Mechanical endovascular recanalization therapies

Current Opinion in Neurology
Helmi L Lutsep

Abstract

The review compares recent trials using mechanical endovascular therapies with and without adjuvants to treat acute stroke. The Multi Mechanical Embolus Removal in Cerebral Ischemia trial showed that good revascularization success could be obtained using the Merci retrievers within 8 h of symptom onset. In patients with persistent vascular occlusions despite intravenous tissue plasminogen activator, mechanical embolectomy appeared to be safe. The Interventional Management of Stroke II study achieved similar final revascularization success using low-dose tissue plasminogen activator within 3 h of symptom onset followed by intra-arterial tissue plasminogen activator or EKOS ultrasound plus intra-arterial tissue plasminogen activator. In these trials, patients with recanalization had better outcomes than those without revascularization. Effects of trial design, such as time to treatment, patient age, and use of adjuvant therapies, may affect outcomes. Recent trials of mechanical endovascular therapies have shown recanalization in the majority of target vessels and better outcomes in those patients in whom recanalization was achieved than in those without recanalization. Differences in trial design and lack of head to head comparis...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Mar 16, 2004·Stroke; a Journal of Cerebral Circulation·Ansgar BerlisMartin Schumacher
Mar 16, 2004·Stroke; a Journal of Cerebral Circulation·UNKNOWN IMS Study Investigators
Oct 30, 2004·Stroke; a Journal of Cerebral Circulation·Y Pierre GobinJeffrey L Saver
Jan 18, 2005·Stroke; a Journal of Cerebral Circulation·Kyra J Becker, Thomas G Brott
Jun 18, 2005·Stroke; a Journal of Cerebral Circulation·Wade S SmithUNKNOWN MERCI Trial Investigators
May 26, 2007·Stroke; a Journal of Cerebral Circulation·UNKNOWN IMS II Trial Investigators

❮ Previous
Next ❯

Citations

Jun 21, 2016·IEEE Reviews in Biomedical Engineering·Aimee SakesPaul Breedveld

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Related Papers

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
S W YusufG S Makin
Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
Amir Motarjeme
The Journal of Experimental Medicine
W S Tillett, R L Garner
© 2021 Meta ULC. All rights reserved