[Technical standards for the interventional treatment of acute ischemic stroke].

Abstract

Acute ischemic stroke is the leading cause of acquired disability and its treatment is still a major challenge. For more than a decade, various mechanical devices have been developed for the recanalization of proximal artery occlusions in acute ischemic stroke but most of them have been approved for clinical use, only on the basis of uncontrolled case series. Intravenous thrombolysis with recombinant tissue-specific plasminogen activator administered (iv rtPA) within 4.5 h of symptom onset is so far the only approved medicinal treatment in the acute phase of cerebral infarction. With the introduction of stent retrievers, mechanical thrombectomy has demonstrated substantial rates of partial or complete arterial recanalization and improved outcomes compared with iv rtPA and best medical treatment alone in multiple randomized clinical trials in select patients with acute ischemic stroke and proximal artery occlusions. This review discusses the evolution of endovascular stroke therapy followed by a discussion of the current technical standards of mechanical thrombectomy that have to be considered during endovascular stroke therapy and the updated treatment recommendations of the ESO Karolinska stroke update.

• Authors: M A Möhlenbruch, M Bendszus
• Journal: Der Nervenarzt (Nervenarzt) Vol. 86 Issue 10 Pg. 1209-16 (Oct 2015) ISSN: 1433-0407 [Electronic] Germany
• Vernacular Title: Technische Standards bei der interventionellen Behandlung des akuten ischämischen Schlaganfalls.
• PMID: 26334350 (Publication Type: English Abstract, Journal Article)

Chemical References

• Fibrinolytic Agents
• Tissue Plasminogen Activator

Topics

• Combined Modality Therapy (standards)
• Evidence-Based Medicine
• Fibrinolytic Agents (therapeutic use)
• Germany
• Humans
• Mechanical Thrombolysis (instrumentation, standards)
• Neurology (standards)
• Practice Guidelines as Topic
• Stents (standards)
• Stroke (diagnosis, therapy)
• Thrombolytic Therapy (standards)
• Tissue Plasminogen Activator (therapeutic use)
• Treatment Outcome