Skip to main content
SpringerLink
Log in

Management (Surgical and Endovascular) of Acute Ischemic Stroke

  • Chapter
  • First Online:
Recent Progress in the Management of Cerebrovascular Diseases

  • 421 Accesses

Abstract

Stroke is the second leading cause of death in the world and the leading cause of death in China [1–4]. Acute ischemic stroke is a common clinical cerebrovascular disease with an increasing incidence in recent years, which is related to diet structure, people’s lifestyle, increased work pressure, and other factors. Acute ischemic stroke is an acute and dangerous situation that endangers the life of the patient. The patients should be sent to the hospital immediately for integrated managements to save their life. At present, the conventional comprehensive treatment is the main preferred method, which can quickly control the disease [5, 6]. At present, intravenous thrombolysis is carried out extensively, but with the development of modern surgical techniques, more clinicians pay attention to surgical and endovascular treatments. In this study, our aim is to discuss the application of surgical and endovascular treatment in acute ischemic stroke in order to explore a good treatment strategy for the patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Zhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet. 2016;387(10015):251–72.

    Article  PubMed  Google Scholar 

  2. Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke during 1990-2010: findings from the global burden of disease study 2010. Lancet. 2014;383(9913):245–54.

    Article  PubMed  PubMed Central  Google Scholar 

  3. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151–210.

    Article  Google Scholar 

  4. Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol. 2019;18(4):394–405.

    Article  PubMed  Google Scholar 

  5. Wang Y, Li Z, Zhao X, et al. Effect of a multifaceted quality improvement intervention on hospital personnel adherence to performance measures in patients with acute ischemic stroke in China: a randomized clinical trial. JAMA. 2018;320(3):245–54.

    Article  PubMed  Google Scholar 

  6. Li Z, Wang C, Zhao X, et al. Substantial progress yet significant opportunity for improvement in stroke care in China. Stroke. 2016;47(11):2843–9.

    Google Scholar 

  7. Dhand S, O’Connor P, Hughes C, et al. Acute ischemic stroke: acute management and selection for endovascular therapy. Semin Intervent Radiol. 2020;37(2):109–18.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Centers for Disease Control and Prevention (CDC). Prevalence and most common causes of disability among adults—United States, 2005. MMWR Morb Mortal Wkly Rep. 2009;58(16):421–6.

    Google Scholar 

  9. Lin CB, Peterson ED, Smith EE, et al. Emergency medical service hospital prenotification is associated with improved evaluation and treatment of acute ischemic stroke. Circ Cardiovasc Qual Outcomes. 2012;5(4):514–22.

    Article  PubMed  Google Scholar 

  10. Saver JL, Goyal M, van der Lugt A, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA. 2016;316(12):1279–88.

    Article  PubMed  Google Scholar 

  11. Goyal M, Demchuk AM, Menon BK, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015;372(11):1019–30.

    Article  PubMed  CAS  Google Scholar 

  12. Saver JL, Goyal M, Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015;372(24):2285–95.

    Article  PubMed  CAS  Google Scholar 

  13. Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 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. 2018;49(3):e46–e110.

    Article  PubMed  Google Scholar 

  14. Zerna C, Thomalla G, Campbell B, et al. Current practice and future directions in the diagnosis and acute treatment of ischaemic stroke. Lancet. 2018;392(10154):1247–56.

    Article  PubMed  Google Scholar 

  15. Campbell BC, Mitchell PJ, Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009–18.

    Article  PubMed  CAS  Google Scholar 

  16. Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723–31.

    Article  PubMed  Google Scholar 

  17. Ciccone A, Valvassori L, Nichelatti M, et al. Endovascular treatment for acute ischemic stroke. N Engl J Med. 2013;368(10):904–13.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Pigretti SG, Alet MJ, Mamani CE, et al. Consensus on acute ischemic stroke. Medicina (B Aires). 2019;79(Suppl 2):1–46.

    Google Scholar 

  19. Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723–31.

    Article  PubMed  Google Scholar 

  20. Sheen JJ, Kim YW. Paradigm shift in intra-arterial mechanical thrombectomy for acute ischemic stroke : a review of randomized controlled trials after 2015. J Korean Neurosurg Soc. 2020;

    Google Scholar 

  21. Will L, Maus V, Maurer C, et al. Mechanical thrombectomy in acute ischemic stroke using a manually expandable stent retriever (tigertriever): preliminary single center experience. Clin Neuroradiol. 2020; https://doi.org/10.1007/s00062-020-00919-w.

  22. Rudilosso S, Laredo C, Amaro S, et al. Clinical improvement within 24 hours from mechanical thrombectomy as a predictor of long-term functional outcome in a multicenter population-based cohort of patients with ischemic stroke. J Neurointerv Surg. 2021;13:119–23.

    Article  PubMed  Google Scholar 

  23. Cao Y, Wang S, Sun W, et al. Prediction of favorable outcome by percent improvement in patients with acute ischemic stroke treated with endovascular stent thrombectomy. J Clin Neurosci. 2017;38:100–5.

    Article  PubMed  CAS  Google Scholar 

  24. Agarwal S, Cutting S, Grory BM, et al. Redefining early neurological improvement after reperfusion therapy in stroke. J Stroke Cerebrovasc Dis. 2020;29(2):104526.

    Article  PubMed  Google Scholar 

  25. Juttler E, Schwab S, Schmiedek P, et al. Decompressive surgery for the treatment of malignant infarction of the middle cerebral artery (DESTINY): a randomized, controlled trial. Stroke. 2007;38(9):2518–25.

    Article  PubMed  Google Scholar 

  26. Vahedi K, Hofmeijer J, Juettler E, et al. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol. 2007;6(3):215–22.

    Article  PubMed  Google Scholar 

  27. Beez T, Munoz-Bendix C, Steiger HJ, et al. Decompressive craniectomy for acute ischemic stroke. Crit Care. 2019;23(1):209.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Heros RC. Surgical treatment of cerebellar infarction. Stroke. 1992;23(7):937–8.

    Article  PubMed  CAS  Google Scholar 

  29. Jauss M, Krieger D, Hornig C, et al. Surgical and medical management of patients with massive cerebellar infarctions: results of the German-Austrian cerebellar infarction study. J Neurol. 1999;246(4):257–64.

    Article  PubMed  CAS  Google Scholar 

  30. Creutzfeldt CJ, Tirschwell DL, Kim LJ, et al. Seizures after decompressive hemicraniectomy for ischaemic stroke. J Neurol Neurosurg Psychiatry. 2014;85(7):721–5.

    Article  PubMed  CAS  Google Scholar 

  31. Pfefferkorn T, Eppinger U, Linn J, et al. Long-term outcome after suboccipital decompressive craniectomy for malignant cerebellar infarction. Stroke. 2009;40(9):3045–50.

    Article  PubMed  Google Scholar 

  32. Arnaout OM, Aoun SG, Batjer HH, et al. Decompressive hemicraniectomy after malignant middle cerebral artery infarction: rationale and controversies. Neurosurg Focus. 2011;30(6):E18.

    Article  PubMed  Google Scholar 

  33. Rahme R, Zuccarello M, Kleindorfer D, et al. Decompressive hemicraniectomy for malignant middle cerebral artery territory infarction: is life worth living? J Neurosurg. 2012;117(4):749–54.

    Article  PubMed  Google Scholar 

  34. Vahedi K, Benoist L, Kurtz A, et al. Quality of life after decompressive craniectomy for malignant middle cerebral artery infarction. J Neurol Neurosurg Psychiatry. 2005;76(8):1181–2.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  35. Campbell BC, Mitchell PJ, Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009–18.

    Article  PubMed  CAS  Google Scholar 

  36. Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015;372(24):2296–306.

    Article  PubMed  CAS  Google Scholar 

  37. Weber R, Nordmeyer H, Hadisurya J, et al. Comparison of outcome and interventional complication rate in patients with acute stroke treated with mechanical thrombectomy with and without bridging thrombolysis. J Neurointerv Surg. 2017;9(3):229–33.

    Article  PubMed  Google Scholar 

  38. Serles W, Gattringer T, Mutzenbach S, et al. Endovascular stroke therapy in Austria: a nationwide 1-year experience. Eur J Neurol. 2016;23(5):906–11.

    Article  PubMed  CAS  Google Scholar 

  39. Nikoubashman O, Jungbluth M, Schurmann K, et al. Neurothrombectomy in acute ischaemic stroke: a prospective single-Centre study and comparison with randomized controlled trials. Eur J Neurol. 2016;23(4):807–16.

    Article  PubMed  CAS  Google Scholar 

  40. Mishra A, Rao A, Pimpalwar Y. Ultrasound guided percutaneous injection of thrombin: effective technique for treatment of iatrogenic femoral pseudoaneurysms. J Clin Diagn Res. 2017;11(4):C4–6.

    Google Scholar 

  41. Balami JS, White PM, McMeekin PJ, et al. Complications of endovascular treatment for acute ischemic stroke: prevention and management. Int J Stroke. 2018;13(4):348–61.

    Article  PubMed  Google Scholar 

  42. Berkhemer OA, Fransen PS, Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372(1):11–20.

    Article  PubMed  CAS  Google Scholar 

  43. Davis MC, Deveikis JP, Harrigan MR. Clinical presentation, imaging, and management of complications due to neurointerventional procedures. Semin Intervent Radiol. 2015;32(2):98–107.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Papanagiotou P, White CJ. Endovascular reperfusion strategies for acute stroke. JACC Cardiovasc Interv. 2016;9(4):307–17.

    Article  PubMed  Google Scholar 

  45. Akpinar SH, Yilmaz G. Periprocedural complications in endovascular stroke treatment. Br J Radiol. 2016;89(1057):20150267.

    Article  PubMed  Google Scholar 

  46. Bracard S, Ducrocq X, Mas JL, et al. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial. Lancet Neurol. 2016;15(11):1138–47.

    Article  PubMed  CAS  Google Scholar 

  47. Saver JL, Goyal M, Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015;372(24):2285–95.

    Article  PubMed  CAS  Google Scholar 

  48. Bauer AM, Rasmussen PA. Treatment of intracranial vasospasm following subarachnoid hemorrhage. Front Neurol. 2014;5:72.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Masoud H, Nguyen TN, Martin CO, et al. Inadvertent stent retriever detachment: a multicenter case series and review of device experience FDA reports. Interv Neurol. 2016;4(3–4):75–82.

    PubMed  Google Scholar 

  50. Mokin M, Fargen KM, Primiani CT, et al. Vessel perforation during stent retriever thrombectomy for acute ischemic stroke: technical details and clinical outcomes. J Neurointerv Surg. 2017;9(10):922–8.

    Article  PubMed  Google Scholar 

  51. Leishangthem L, Satti SR. Vessel perforation during withdrawal of Trevo ProVue stent retriever during mechanical thrombectomy for acute ischemic stroke. J Neurosurg. 2014;121(4):995–8.

    Article  PubMed  Google Scholar 

  52. Doerfler A, Wanke I, Egelhof T, et al. Aneurysmal rupture during embolization with Guglielmi detachable coils: causes, management, and outcome. AJNR Am J Neuroradiol. 2001;22(10):1825–32.

    PubMed  PubMed Central  CAS  Google Scholar 

  53. Darkhabani Z, Nguyen T, Lazzaro MA, et al. Complications of endovascular therapy for acute ischemic stroke and proposed management approach. Neurology. 2012;79(13 Suppl 1):S192–8.

    Article  PubMed  CAS  Google Scholar 

  54. Yilmaz R, Yuksekbas O, Erkol Z, et al. Postmortem findings after anaphylactic reactions to drugs in Turkey. Am J Forensic Med Pathol. 2009;30(4):346–9.

    Article  PubMed  Google Scholar 

  55. Brown SG. Cardiovascular aspects of anaphylaxis: implications for treatment and diagnosis. Curr Opin Allergy Clin Immunol. 2005;5(4):359–64.

    Article  PubMed  Google Scholar 

  56. Kurland DB, Khaladj-Ghom A, Stokum JA, et al. Complications associated with decompressive craniectomy: a systematic review. Neurocrit Care. 2015;23(2):292–304.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Bruder M, Schuss P, Konczalla J, et al. Ventriculostomy-related hemorrhage after treatment of acutely ruptured aneurysms: the influence of anticoagulation and antiplatelet treatment. World Neurosurg. 2015;84(6):1653–9.

    Article  PubMed  Google Scholar 

  58. Fischer U, Taussky P, Gralla J, et al. Decompressive craniectomy after intra-arterial thrombolysis: safety and outcome. J Neurol Neurosurg Psychiatry. 2011;82(8):885–7.

    Article  PubMed  Google Scholar 

  59. Lee MH, Yang JT, Weng HH, et al. Hydrocephalus following decompressive craniectomy for malignant middle cerebral artery infarction. Clin Neurol Neurosurg. 2012;114(6):555–9.

    Article  PubMed  Google Scholar 

  60. Waziri A, Fusco D, Mayer SA, et al. Postoperative hydrocephalus in patients undergoing decompressive hemicraniectomy for ischemic or hemorrhagic stroke. Neurosurgery. 2007;61(3):489–93, 493–494.

    Article  PubMed  Google Scholar 

  61. Ropper AE, Nalbach SV, Lin N, et al. Resolution of extra-axial collections after decompressive craniectomy for ischemic stroke. J Clin Neurosci. 2012;19(2):231–4.

    Article  PubMed  Google Scholar 

  62. Burn J, Dennis M, Bamford J, et al. Epileptic seizures after a first stroke: the Oxfordshire Community Stroke Project. BMJ. 1997;315(7122):1582–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  63. So EL, Annegers JF, Hauser WA, et al. Population-based study of seizure disorders after cerebral infarction[J]. Neurology. 1996;46(2):350–5.

    Article  PubMed  CAS  Google Scholar 

  64. Creutzfeldt CJ, Tirschwell DL, Kim LJ, et al. Seizures after decompressive hemicraniectomy for ischaemic stroke. J Neurol Neurosurg Psychiatry. 2014;85(7):721–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Tianwei Wang, Hui Wu & Jiong Dai

  2. Department of Neurosurgery, Shanghai Minhang District Central Hospital, Shanghai, China

    Fulin Xu

  3. Department of Neurosurgery, Shanghai No. 5 People’s Hospital, Shanghai, China

    Jun Li

  4. Department of Neurosurgery, Shanghai Baoshan District Central Hospital, Shanghai, China

    Ximin Zhao

Authors
  1. Tianwei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fulin Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ximin Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jiong Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan

    Yoko Kato

  2. Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Xiaohua Zhang

  3. Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Jiong Dai

  4. Department of Neurosurgery, UP University of Medical Sciences, Saifai, UP, India

    Ahmed Ansari

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wang, T., Wu, H., Xu, F., Li, J., Zhao, X., Dai, J. (2021). Management (Surgical and Endovascular) of Acute Ischemic Stroke. In: Kato, Y., Zhang, X., Dai, J., Ansari, A. (eds) Recent Progress in the Management of Cerebrovascular Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-16-3387-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-981-16-3387-4_10

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-3386-7

  • Online ISBN: 978-981-16-3387-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation