Mechanical Embolectomy

Katz, Jeffrey M.; Gobin, Y. Pierre; Segal, Alan Z.; Riina, Howard A.

doi:10.1016/j.nec.2005.03.002

Cited by 11 publications

(4 citation statements)

References 39 publications

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“…A meta-analysis of multiple case series comparing IV and IA fibrinolysis for acute vertebrobasilar stroke showed marginally better recanalization rates with intra-arterial therapy (65% versus 53%; P = 0.05). [40] Similar findings were demonstrated by the Basilar Artery International Cooperative Study (BASICS) registry [41]. …”

Section: Intra-arterial (Ia) Thrombolysissupporting

confidence: 71%

The Quest for Arterial Recanalization in Acute Ischemic Stroke-The Past, Present and the Future

Yeo

Sharma

2013

J Clin Med Res

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Ischemic stroke is one of the major causes of mortality and longterm disability. In the recent past, only very few treatment options were available and a considerable proportion of stroke survivors remained permanently disabled. However, over the last 2 decades rapid advances in acute stroke care have resulted in a corresponding improvement in mortality rates and functional outcomes. In this review, we describe the evolution of systemic thrombolytic agents and various interventional devices, their current status as well as some of the future prospects. We reviewed literature pertaining to acute ischemic stroke reperfusion treatment. We explored the current accepted treatment strategies to attain cerebral reperfusion via intravenous modalities and compare and contrast them within the boundaries of their clinical trials. Subsequently we reviewed the trials for interventional devices for acute ischemic stroke, categorizing them into thrombectomy devices, aspiration devices, clot disruption devices and thrombus entrapment devices. Finally we surveyed several of the alternative reperfusion strategies available. We also shed some light on the controversies surrounding the current strategies of treatment of acute ischemic stroke. Acute invasive interventional strategies continue to improve along with the noninvasive modalities. Both approaches appear promising. We conducted a comprehensive chronological review of the existing treatments as well as upcoming remedies for acute ischemic stroke.

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Section: Intra-arterial (Ia) Thrombolysissupporting

confidence: 71%

The Quest for Arterial Recanalization in Acute Ischemic Stroke-The Past, Present and the Future

Yeo

Sharma

2013

J Clin Med Res

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“…14 Furthermore, suppression of microembolic signals may have occurred in the patient in whom recurrent TIAs ceased after he was treated with aspirin and clopidogrel. More aggressive therapies (like mechanical embolectomy or surgical thrombus removal) 25,26 to restore cerebral blood flow may be justified in patients who have persistent or enlarged iNOT and deteriorate clinically despite combination antithrombotic therapy.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Clinical Course of Stroke and Transient Ischemic Attack Patients With Intracranial Nonocclusive Thrombus on Computed Tomographic Angiography

Puetz

Dzialowski

Coutts

et al. 2009

Stroke

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“…[3] Endovascular mechanical methods comprise a wide range of mechanical devices designed to mechanically retrieve, fragment or obliterate thromboemboli, atherosclerotic plaque and other vascular occlusions. [34,35] The mechanical embolus removal in cerebral ischemia (MERCI) trial is a single arm trial to study the safety and technical efficacy of mechanical embolus removal.…”

Section: Thrombolysismentioning

confidence: 99%

Re-canalization in acute ischemic stroke: The strategies

Pandian

2009

Neurol India

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Thrombolytic stroke therapy is based on the "re-canalization hypothesis," i.e., that reopening of occluded vessels improves clinical outcome in acute ischemic stroke through regional reperfusion and salvage of threatened tissues. Re-canalization is an important predictor of stroke outcome in all the modalities of thrombolysis. Thrombolysis in acute ischemic stroke evolved from clinical trials with intravenous (IV) tissue plasminogen activator (tPA) to combination treatments with Intra-arterial (IA)/mechanical reperfusion techniques. The combined approach reduces time to initiation of treatment and may increase re-canalization and chances of a good clinical outcome. In IV thrombolysis overall re-canalization rate is 46.2% during the first 6-24 hrs. Intra-arterial thrombolysis has higher early re-canalization rate, 63.2%. The highest re-canalization rate is seen with mechanical thrombolysis, 83.6%. Other factors in addition to re-canalization: stroke severity, older age, systolic hypertension, location of arterial occlusion, collateral blood supply, and time from stroke onset to treatment play an important role in determining the clinical outcome following thrombolysis with tPA. Future trials should look at the interplay of various factors like re-canalization, reperfusion, and collateral flow and clot burden in the evaluation of reperfusion therapies in acute ischemic stroke.

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Mechanical Embolectomy

Cited by 11 publications

References 39 publications

The Quest for Arterial Recanalization in Acute Ischemic Stroke-The Past, Present and the Future

The Quest for Arterial Recanalization in Acute Ischemic Stroke-The Past, Present and the Future

Frequency and Clinical Course of Stroke and Transient Ischemic Attack Patients With Intracranial Nonocclusive Thrombus on Computed Tomographic Angiography

Re-canalization in acute ischemic stroke: The strategies

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