Current Opinion on Endovascular Therapy for Emergent Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Stenosis

For recanalization of emergent large vessel occlusions (ELVOs), endovascular therapy (EVT) using newer devices, such as a stent retriever and large-bore catheter, has shown better patient outcomes compared with intravenous recombinant tissue plasminogen activator only. Intracranial atherosclerotic s...

Full description

Saved in:
Bibliographic Details
Published in:Korean journal of radiology 2019, 20(5), , pp.739-748
Main Authors: Kang, Dong Hun, Yoon, Woong
Format: Article
Language:English
Subjects:
Atherosclerosis
Constriction, Pathologic
Diabetes
Embolisms
Endovascular Procedures - methods
Hemodynamics
Humans
Hyperlipidemia
Intracranial Arteriosclerosis - surgery
Lipids
Medical imaging
Metabolic disorders
Neurointervention
Patients
Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors
Stents
Stroke
Stroke - surgery
Thrombectomy
Thrombosis
Veins & arteries
방사선과학
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:For recanalization of emergent large vessel occlusions (ELVOs), endovascular therapy (EVT) using newer devices, such as a stent retriever and large-bore catheter, has shown better patient outcomes compared with intravenous recombinant tissue plasminogen activator only. Intracranial atherosclerotic stenosis (ICAS) is a major cause of acute ischemic stroke, the incidence of which is rising worldwide. Thus, it is not rare to encounter underlying ICAS during EVT procedures, particularly in Asian countries. ELVO due to underlying ICAS is often related to EVT procedure failure or complications, which can lead to poor functional recovery. However, information regarding EVT for this type of stroke is lacking because large clinical trials have been largely based on Western populations. In this review, we discuss the unique pathologic basis of ELVO with underlying ICAS, which may complicate EVT procedures. Moreover, we review EVT data for patients with ELVO due to underlying ICAS and suggest an optimal endovascular recanalization strategy based on the existing literature. Finally, we present future perspectives on this subject.
ISSN:1229-6929
2005-8330
DOI:10.3348/kjr.2018.0809