[Stroke--endovascular treatment methods].
BACKGROUND
Over the last years, endovascular treatment (intra-arterial thrombolysis, thrombembolectomy, angioplasty or intracranial stenting) has been used to treat acute ischemic stroke. The aim of this article is to discuss endovascular treatment of stroke, based on 3 cases and the present knowledge in this field.


METHODS
Three patients presented with symptoms of acute stroke and received endovascular treatment. The cases are discussed with reference to literature identified in Pubmed.


CONCLUSIONS
A prospective randomized study of intraarterial thrombolysis within 6 hours of symptom debut has been published, but there is no randomized study on mechanical thrombectomy in acute stroke. Several phase II studies have however shown promising results. The patients presented here illustrate the need for urgent diagnosis and collaboration between various specialities when neurointervention is considered. Patients with symptomatic intracranial stenosis, already on anti-platelet therapy, should be evaluated for angioplasty with or without stenting. Patients with acute ischemic stroke who have not had effect of intravenous thrombolysis, or have been admitted too late to receive such treatment, should be assessed quickly for mechanical thrombectomy, intra-arterial thrombolysis or both.
Jacobsen
Eva A
EA
Stanford Hospital and Clinics, Stanford, CA 94305-5105, USA. eva.jacobsen@rikshospitalet.no
D000368:Aged; D000800:Angioplasty, Balloon; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D002533:Cerebral Angiography; D006801:Humans; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D014656:Vascular Surgical Procedures / Q000379:methods