title: [Current status of endovascular therapy for acute ischemic stroke].
abstract: Endovascular therapy (EVT) is performed in patients with acute ischemic stroke due to major artery occlusion, if they were ineligible of intravenous (IV) rt-PA or failure to achieve reperfusion by IV rt-PA. In Japan, intra-arterial thrombolysis has been generally performed, and mechanical thrombectomy using Merci retriever and Penumbra system are gradually spreading. In 2013, the results of three randomized trials (IMS 3, SYNTHESIS expansion, and MR RESCUE) were published, and they could not prove the usefulness of EVT in patients with acute ischemic stroke compared with standard therapy including IV rt-PA. However, these trials suggested important issues of EVT. Especially, adequate selection of patients, improvement of reperfusion rate, and shorter onset to reperfusion time are needed to establish the usefulness of EVT.
authors.affiliation: Department of Neurology, National Cerebral and Cardiovascular Center.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
mesh_terms: D000075202:Contraindications; D057510:Endovascular Procedures / Q000379:methods / Q000639:trends; D019317:Evidence-Based Medicine; D006801:Humans; D018579:Patient Selection; D011994:Recombinant Proteins; D015424:Reperfusion / Q000379:methods; D020521:Stroke / Q000601:surgery*; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator