[Endovascular therapy in the treatment of acute ischemic stroke: what the cardiologist should know]

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.8K

G Vellieux1, S Evrard1, P Guedin2

  • 1Unité de neurovasculaire, service de neurologie, hôpital Foch, université Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.

Annales De Cardiologie Et D'Angeiologie
|December 3, 2014
PubMed

Insights

Mechanical thrombectomy offers a vital alternative for ischemic stroke patients ineligible for IV fibrinolysis. This endovascular procedure effectively recanalizes cerebral occlusions, improving clinical outcomes in critical situations.

Area of Science:

  • Neurology
  • Interventional Cardiology
  • Neuroradiology

Background:

  • Ischemic stroke complications frequently occur during interventional cardiology procedures.
  • Intravenous fibrinolysis, the standard treatment, is often contraindicated in these patients.
  • Interventional neuroradiology has developed mechanical thrombectomy techniques to address this gap.

Observation:

  • Two cases of ischemic stroke during cardiovascular procedures with contraindications to IV fibrinolysis were treated.
  • Patients presented with contraindications including anticoagulation for atrial fibrillation and recent carotid surgery.
  • Endovascular thrombectomy was successfully employed in both emergency cases.

Findings:

  • Mechanical thrombectomy is an effective alternative or complementary treatment to IV fibrinolysis for ischemic stroke.
  • Endovascular thrombectomy devices enable recanalization of proximal cerebral occlusions.
  • Successful recanalization correlates with a favorable clinical prognosis.

Implications:

  • A "thrombolysis alert" system is crucial for rapid diagnosis and treatment selection in stroke patients during cardiovascular procedures.
  • Mechanical thrombectomy expands treatment options for stroke patients with contraindications to fibrinolysis.
  • Ongoing advancements in endovascular techniques and patient selection are improving stroke management.
Abstract

Keywords:
Accident vasculaire cérébralFibrinolyseFibrinolysisInfarctus cérébralIschemic strokeMechanical thrombectomyNeuroradiologie interventionnelleThrombectomie

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