Current status of mechanical thrombectomy for acute stroke treatment

Summary Acute ischemic stroke is a morbid and disabling medical condition with a significant social and economic impact throughout the world. Intravenous thrombolysis (IVT) has been the first line treatment for patients presenting up to 4.5 hours after symptom onset for many years. Endovascular stro...

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Bibliographic Details
Published in:Journal of neuroradiology 2015-02, Vol.42 (1), p.12-20
Main Authors: Pereira, Vitor Mendes, Yilmaz, Hasan, Pellaton, Alain, Slater, Lee-Anne, Krings, Timo, Lovblad, Karl-Olof
Format: Article
Language:English
Subjects:
Acute stroke
Cerebral Angiography - methods
Endovascular treatment
Evidence-Based Medicine
Humans
Mechanical Thrombolysis - instrumentation
Mechanical Thrombolysis - methods
Radiology
Stent retriever
Stroke - diagnosis
Stroke - therapy
Surgery, Computer-Assisted - methods
Thrombectomy
Treatment Outcome
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Summary:Summary Acute ischemic stroke is a morbid and disabling medical condition with a significant social and economic impact throughout the world. Intravenous thrombolysis (IVT) has been the first line treatment for patients presenting up to 4.5 hours after symptom onset for many years. Endovascular stroke treatment has been used successfully as rescue therapy after failed IVT; in patients with contraindications to rtPA or presenting outside the 4.5-hour window. The effectiveness of IVT is high for distal thrombi but significantly lower for proximal occlusions. Endovascular treatment has been revolutionized by the evolution from intra-arterial thrombolysis and first generation mechanical devices to the current generation of stent retrievers and aspiration systems with large bore catheters. These devices have been associated with excellent revascularization, improved clinical outcomes, shorter procedure times and reduced device and procedure related complications. We report the current literature, clinical standards and perspectives on mechanical thrombectomy in acute ischemic stroke.
ISSN:0150-9861
DOI:10.1016/j.neurad.2014.11.002