[New options in the therapeutic management of acute ischaemic stroke. Good results with combined i. v. and i. a. lysis and mechanical thrombectomy].
BACKGROUND
Standard therapy for acute ischaemic stroke is the intravenous thrombolysis with rtPA. A combined therapy with intravenous bridging and consecutive intraarterial thrombolysis and mechanical thrombectomy is a relatively new option in patients with proximal vessel occlusion.


METHODS
10 Patients with a CTA proven proximal vessel occlusion in the anterior circulation (ACI, carotis bifurcation, MCA) in CTA were treated with a combined therapy with i. v. and i. a. thrombolysis and thrombectomy with a Solitaire FR stent device.


RESULTS
All Patients were recanalized, the NIHSS changed from 15.6 to 3.3. 8 out of 10 patients had nearly no symptoms when dismissed. There were no direct therapeutic complications.


CONCLUSIONS
Combined therapy with i. v. and i. a. thrombolysis and thombectomy with the Solitaire FR stent device is a promising option in patients with acute proximal vessel occlusion in the anterior circulation.
Klinik für Neurologie, Alfried-Krupp Krankenhaus, Essen. conrad.venker@gmx.de
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Venker
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Stracke
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Berlit
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Diehl
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Kurre
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Sorgenfrei
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Krämer
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Chapot
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000188:drug therapy / Q000628:therapy; D002533:Cerebral Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy / Q000628:therapy; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D017131:Thrombectomy; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D010959:Tissue Plasminogen Activator; D001241:Aspirin