Endovascular treatment of acute ischemic stroke

Abstract

Early recanalization of the occluded artery leads to better clinical outcomes in patients with acute ischemic stroke (AIS) through protection of the time-sensitive penumbra. Intravenous administration of pharmacologic thrombolytic agents has been a standard treatment for AIS. To get better rates of recanalization, enhance the time window, and diminish the possibility of intracranial hemorrhage, endovascular thrombectomy was launched, with first authorization of the Merci clot retriever, a corkscrew-like apparatus, followed by approval of the Penumbra thromboaspiration system. Both devices lead to a high rate of recanalization. On the other hand, time to recanalization was on an average of 45 minutes, with most of the patients attaining only partial recanalization. More lately, retrievable stents have shown promise in decreasing the time to recanalization, and attaining a superior rate of complete clot resolution. The retrievable stent can be released within the clot to engage it within the struts of the stent, and afterwards it is taken back by pulling it under flow arrest. Neurointerventional techniques have a persistently ever-increasing and stimulating role in the management of AIS, as indicated by the advent of several important techniques. Stent retrievers have the capability to be ascertained as the most important approach to endovascular stroke treatment.

Commentary

“…It is without doubt an excellent review article on the endovascular treatment of acute ischemic stroke (AIS). [1] As we know, AIS is a leading cause of death and disability in the developed world. For the patient, a stroke can be devastating, involving problems such as loss of mobility, independence, and communication, and comprehension skills, thus leading to huge costs in healthcare and loss of productivity.…”

Young Paradoxical Stroke Treated Successfully with Mechanical Thrombectomy Using Solitaire and Transcatheter Closure of Patent Foramen Oval

“…4,5) In recent years, mechanical thrombectomy has emerged to treat acute ischemic stroke and shown significant technical advances, even when chemical thrombolysis is not possible because of the potential risk of hemorrhagic complications. 6,7) We report herein a young patient with paradoxical stroke, who was successfully treated with mechanical thrombectomy and transcatheter PFO closure, but also prevented the recurrence of ischemic stroke.…”

The effect of physical training on glutamate transporter expression in an experimental ischemic stroke rat model

“…Ischemic strokes, accounting for 80% of all strokes may be caused due to atherosclerotic disease, embolism, hypercoagulable disorders, and in certain cases, due to undetermined causes [2]. It is also one of the leading causes of motor dysfunction, cognitive impairment, movement and gait disorder [3]. The restoration of these main functions is therefore, a major aim in stroke rehabilitation.…”