Endovascular treatment strategies for acute ischemic stroke

Department of Neurological Surgery, Columbia University Medical Center, New York, NY 10032, USA.
International Journal of Stroke (Impact Factor: 3.83). 12/2011; 6(6):511-22. DOI: 10.1111/j.1747-4949.2011.00670.x
Source: PubMed


The limitations of intravenous thrombolysis therapy have paved the way for the development of novel endovascular technologies for use in the setting of acute stroke. These technologies range from direct intraarterial thrombolysis to various thrombus disruption or retrieval devices to angioplasty and stenting. The tools in the armamentarium of the neuroendovascular interventionalist enable fast, effective revascularization to be offered to a wider population of patients that may otherwise have few therapeutic options available to them. In this paper, we review the current state-of-the-art in neuroendovascular intervention for acute ischemic stroke. Particular emphasis is placed on delineating the indications and outcomes for use of these various technologies.

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    • "Apart from the s-TPI, these predictive instruments, however, have been developed and validated in patients treated with intravenous recombinant tissue plasminogen activator (IV rtPA) according to restrictive criteria. In daily practice, patients are being treated according to local institutional guidelines, which may involve off-license use of IV rtPA and intra-arterial thrombolytic therapy [16] [17]. "
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