Article ID: oa.2018-0004
Objective: We report here the current status of mechanical thrombectomy performed in the Tama region of the Tokyo metropolitan area.
Methods: The Tama region, with a population of about 4.3 million, comprises the western half of Tokyo metropolis. Mechanical thrombectomy in the region is performed by a limited number of specialists, in a limited number of centers. To make mechanical thrombectomy more available throughout the region, several efforts are underway. Creation of a study seminar for mechanical thrombectomy (Tama Forum of Acute ischemic Stroke Therapy: Tama-FAST), sharing of information, initiation of a multicenter registration of mechanical thrombectomy (Tama-REgistry of Acute endovascular Thrombectomy: TREAT), and educating emergency service personnel.
Results: There are 44 acute stroke centers in the region, of which 33 provide intravenous tissue-plasminogen activator (t-PA), and of which 13 perform mechanical thrombectomy. A triannual study seminar, which started 3 years ago, resulted in a close relationship between health care providers, leading to a better coordination between hospitals for acute neurosurgical care. We have started a multicenter registration from April 2017, with over 600 patients registered at this point, and with data analysis planned in the future.
Conclusion: In the Tama region, many patients are already being transported to hospitals providing mechanical thrombectomy, making them function in essence as stroke care centers. In the future, taking regional characteristics into account, efforts should be made to maximize the opportunities of mechanical thrombectomy, like the creation of an emergency transport system that gives priority to patients potentially in need of endovascular treatment.
