The Present State of Neuroendovascular Treatment in Miyako Islands —Regional Activities to Spread Endovascular Therapy in Sakishima Islands—

Abstract

Objective: Miyako islands is located about 300 km south east of Naha, with a population of about 54600. There are over a 100000 people in Sakishima islands. It is hard to transport all critical patients to the central of Okinawa because it takes several hours for the helicopter transportation with many human effort, and they are tend to be treated there. We report the state of neuroendovascular treatment in Miyako islands before and after the arrival of the certified neuroendovascular doctor, and the regional activities to spread endovascular therapy in Sakishima islands.

Methods: Cases of neuroendovascular treatment were retrospectively examined in the first period (from September/2013 to march/2016) and the second period (from April/2016 to September/2018) in Okinawa Miyako Hospital.

Results: The ratio of neuroendovascular cases in all neurosurgery cases increased from 5.9% (11/188 cases) in the first period to 13.6% (24/176 cases) in the second period because the difficult cases for direct surgery were treated mainly by endovascular treatment in the second period. As for the recanalization therapy for acute ischemic stroke, door-to-puncture time (median 137 min vs 217 min, p = 0.01), and puncture-to-recanalization time (median 67 min vs 112 min, p = 0.01) significantly decreased in the second period. Because of the connection with the Okinawa Yaeyama Hospital, three cases with subarachnoid hemorrhage were treated.

Conclusion: Neuroendovascular treatment plays an important role in Sakishima islands. Certified neuroendovascular doctor is needed to be there for the future progress.