Current recommendations for endovascular interventions in the treatment of ischemic stroke.
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.
Appelboom
Geoffrey
G
Departments of Radiology and Neurological Surgery, Columbia University, New York, NY, USA.
Strozyk
Dorothea
D
Meyers
Philip M
PM
Higashida
Randall T
RT
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
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):3-13
8427107
Neurology. 2001;57(5 Suppl 2):S58-60
11552057
Stroke. 2008 Apr;39(4):1205-12
18309168
Eur Radiol. 2009 Sep;19(9):2286-93
19350248
Stroke. 2000 Nov;31(11):2552-7
11062274
Stroke. 2007 Jul;38(7):2127-35
17525387
Neurocrit Care. 2009;11(2):217-22
19225909
AJNR Am J Neuroradiol. 2007 May;28(5):860-3
17494657
JAMA. 1999 Dec 1;282(21):2003-11
10591382
AJNR Am J Neuroradiol. 2008 Aug;29(7):1409-13
18499798
Stroke. 2007 May;38(5):1655-711
17431204
Stroke. 2009 Aug;40(8):2761-8
19590057
AJNR Am J Neuroradiol. 2007 Nov-Dec;28(10):1890-4
17898199
Neurosurgery. 2006 Mar;58(3):458-63; discussion 458-63
16528185
AJNR Am J Neuroradiol. 2010 Mar;31(3):454-8
20075087
AJNR Am J Neuroradiol. 2010 Jan;31(1):161-4
19713319
Stroke. 2004 Dec;35(12):2848-54
15514171
Cerebrovasc Dis. 2008;25(5):457-507
18477843
Stroke. 2006 Mar;37(3):922-8
16439705
Lancet Neurol. 2009 Sep;8(9):802-9
19647488
Stroke. 2009 May;40(5):1780-5
19359652
Stroke. 2007 Jan;38(1):80-4
17122433
Neurocrit Care. 2006;5(2):134-40
17099260
N Engl J Med. 1995 Dec 14;333(24):1581-7
7477192
Stroke. 2002 Jan;33(1):279-82
11779923
Stroke. 2007 Oct;38(10):2633-9
17702958
Neurosurgery. 2002 Feb;50(2):251-9; discussion 259-60
11844259
Neurocrit Care. 2007;6(1):11-21
17356186
Stroke. 1999 Dec;30(12):2598-605
10582984
N Engl J Med. 2008 Sep 25;359(13):1317-29
18815396