Christo Ranguelov
University Hospital Sofiamed, Bulgaria
Title: NS management of ischemic and hemorrhagic stroke- SAH and aneurysm
Biography
Biography: Christo Ranguelov
Abstract
Stroke is still one of the leading healthcare problems worldwide. We present you some important points from our 5 years’ experience. In this retrospective review we analyze a series of about 500 pts with ischemic stroke (IS) treated last 2y at stroke centers in Sofia, so as another 500 pts with hemorrhagic stroke treated at NS Clinic, Sv. Ivan Rilsky Hospital, and Department of Neurosurgery at Sofiamed hospital, Sofia. Bulgaria is a small country and the capital Sofia has about 2 million inhabitants. In NS Clinics there is a tradition with neurosurgical treatment of hemorrhagic stroke and aneurysms, but since year 2011 progressively growing number of endovascular procedures for hemorrhagic stroke and aneurysms: more than 500 pts, incl. 411 aneurysms, 79 brain AVM, 10 spinal AVM. Since year 2015/16 started acute treatment of ischemic stroke at 2 stroke centers, so as endovascular treatment of ischemia. From more than 50000 pts with IS annually 330 are treated with tPA during first 3 h. Recently there are 250 pts with tPa, and 60 with additionally endovascular thrombectomy following initial venous thrombolysis. Inspite of huge number of patients only 1.6% of them can be treated with tPa, and lately with endovascular. Mortality rate among surgical and endovascular treatment of hemorrhagic stroke patients is about 5%, morbidity – 10% Mortality rate in ischemic. We discuss the cause of delay and how to increase further this type of treatment, and how to improve the outcome.