Combined intravenous and intra-arterial approach in acute stroke treatment.
Despite the significant improvement in the outcome of ischaemic stroke with the use of intravenous recombinant tissue plasminogen activator, experience has shown limitations of the sole use of this approach in acute stroke treatment. This has encouraged the search for alternative managements for acute stroke. The combined use of intravenous/intra-arterial therapy is one such alternate treatment, if used in the right setting. In this review, the authors discuss the advantages and limitations of using this approach, together with an overview of the available therapies used through each route. The authors discuss the process of patient selection using clinical, as well as state of the art imaging modalities.
Almekhlafi
Mohammed A
MA
University of Calgary, Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Hospital, Calgary, Alberta, Canada.
Hill
Michael D
MD
D000208:Acute Disease; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator