Articles Tagged With: thrombectomy
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Blood Pressure Management After Endovascular Thrombectomy: What Is the Best Number?
Approximately 50% of patients who undergo endovascular therapy for ischemic stroke still have a severe impairment or will die within 90 days. Therefore, additional interventions are being investigated to improve overall outcome. Current guidelines from the American Heart Association suggest maintaining systolic blood pressure below 180 mmHg for patients who were treated both with intravenous thrombolysis and endovascular thrombectomy. A number of centers around the world have tried different systolic blood pressure thresholds ranging from 120 mmHg to 160 mmHg. Many of these studies have been single-center or small non-randomized studies and have not been designed to get a definitive answer.
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Should Endovascular Thrombectomy Be Performed With or Without Intravenous Alteplase?
With the widespread adoption of endovascular thrombectomy for the treatment of acute ischemic stroke caused by large vessel occlusion, a debate has raged about the role of intravenous thrombolysis. None of the clinical trials published to date have given us a clear evidence-based answer regarding the relative risks and benefits of this approach.
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Mechanical Thrombectomy with or Without Intravenous Thrombolysis?
Current stroke treatment guidelines recommend combined use of intravenous thrombolysis with alteplase prior to endovascular thrombectomy for patients with large vessel occlusion. However, there continues to be controversy surrounding this recommendation, and these investigators undertook a systematic review and meta-analysis of completed therapeutic trials to help resolve the controversy.
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Endovascular Thrombectomy with or Without Alteplase? Get With The Guidelines.
Since 2015, endovascular thrombectomy with intravenous alteplase has been the standard of care for patients with large vessel occlusion and ischemic stroke. However, since that time, the continuing use of alteplase has been questioned by many practitioners and investigators.
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Mechanical Thrombectomy with or Without Intravenous Thrombolysis?
Current stroke treatment guidelines recommend combined use of intravenous thrombolysis with alteplase prior to endovascular thrombectomy for patients with large vessel occlusion. However, there continues to be controversy surrounding this recommendation, and these investigators undertook a systematic review and meta-analysis of completed therapeutic trials to help resolve the controversy.
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Mechanical Thrombectomy for Acute Ischemic Stroke
Stroke is a debilitating illness affecting millions of individuals across the globe. While effective and life-saving treatment modalities exist at a majority of stroke receiving centers in the form of IV thrombolytics, there is an emerging new standard in acute ischemic stroke with mechanical thrombectomy.
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Clinical and Perfusion Mismatch Criteria Both Are Reliable in Identifying Patients Who Will Benefit from Endovascular Therapy
Since 2015, when multiple clinical trials were published showing the efficacy of endovascular thrombectomy (EVT) for large vessel occlusion within six hours of stroke onset, additional criteria have been developed to identify those patients who will benefit from EVT beyond six hours. The AURORA investigators collected patient data from six large clinical trials and performed a meta-analysis to determine if a clinical mismatch or an imaging mismatch protocol was better at predicting good outcomes in patients treated between six hours and 24 hours after the onset of clinical stroke symptoms.
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Telestroke Consultation Increases Rate of Thrombolysis and Reduces Mortality
Real-time video conferencing between the patient, a remotely located stroke specialist, and the bedside healthcare provider in a hospital emergency department is referred to as “telestroke.” However, there are little data comparing its benefit with in-person evaluation and treatment for hospitals that do not have in-hospital stroke specialists 24 hours per day, seven days per week.
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Ischemic Stroke in Patients with COVID-19
Since the first cases of COVID-19 were reported in the United States, severe ischemic strokes also have been reported in some of these patients, some with large vessel occlusions and case reports of thrombectomy for treatment. -
Special Report from the 2021 International Stroke Conference
These reviews of studies presented at the virtual 2021 International Stroke Conference were written by Neurology Alert's editor. All comments and opinions are solely those of the editor.