Endovascular management of acute ischemic stroke A review

被引:11
作者
Gandhi, Chirag D. [1 ]
Christiano, Lana D. [1 ]
Prestigiacomo, Charles J. [1 ]
机构
[1] Univ Med & Dent New Jersey, Dept Neurol Surg, Newark, NJ 07103 USA
关键词
PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; RECANALIZATION; THROMBOLYSIS; ABCIXIMAB; THERAPY; OCCLUSION;
D O I
10.3171/2009.1.FOCUS08275
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The management of stroke has progressed significantly over the past 2 decades due to successful treatment protocols including intravenous and intraarterial options. The intravenous administration of tissue plasminogen activator within an established treatment window has been proven in large, well-designed studies. The evolution of endovascular strategies for acute stroke has been prompted by the limits of the intravenous treatment, as well as by the desire to demonstrate improved recanalization rates and improved long-term outcomes. The interventional treatment options available today are the intraarterial administration of tissue plasminogen activator and newer antiplatelet agents, mechanical thrombectomy with the MERCI device and the Penumbra system, and intracranial angioplasty and stent placement. In this review the authors outline the major studies that have defined the current field of acute stroke management and discuss the basic treatment paradigms that are commonly used today. (DOI: 10.3171.2009.1.FOCUS08275)
引用
收藏
页数:8
相关论文
共 34 条
[1]  
Adams HP, 2000, STROKE, V31, P601
[2]   Management of intraprocedural arterial thrombus in cerebral aneurysm embolization with abciximab:: Technical case report [J].
Alexander, MJ ;
Duckwiler, GR ;
Gobin, YP ;
Viñuela, F .
NEUROSURGERY, 2002, 50 (04) :899-901
[3]   Why are stroke patients excluded from TPA therapy? An analysis of patient eligibility [J].
Barber, PA ;
Zhang, J ;
Demchuk, AM ;
Hill, MD ;
Buchan, AM .
NEUROLOGY, 2001, 56 (08) :1015-1020
[4]   The penumbra system: A mechanical device for the treatment of acute stroke due to thromboembolism [J].
Bose, A. ;
Henkes, H. ;
Alfke, K. ;
Reith, W. ;
Mayer, T. E. ;
Berlis, A. ;
Branca, V. ;
Sit, S. Po .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2008, 29 (07) :1409-1413
[6]   Early dramatic recovery during intravenous tissue plasminogen activator infusion - Clinical pattern and outcome in acute middle cerebral artery stroke [J].
Felberg, RA ;
Okon, NJ ;
El-Mitwalli, A ;
Burgin, WS ;
Grotta, JC ;
Alexandrov, AV .
STROKE, 2002, 33 (05) :1301-1307
[7]   Intra-arterial prourokinase for acute ischemic stroke - The PROACT II study: A randomized controlled trial [J].
Furlan, A ;
Higashida, R ;
Wechsler, L ;
Gent, M ;
Rowley, H ;
Kase, C ;
Pessin, M ;
Ahuja, A ;
Callahan, F ;
Clark, WM ;
Silver, F ;
Rivera, F .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (21) :2003-2011
[8]   Coronary angioplasty with or without stent implantation for acute myocardial infarction [J].
Grines, CL ;
Cox, DA ;
Stone, GW ;
Garcia, E ;
Mattos, LA ;
Giambartolomei, A ;
Brodie, BR ;
Madonna, O ;
Eijgelshoven, M ;
Lansky, AJ ;
O'Neill, WW ;
Morice, MC .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (26) :1949-1956
[10]   Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (WingSpan) [J].
Henkes, H ;
Miloslavski, E ;
Lowens, S ;
Reinartz, J ;
Liebig, T ;
Kühne, D .
NEURORADIOLOGY, 2005, 47 (03) :222-228