title: Stent retriever thrombectomy for acute ischemic stroke: Indications, results and management in 2015.
abstract: The functional benefit of stent retriever thrombectomy in acute ischemic stroke has been clearly demonstrated in recent positive MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, REVASCAT and THRACE trials. Thrombectomy, in association with intravenous thrombolysis, should now be offered to patients with documented occlusion of the distal internal carotid or proximal middle cerebral arteries, with a relatively normal unenhanced computed tomography (CT), and within 6hours after the onset of symptoms. Thrombectomy results in a mean absolute decrease in handicap of 22% (14 to 31%). Of the 3 up to 8 patients treated, 1 is independent at 3 months according to the initial selection. In case of a contraindication to thrombolysis, early primary thrombectomy should be considered. In acute basilar artery occlusion, thrombectomy should be performed alone or combined with thrombolysis. In an effort to increase the number of patients treated, a very rapid transfer to interventional neuroradiology centers is mandatory. In the future, thrombectomy should be evaluated in patients with distal arterial occlusion, or beyond 6hours after the onset of symptoms, or when the time of symptoms onset is unknown.
authors.affiliation: DHU IRIS, service de neuroradiologie interventionnelle, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69609 Lyon, France; Centre de neuroscience cognitive, CNRS UMR 5229, 69675 Bron, France. Electronic address: benjamin.gory@chu-lyon.fr.
authors.forename: B
authors.initials: B
authors.lastname: Gory
authors.affiliation: DHU IRIS, service de neuroradiologie interventionnelle, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France.
authors.forename: R
authors.initials: R
authors.lastname: Riva
authors.affiliation: DHU IRIS, service de neuroradiologie interventionnelle, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France; Unité Inserm UMR-S 919, sérine protéases et physiopathologie de l'unité neurovasculaire, GIP Cyceron, université de Caen Basse-Normandie, 14000 Caen, France.
authors.forename: P E
authors.initials: PE
authors.lastname: Labeyrie
authors.affiliation: DHU IRIS, service de neuroradiologie interventionnelle, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69609 Lyon, France; Centre de neuroscience cognitive, CNRS UMR 5229, 69675 Bron, France.
authors.forename: F
authors.initials: F
authors.lastname: Turjman
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000601:surgery*; D006801:Humans; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
keywords: Intra-arterial therapy; Large vessel occlusion; Outcome; Stroke; Thrombectomy