Interventional Management of Acute Ischemic Stroke: A Systematic Review
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Historically, acute ischemic stroke (AIS) trials defined syndromes according to acute clinical presentation and post-ictus parenchymal imaging. With improvements in real-time arterial imaging, modern AIS treatment demands a structural approach based upon the level of cerebrovascular occlusion. The poor concordance of presenting National Institute of Health Stroke Scale (NIHSS) with vessel occlusion in recent trials bespeaks the need for an anatomic perspective. Specifically, patients with large-vessel occlusion (LVO) represent a distinct entity with a poorer prognosis than general AIS patients. Ongoing clinical trials and therapeutic strategies must recognize the varied natural history of AIS patients. Endovascular therapy offers promise in patients with the most severe strokes.
- Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: Final Data for 2009. Nat Vital Stat Rep. 2011;60(3).
- Khalessi AA, Fargen KM, Lavine S, Mocco J. Commentary: societal statement on recent acute stroke intervention trials: results and implications. Neurosurgery. 2013;73(2):E375–9. This publication represents the first complete consensus statement on catheter-based therapy for that was endorsed by the five major societies involved in catheter-based AIS treatment, including the Joint Cerebrovascular Section of the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS), the Society of Vascular and Interventional Neurology (SVIN), the Society of NeuroInterventional Surgery (SNIS), and the American Society of NeuroRadiology (ASNR). CrossRef
- Furlan A, Higashida R, Wechsler L, et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA. 1999;282(21):2003–11. CrossRef
- Janardhan V, Gianatasio RM, Chen SH, et al. Abstract 194: preliminary results from the FIRST trial: a natural history of acute stroke from large vessel occlusion. Stroke. 2013;44:A194. This publication reinforced the distinctively poor natural history of AIS due to LVO.
- Broderick JP, Palesch YY, Demchuk AM, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med. 2013;368(10):893–903. CrossRef
- Wolpert SM, Bruckmann H, Greenlee R, Wechsler L, Pessin MS, del Zoppo GJ. Neuroradiologic evaluation of patients with acute stroke treated with recombinant tissue plasminogen activator. The rt-PA Acute Stroke Study Group. AJNR Am J Neuroradiol. 1993;14(1):3–13.
- Ciccone A, Valvassori L, Nichelatti M, et al. Endovascular treatment for acute ischemic stroke. N Engl J Med. 2013;368(10):904–13. CrossRef
- Pexmana JH, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22:1534–42.
- Hacke W, Kaste M, Fieschi C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA. 1995;274:1017–25. CrossRef
- Boxerman JL, Jayaraman MV, Mehan WA, Rogg JM, Haas RA. Clinical stroke penumbra: use of National Institutes of Health Stroke Scale as a surrogate for CT perfusion in patient triage for intra-arterial middle cerebral artery stroke therapy. AJNR Am J Neuroradiol. 2012;33:1893–900. CrossRef
- Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007;38(3):967–73. CrossRef
- Fargen KM, Meyers PM, Khatri P, Mocco J. Improvements in recanalization with modern stroke therapy: a review of prospective ischemic stroke trials during the last two decades. 2013;5(6):506–11. doi: 10.1136/neurintsurg-2012-010541
- Saver JL, Jahan R, Levy EI, et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet. 2012;380(9849):1241–9. This was the first study to objectively demonstrate the superiority of retrievable stents over the Merci device in the treatment of AIS. CrossRef
- Nogueira RG, Lutsep HL, Gupta R, et al. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet. 2012;380(9849):1231–40. CrossRef
- Kidwell CS, Jahan R, Gornbein J, et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med. 2013;368(10):914–23. CrossRef
- Ciccone A. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med. 1995;333(24):1581–7. CrossRef
- Jauch EC, Saver JL, Adams Jr HP, Bruno A, Connors JJ, Demaerschalk BM, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870–947. doi:10.1161/STR.0b013e318284056a. CrossRef
- Adeoye O, Hornung R, Khatri P, Kleindorfer D. Recombinant tissue-type plasminogen activator use for ischemic stroke in the United States: a doubling of treatment rates over the course of 5 years. Stroke. 2011;42(7):1952–5. CrossRef
- Morgenstern LB, Staub L, Chan W, et al. Improving delivery of acute stroke therapy: the TLL Temple Foundation Stroke Project. Stroke. 2002;33(1):160–6. CrossRef
- de Los Ríos la Rosa F, Khoury J, Kissela BM, et al. Eligibility for intravenous recombinant tissue-type plasminogen activator within a population: the effect of the European Cooperative Acute Stroke Study (ECASS) III Trial. Stroke. 2012;43(6):1591–5. CrossRef
- Interventional Management of Acute Ischemic Stroke: A Systematic Review
Current Treatment Options in Cardiovascular Medicine
- Online Date
- June 2014
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Acute ischemic stroke
- Large-vessel occlusion
- CT angiography
- Intra-arterial stroke therapy
- Endovascular therapy
- Retrievable stent
- Industry Sectors