Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Remarks on the Concept of Defects of Consent in Polish and French Law

The aim of the article is to present the basic principles of the Polish and French law which determined the regulation of defects of consent in each of the legal orders. Firstly, the views of both systems on the concept of declaration of will, without which it is impossible to understand the construction of defects of consent, are presented. Next, the concepts of defects of consent adopted by the two systems are presented: normative in Polish law and psychological in French. The values protected by the construction of defects of consent are also identified and discussed. The general differences between the two systems in terms of the code regulation of such defects are explained. The reason for the consideration of the title issue is the reform of the French law of obligations made by the 2016 ordonnance which also included the regulation of defects of consent. It has been accompanied by a lively discussion that has enriched the body of French academic writings with new statements regarding the regulation of defects of consent.Artykuł ma na celu przedstawienie podstawowych założeń ustawodawców polskiego i francuskiego, które zadecydowały o ukształtowaniu regulacji wad oświadczenia woli w każdym z porządków prawnych. W pierwszej kolejności zaprezentowane zostały zapatrywania obu systemów na pojęcie oświadczenia woli, bez którego rozważenia nie sposób zrozumieć konstrukcji wad oświadczenia woli. Następnie przedstawione zostały koncepcje wad oświadczenia woli przyjęte w dwu systemach: normatywna w prawie polskim i psychologiczna w prawie francuskim. Zidentyfikowane i omówione zostały również wartości chronione przez konstrukcję wad oświadczenia woli. Wyjaśnione zostały nadto ogólne różnice w kodeksowym unormowaniu tych wad w obu systemach. Asumpt do podjęcia rozważań nad tytułowym zagadnieniem stanowi reforma francuskiego prawa zobowiązań dokonana ordonansem z 2016 r., która objęła również regulację wad oświadczenia woli. Towarzyszyła jej żywa dyskusja, która wzbogaciła dorobek doktryny francuskiej o nowe wypowiedzi dotyczące unormowania wad oświadczenia woli

Mechanical thrombectomy in acute stroke : five years of experience in Poland

Objectives: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250 99 min. 90.3% of the studied patients had MT within 6 h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0–2 - in 31.4% and mRS of 6 in 22% of cases. Conclusion: Our results can help harmonize standards for MT in Poland according to international guideline