Neuroendovascular Surgery for the Treatment of Ischemic Stroke

This review discusses modern therapeutic interventions for acute ischemic stroke with a focus on endovascular therapy. In 2015, the American Heart Association made major changes to the guidelines for the endovascular treatment of acute ischemic stroke. The Class IA indications for endovascular therapy of stroke patients include symptom onset within 6 h, proven large vessel occlusion of an artery in the anterior circulation, and the use of a stent retriever as part of the mechanical thrombectomy. Advanced perfusion imaging helps identify patients with a low ratio of ischemic core to salvageable penumbra. Equally important to overall clinical outcome is the organization of comprehensive stroke centers and the recent advent of the mobile stroke unit. Future clinical endovascular stroke trials will help us to better understand the role of endovascular interventions.