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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis.

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Related Experiment Video

Updated: Feb 23, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Published on: January 18, 2018

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[Endovascular thrombectomy for ischemic stroke].

B Kallmünzer1, M Köhrmann2

  • 1Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland. bernd.kallmuenzer@uk-erlangen.de.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|September 13, 2017
PubMed
Summary
This summary is machine-generated.

Acute stroke treatment combines intravenous thrombolysis and endovascular thrombectomy for large vessel occlusions. Extended treatment windows up to 24 hours are now supported for select patients with significant clinical deficits.

Keywords:
AlteplaseCerebral infarctionConscious sedationThrombectomyThrombolytic therapy

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Area of Science:

  • Neurology
  • Interventional Cardiology
  • Emergency Medicine

Background:

  • The standard treatment for acute anterior circulation large vessel occlusion stroke involves intravenous rt-PA (recombinant tissue-type plasminogen activator) and endovascular thrombectomy.
  • This combined therapy significantly improves outcomes, reducing functional deficits and long-term disability.

Purpose of the Study:

  • To summarize the current standard of care for acute stroke with large vessel occlusion.
  • To highlight evolving treatment guidelines and emerging research areas in stroke management.

Main Methods:

  • Review of current international guidelines and recent clinical evidence.
  • Discussion of the 'drip-and-ship' paradigm for stroke care infrastructure.

Main Results:

  • Intravenous thrombolysis combined with endovascular thrombectomy is highly effective for acute anterior circulation large vessel occlusions.
  • Treatment is recommended within 6 hours, with evidence supporting extended windows up to 24 hours for selected patients exhibiting clinical-core mismatch.

Conclusions:

  • The combination of rt-PA and thrombectomy is the established standard of care, offering significant benefits for stroke patients.
  • Future research should focus on M2 segment occlusions and optimal anesthetic management during interventions, alongside optimizing stroke care infrastructure, particularly in rural settings using the drip-and-ship model.