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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Endovascular Stroke Therapy.

Wade S Smith1

  • 1Department of Neurology, University of California, San Francisco, 505 Parnassus Ave, Box 0114, San Francisco, CA, 94143-0114, USA. smithw@neurology.ucsf.edu.

Neurotherapeutics : the Journal of the American Society for Experimental Neurotherapeutics
|March 7, 2019
PubMed
Summary
This summary is machine-generated.

Endovascular stroke therapy is highly effective for severe ischemic stroke. New research suggests a "tissue clock" approach, using advanced imaging, may expand treatment eligibility beyond traditional time limits.

Keywords:
Thrombectomyischemic penumbralarge-vessel strokepenumbral imagingsystems of care

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Ischemic stroke is a major global cause of death and disability.
  • Large-vessel ischemic stroke represents a severe subtype requiring urgent intervention.
  • Endovascular techniques have emerged as a highly effective treatment option.

Purpose of the Study:

  • To review the current state of endovascular stroke therapy for large-vessel ischemic stroke.
  • To explore recent advancements in patient selection for endovascular treatment.
  • To discuss the implications of a "tissue clock" versus a "time clock" for treatment eligibility.

Main Methods:

  • Review of recent clinical trials and research on endovascular stroke therapy.
  • Analysis of advanced imaging techniques for identifying salvageable brain tissue.
  • Examination of evolving stroke systems of care and treatment protocols.

Main Results:

  • Endovascular therapies for large-vessel ischemic stroke were proven effective in 2015 and represent highly beneficial surgical interventions.
  • Emerging research indicates that advanced imaging can identify patients eligible for treatment up to 24 hours after stroke onset, based on tissue viability rather than time alone.
  • Stroke systems globally are adopting these advanced endovascular treatments.

Conclusions:

  • Endovascular therapy is a critical treatment for large-vessel ischemic stroke.
  • The concept of a "tissue clock" is revolutionizing patient selection, potentially expanding treatment windows.
  • Ongoing efforts focus on optimizing stroke systems and broadening patient eligibility for these life-saving interventions.