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Management of the Interventional Stroke Patient

  • Critical Care Neurology (K Sheth, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

The acute treatment of major ischemic stroke has been revolutionized by strong and consistent evidence from multiple randomized trials. Endovascular treatment by mechanical thrombectomy will be increasingly chosen as an adjunctive or alternative to intravenous thrombolysis. To apply this form of stroke treatment is associated with the challenge of optimal periinterventional treatment. The patient has to be identified, counselled, prepared, monitored, cardiovascularly stabilized, possibly sedated and ventilated, and postprocedurally treated in the optimal way. However, most aspects of periinterventional treatment have as yet not been clarified and require prospective research. Among these, the question of general anesthesia vs conscious sedation has received most attention and may be the most crucial one. Based on a great amount of retrospective data, it appears reasonable to start the intervention under conscious sedation of the non-intubated patient with standby measures for emergent intubation, until prospective randomized trials have clarified that issue. Periinterventional management will significantly affect the success of recanalization.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Conflict of Interest

Julian Bösel has received honoraria and travel support from Covidien, Sedana Medical, Bard, and Orion Pharma, unrelated to this work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Julian Bösel MD

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Correspondence to Julian Bösel MD.

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This article is part of the Topical Collection on Critical Care Neurology

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Bösel, J. Management of the Interventional Stroke Patient. Curr Treat Options Neurol 17, 45 (2015). https://doi.org/10.1007/s11940-015-0376-z

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