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Related Concept Videos

Ischemic Heart Disease: Overview01:17

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Current perspectives on endovascular therapy for large core ischemic stroke.

Chloe A Mutimer1, Bruce C V Campbell1

  • 1Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.

Neurotherapeutics : the Journal of the American Society for Experimental Neurotherapeutics
|June 17, 2025
PubMed
Summary

Endovascular thrombectomy is now beneficial for ischemic stroke patients with large infarcts. Recent trials show improved outcomes and reduced mortality, changing treatment guidelines for this patient group.

Keywords:
Endovascular therapyIschemic strokeLarge ischemic coreLow ASPECTS

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Stroke Medicine

Background:

  • Historically, large ischemic core stroke patients were excluded from thrombectomy trials.
  • Concerns included limited benefit and high procedural risks for extensive infarcts.

Purpose of the Study:

  • To review recent randomized controlled trials on endovascular thrombectomy for large ischemic core stroke.
  • To summarize imaging selection, functional outcomes, safety, and long-term benefits.

Main Methods:

  • Narrative review of six recent randomized controlled trials.
  • Analysis of imaging selection criteria, functional outcomes (modified Rankin Scale), and safety (mortality, hemorrhage).

Main Results:

  • Thrombectomy consistently improved functional outcomes at 3 and 12 months.
  • While absolute independence rates were lower than in smaller core trials, they significantly favored thrombectomy.
  • Endovascular thrombectomy reduced mortality without increasing symptomatic intracerebral hemorrhage.

Conclusions:

  • Recent trials support endovascular thrombectomy for large ischemic core stroke.
  • Guidelines are updating, but clinical decisions require individualized assessment.
  • Future research should explore adjunctive therapies and optimized care systems.