title: State-of-the-art endovascular treatment of acute ischemic stroke.
abstract: Stroke is the third leading cause of death in the USA. An estimated 795,000 new or recurrent stroke events occur annually, mostly ischemic in nature. Arterial recanalization and subsequent reperfusion performed shortly after symptom onset can help to restore brain function in acute ischemic stroke (AIS). The only treatment currently approved by the United States Food and Drug Administration is intravenous tissue plasminogen activator, administered within 4.5 h of symptom onset. However, this short window often precludes effective intervention. Mechanical neurothrombectomy devices offer many potential advantages over pharmacologic thrombolysis, including more rapid achievement of recanalization, enhanced efficacy in treating large-vessel occlusions, and a potentially lower risk of hemorrhagic events. The goal of this chapter is to describe the state-of-the-art neurothrombectomy devices and stenting techniques for endovascular treatment of acute ischemic stroke, as well as to highlight recent advances in reperfusion therapies. Ongoing clinical trials, some with randomized, controlled designs, are included.
authors.affiliation: Interventional Neuroradiology Unit, Rabin Medical Center, Beilinson Hospital, Petach-Tikva, Israel, graphaeli@gmail.com.
authors.forename: Guy
authors.initials: G
authors.lastname: Raphaeli
authors.forename: Mikael
authors.initials: M
authors.lastname: Mazighi
authors.forename: Vitor Mendes
authors.initials: VM
authors.lastname: Pereira
authors.forename: Francis
authors.initials: F
authors.lastname: Turjman
authors.forename: Jonathan
authors.initials: J
authors.lastname: Striefler
mesh_terms: D002545:Brain Ischemia / Q000628:therapy*; D006801:Humans; D015607:Stents; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000295:instrumentation / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator