title: Current recommendations for endovascular interventions in the treatment of ischemic stroke.
abstract: Ischemic stroke remains one of the leading cause of adult death and disability in the United States. Reperfusion of the occluded vessel is the standard of care in the setting of acute ischemic stroke according to established guidelines. Since the introduction of intravenous (IV) recombinant tissue plasminogen activator (rt-PA) in the late 1990s, significant advances have been made in methods to deliver thrombolytic agents and in devices for mechanical recanalization of occluded vessels. Furthermore, improvements in patient selection contribute to achievement of good clinical outcomes after endovascular therapy. This article summarizes findings from recent clinical trials and presents evidence-based guidelines for endovascular interventions in the treatment of ischemic stroke.
authors.affiliation: Departments of Radiology and Neurological Surgery, Columbia University, New York, NY, USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Appelboom
authors.forename: Dorothea
authors.initials: D
authors.lastname: Strozyk
authors.forename: Philip M
authors.initials: PM
authors.lastname: Meyers
authors.forename: Randall T
authors.initials: RT
authors.lastname: Higashida
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D002986:Clinical Trials as Topic; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D018579:Patient Selection; D015424:Reperfusion / Q000379:methods; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D017131:Thrombectomy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
references.citation: AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):3-13
references.pmid: 8427107
references.citation: Neurology. 2001;57(5 Suppl 2):S58-60
references.pmid: 11552057
references.citation: Stroke. 2008 Apr;39(4):1205-12
references.pmid: 18309168
references.citation: Eur Radiol. 2009 Sep;19(9):2286-93
references.pmid: 19350248
references.citation: Stroke. 2000 Nov;31(11):2552-7
references.pmid: 11062274
references.citation: Stroke. 2007 Jul;38(7):2127-35
references.pmid: 17525387
references.citation: Neurocrit Care. 2009;11(2):217-22
references.pmid: 19225909
references.citation: AJNR Am J Neuroradiol. 2007 May;28(5):860-3
references.pmid: 17494657
references.citation: JAMA. 1999 Dec 1;282(21):2003-11
references.pmid: 10591382
references.citation: AJNR Am J Neuroradiol. 2008 Aug;29(7):1409-13
references.pmid: 18499798
references.citation: Stroke. 2007 May;38(5):1655-711
references.pmid: 17431204
references.citation: Stroke. 2009 Aug;40(8):2761-8
references.pmid: 19590057
references.citation: AJNR Am J Neuroradiol. 2007 Nov-Dec;28(10):1890-4
references.pmid: 17898199
references.citation: Neurosurgery. 2006 Mar;58(3):458-63; discussion 458-63
references.pmid: 16528185
references.citation: AJNR Am J Neuroradiol. 2010 Mar;31(3):454-8
references.pmid: 20075087
references.citation: AJNR Am J Neuroradiol. 2010 Jan;31(1):161-4
references.pmid: 19713319
references.citation: Stroke. 2004 Dec;35(12):2848-54
references.pmid: 15514171
references.citation: Cerebrovasc Dis. 2008;25(5):457-507
references.pmid: 18477843
references.citation: Stroke. 2006 Mar;37(3):922-8
references.pmid: 16439705
references.citation: Lancet Neurol. 2009 Sep;8(9):802-9
references.pmid: 19647488
references.citation: Stroke. 2009 May;40(5):1780-5
references.pmid: 19359652
references.citation: Stroke. 2007 Jan;38(1):80-4
references.pmid: 17122433
references.citation: Neurocrit Care. 2006;5(2):134-40
references.pmid: 17099260
references.citation: N Engl J Med. 1995 Dec 14;333(24):1581-7
references.pmid: 7477192
references.citation: Stroke. 2002 Jan;33(1):279-82
references.pmid: 11779923
references.citation: Stroke. 2007 Oct;38(10):2633-9
references.pmid: 17702958
references.citation: Neurosurgery. 2002 Feb;50(2):251-9; discussion 259-60
references.pmid: 11844259
references.citation: Neurocrit Care. 2007;6(1):11-21
references.pmid: 17356186
references.citation: Stroke. 1999 Dec;30(12):2598-605
references.pmid: 10582984
references.citation: N Engl J Med. 2008 Sep 25;359(13):1317-29
references.pmid: 18815396