Neuroendovascular Rescue 2025: Trends in Stroke Endovascular Therapy.

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Acute ischemic stroke due to large arterial occlusion presents a significant clinical challenge.
• Neuroendovascular rescue has emerged as a critical treatment modality over the past two decades.

Purpose of the Study:

• To review the evolution and current status of neuroendovascular techniques for acute ischemic stroke.
• To highlight advancements in patient selection and procedural care.

Main Methods:

• Review of neuroendovascular techniques including intra-arterial thrombolysis, direct aspiration, stent retrieval, and adjuvant therapies.
• Discussion of imaging advancements for patient selection.
• Consideration of periprocedural care optimization.

Main Results:

• Neuroendovascular rescue has shown consistent patient benefit for large arterial occlusions.
• Techniques have evolved from simple thrombolysis to complex mechanical interventions.
• Improved patient selection and periprocedural care enhance outcomes.

Conclusions:

• Modern neuroendovascular techniques offer significant benefits for acute ischemic stroke patients with large arterial occlusions.
• The field continues to evolve with ongoing innovation in devices and strategies.
• Multimodal approaches, including advanced imaging and optimized care, are crucial for successful neurointervention.