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Updated: May 18, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Treatment of acute ischemic stroke: systemic or local?
Rüdiger von Kummer1, Johannes Gerber
1Neuroradiology and Dresden University Stroke Center, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Ruediger.vonkummer@uniklinikum-dresden.de
Abstract:
Systemic treatment of acute ischemic stroke currently means intravenous infusion of plasminogen activator in patients with the stroke syndrome after exclusion of brain hemorrhage irrespective of whether thrombotic arterial obstruction is present or not. In contrast, local intra-arterial treatment requires digital subtraction angiography and means direct treatment of the arterial pathology with the aim of recanalization and brain tissue reperfusion. Randomized controlled trials that test these two treatment approaches are missing. This paper discusses whether the time-saving systemic treatment approach is more promising for acute ischemic stroke patients than is the time-consuming endovascular local approach.
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