T07:15:09Z 2025-09-08T07:15:09Z 2025 2025-09-08T07:08:05Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41710 en eng application/pdf Division of General Surgery Faculty of Health Sciences University of Cape Town |
| spellingShingle | Mechanical thrombectomy Groote Schuur Hospital Kiriinya, Martin Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa |
| thesis_degree_str | Master's |
| title | Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa |
| title_full | Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa |
| title_fullStr | Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa |
| title_full_unstemmed | Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa |
| title_short | Outcomes of mechanical thrombectomy at a single-centre tertiary level public health care hospital in South Africa |
| title_sort | outcomes of mechanical thrombectomy at a single centre tertiary level public health care hospital in south africa |
| topic | Mechanical thrombectomy Groote Schuur Hospital |
| url | http://hdl.handle.net/11427/41710 |
| work_keys_str_mv | AT kiriinyamartin outcomesofmechanicalthrombectomyatasinglecentretertiarylevelpublichealthcarehospitalinsouthafrica |