title: Stroke unit management and revascularisation in acute ischemic stroke.
abstract: BACKGROUND
  Stroke affects one in six people throughout their lifetimes and is the most frequent cause of disability in adults. Several recanalization therapies have emerged and the management of patients in stroke units has improved over the last decades.
  
  
  CONCLUSIONS
  This article examines the current treatment options for stroke patients, summarizing the key clinical evidence, as well as listing the complications and practical issues related to each of these main treatment options.
  
  
  CONCLUSIONS
  Recent advances in the treatment of acute stroke include developments in intravenous thrombolysis (IVT), intra-arterial treatment and bridging therapies.
  
  
  CONCLUSIONS
  Treatment within a stroke unit reduces mortality and disability regardless of age, sex and stroke severity. IVT is widely available and reduces disability when initiated within 4.5 h after the onset of symptoms. The major limitations of IVT are the low recanalization rates and the narrow time frame. Intra-arterial treatment, especially when using newly developed stent-retrievers, achieves very high recanalization rates. It is restricted by its limited availability and by the longer time span required to initiate therapy. Bridging both therapies is a promising approach that combines the advantages of both therapies, but the superiority of this approach remains to be proven. Future strategies to reduce the burden of acute stroke in Europe should focus on immediate access to acute stroke care and dedicated stroke units for all patients.
authors.affiliation: Departments of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Jung
authors.forename: Christian
authors.initials: C
authors.lastname: Stapf
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
mesh_terms: D000328:Adult; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods* / Q000639:trends*; D016896:Treatment Outcome