Endovascular management of acute symptomatic intracranial arterial occlusion.
OBJECTIVE
Acute ischemic stroke has reached epidemic proportions in the United States, affecting approximately 700,000 people annually. With the recent technological advancements in endovascular devices, clinicians now have tools capable of recanalizing acute intracranial occlusions. The combination of pharmacological thrombolysis and mechanical clot perturbation may result in increased rates of angiographic recanalization, which may lead to improvement in patient outcomes after acute stroke.


METHODS
In this article, the various intra-arterial pharmacological and mechanical therapies used by interventionists to treat acute stroke are described. Strategies for using combinations of these therapies are discussed, as are preliminary radiographic and clinical outcomes. Techniques for complex mechanical stroke interventions are discussed in detail.


RESULTS
Several advances in endovascular stroke technologies are becoming increasingly available.


CONCLUSIONS
With proper patient selection, these therapies may lead to increased recanalization rates and better patient outcomes.
Veznedaroglu
Erol
E
Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Levy
Elad I
EI
D000208:Acute Disease; D001807:Blood Vessel Prosthesis; D002545:Brain Ischemia / Q000628:therapy*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015607:Stents; D015912:Thrombolytic Therapy / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*
D005343:Fibrinolytic Agents