title: History, Evolution, and Importance of Emergency Endovascular Treatment of Acute Ischemic Stroke.
abstract: More than 800,000 people in North America suffer a stroke each year, with ischemic stroke making up the majority of these cases. The outcomes of ischemic stroke range from complete functional and cognitive recovery to severe disability and death; outcome is strongly associated with timely reperfusion treatment. Historically, ischemic stroke has been treated with intravenous thrombolytic agents with moderate success. However, five recently published positive trials have established the efficacy of endovascular treatment in acute ischemic stroke. In this review, we will discuss the history of stroke treatments moving from various intravenous thrombolytic drugs to intra-arterial thrombolysis, early mechanical thrombectomy devices, and finally modern endovascular devices. Early endovascular therapy failures, recent successes, and implications for current ischemic stroke management and future research directions are discussed.
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, Health Sciences Centre, University of Calgary, HBA 2935D, 3300 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada. jkholodi@ucalgary.ca.
authors.forename: Jessalyn K
authors.initials: JK
authors.lastname: Holodinsky
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, Health Sciences Centre, University of Calgary, HBA 2935D, 3300 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.|Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Amy Y X
authors.initials: AY
authors.lastname: Yu
authors.affiliation: Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Zarina A
authors.initials: ZA
authors.lastname: Assis
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, Health Sciences Centre, University of Calgary, HBA 2935D, 3300 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Abdulaziz S
authors.initials: AS
authors.lastname: Al Sultan
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, Health Sciences Centre, University of Calgary, HBA 2935D, 3300 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.|Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Bijoy K
authors.initials: BK
authors.lastname: Menon
authors.affiliation: Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.affiliation: Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Mayank
authors.initials: M
authors.lastname: Goyal
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, Health Sciences Centre, University of Calgary, HBA 2935D, 3300 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.|Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
mesh_terms: D000818:Animals; D002545:Brain Ischemia / Q000628:therapy*; D057510:Endovascular Procedures; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020521:Stroke / Q000628:therapy*; D017131:Thrombectomy; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents
keywords: Endovascular techniques; Ischemic stroke; Reperfusion; Thrombectomy; Thrombolytic therapy