title: [Endovascular therapy in the treatment of acute ischemic stroke: what the cardiologist should know].
abstract: BACKGROUND
  Interventional cardiology procedures are regularly exposed to ischemic neurological complications. IV fibrinolysis is the only approved treatment in ischemic stroke but is very often contraindicated in these situations. Many techniques of interventional neuroradiology (mechanical thrombectomy) have been developed over the past years and are used to treat these patients.
  
  
  METHODS
  We report the case of two patients who were admitted in emergency for ischemic stroke with contraindication to IV fibrinolysis (cardioversion for atrial fibrillation under anticoagulation; 24 hours after carotid surgery). These patients were treated by endovascular thrombectomy procedure.
  
  
  CONCLUSIONS
  After validation of IV fibrinolysis within 4.5 hours after stroke onset, techniques of mechanical thrombectomy have gradually been developed, either as a complementary treatment or as an alternative in the case of CI to fibrinolysis. These endovascular thrombectomy devices currently allow recanalization of proximal cerebral occlusions, which correlates with a favorable clinical prognosis. A review of the literature is provided, along with a discussion about the techniques currently being improved, their advantages and disadvantages and the selection of patients that can benefit from endovascular procedures.
  
  
  CONCLUSIONS
  In the case of a sudden occurrence of a neurological deficit during a cardiovascular procedure, a "thrombolysis alert" should be triggered. This will permit the rapid establishment of a clinico-radiological report for selecting stroke patients eligible for a procedure of recanalization by thrombolysis and/or mechanical thrombectomy.
authors.affiliation: Unité de neurovasculaire, service de neurologie, hôpital Foch, université Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
authors.forename: G
authors.initials: G
authors.lastname: Vellieux
authors.affiliation: Unité de neurovasculaire, service de neurologie, hôpital Foch, université Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
authors.forename: S
authors.initials: S
authors.lastname: Evrard
authors.affiliation: Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, université Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
authors.forename: P
authors.initials: P
authors.lastname: Guedin
authors.affiliation: Unité de neurovasculaire, service de neurologie, hôpital Foch, université Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France. Electronic address: b.lapergue@hopital-foch.org.
authors.forename: B
authors.initials: B
authors.lastname: Lapergue
mesh_terms: D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D000075202:Contraindications; D057510:Endovascular Procedures; D005260:Female; D005343:Fibrinolytic Agents; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D017131:Thrombectomy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents
keywords: Accident vasculaire cérébral; Fibrinolyse; Fibrinolysis; Infarctus cérébral; Ischemic stroke; Mechanical thrombectomy; Neuroradiologie interventionnelle; Thrombectomie