Abstract
Despite heterogeneity of stroke mechanisms, one challenge remains across all reperfusion therapies—the persistence of a proximal arterial occlusion. Thrombus burden in stroke patients is often disproportionately larger than allowed doses of systemic thrombolytic, and many patients do not recover during or shortly after treatment. Moreover, a substantial proportion of patients arrive beyond currently established time frame for systemic thrombolytic, thus necessitating our search for effective and direct ways of dissolving or removing the thrombus from cerebral vessels. This chapter will discuss specifics how endovascular approach can be utilized for stroke treatment.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Papers to Read
Furlan A, Higashida R, Wechsler L, Gent M, Rowley H, Kase C, Pessin M, Ahuja A, Callahan F, Clark WM, Silver F, Rivera F. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: A randomized controlled trial. Prolyse in acute cerebral thromboembolism. JAMA. 1999;282: 2003–11.
The interventional management of stroke (IMS) II study. Stroke 2007;38: 2127–2135
Adams Jr HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks EF. Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655–711.
Smith WS, Sung G, Saver J, Budzik R, Duckwiler G, Liebeskind DS, Lutsep HL, Rymer MM, Higashida RT, Starkman S, Gobin YP, Frei D, Grobelny T, Hellinger F, Huddle D, Kidwell C, Koroshetz W, Marks M, Nesbit G, Silverman IE. Mechanical thrombectomy for acute ischemic stroke: final results of the multi MERCI trial. Stroke. 2008;39:1205–12.
The Penumbra Pivotal Stroke Trial Investigators. The Penumbra pivotal stroke trial: Safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke. 2009;40:2761–8.
Rubiera M, Cava L, Tsivgoulis G, Patterson DE, Zhao L, Zhang Y, Anderson AM, Robinson A, Harrigan M, Horton J, Alexandrov AV. Diagnostic criteria and yield of real time transcranial Doppler (TCD) monitoring of intra-arterial (IA) reperfusion procedures. Stroke. 2010;41:695–9.
Qureshi AI, Siddiqi AM, Kim SH, Hanel RA, Xavier AR, Kirmani JF, Fareed M, Suri K, Boulos AS, Hopkins LN. Reocclusion of recanalized arteries during intra-arterial thrombolysis for acute ischemic stroke. Am J Neuroradiol. 2004;25:322–8.
Khatri P, Neff J, Broderick JP, Khoury JC, Carrozzella J, Tomsick T for the IMS-1 Investigators. Revascularization end points in stroke interventional trials. Recanalization versus reperfusion in IMS-I. Stroke 2005;36:2400–2403
Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira RG, Clark W, BudzikR, Zaidat OO; for the SWIFT Trialists. Solitaire flow restoration device versusthe Merci Retriever in patients with acute ischaemic stroke (SWIFT): arandomised, parallel-group, non-inferiority trial. Lancet. 2012 doi:10.1016/S0140-6736(12)61384-1
Nogueira RG, Lutsep HL, Gupta R, Jovin T, Albers GW, Walker GA, Liebeskind DS, Smith WS. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet 2012 doi:10.1016/S0140-6736(12)61299-9
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Ribo, M., Rubiera, M., Alexandrov, A.V. (2013). Endovascular Treatment of Acute Ischemic Stroke. In: Kumar, A., Ouriel, K. (eds) Handbook of Endovascular Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5013-9_10
Download citation
DOI: https://doi.org/10.1007/978-1-4614-5013-9_10
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-5012-2
Online ISBN: 978-1-4614-5013-9
eBook Packages: MedicineMedicine (R0)