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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

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Update on Treatment of Acute Ischemic Stroke

Alejandro A Rabinstein

    Continuum (Minneapolis, Minn.)
    |April 1, 2020
    PubMed

    Insights

    Recent advancements expand reperfusion treatment for acute ischemic stroke. Carefully selected patients can now receive emergency reperfusion therapy up to 24 hours after symptom onset, improving outcomes.

    Area of Science:

    • Neurology
    • Cerebrovascular Diseases

    Background:

    • Acute ischemic stroke requires timely intervention.
    • Reperfusion therapy is critical for improving outcomes.

    Purpose of the Study:

    • To provide an update on the current treatment of acute ischemic stroke.
    • To emphasize indications for reperfusion therapy.

    Main Methods:

    • Review of recent randomized controlled trials.
    • Analysis of expanded indications for reperfusion therapy.

    Main Results:

    • Established indications for intravenous thrombolysis (within 4.5 hours) and mechanical thrombectomy (within 6 hours).
    • New indications for reperfusion in wake-up or delayed presentation strokes (up to 24 hours).
    • Perfusion imaging or MRI is crucial for patient selection in extended windows.

    Conclusions:

    • Timely and successful reperfusion is the most effective treatment.
    • Recent evidence supports expanded time windows for reperfusion in selected patients.

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