Direct angiographic intervention for acute ischemic stroke with large vessel occlusion.
Neurol Res
; 43(11): 926-931, 2021 Nov.
Article
em En
| MEDLINE
| ID: mdl-34130617
ABSTRACT
Background:
Rapid and effective revascularization is the cornerstone of acute ischemic stroke treatment. Endovascular thrombectomy reperfusion has dramatically changed patients' outcomes with large vessel occlusions. Results of randomized controlled trials have shown that the benefit of this treatment is highly time-sensitive. The purpose of this review is to introduce a new approach to acute stroke treatment - direct angiographic intervention for selected patients. Methods &Results:
We examined the issues related to the current guideline-based practice, emphasizing whether the benefit of using advanced multimodal imaging is worth the potential resultant disability generated by delayed reperfusion times. The published evidence supporting this novel concept was reviewed, its safety and feasibility discussed, and appropriate predictive tools for patient selection explored.Conclusion:
This new approach may provide benefits for appropriately selected patients. Further prospective trials are needed to clarify the risk-versus-benefit of this approach.Abbreviations and Acronyms AHA American Heart AssociationAIS acute ischemic strokeASA American Stroke AssociationASPECTS Alberta Stroke Program Early Computed Tomography ScoreCT computed tomographyCTA computed tomography angiographyCTP computed tomography perfusionDMVO distal, medium vessel occlusionDSA digital subtraction angiographyED Emergency DepartmentEVT endovascular thrombectomyFD flat detectorIA intra-arterialIV intravenousICH intracerebral hemorrhageMR magnetic resonanceMRA magnetic resonance angiographyMSU mobile stroke unitNIHSS National Institutes of Health Stroke ScaleNCCT non-contrast computed tomographyPLVO proximal, large vessel occlusionPPV positive predictive valuePWI magnetic resonance perfusion-weighted imaging.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Angiografia Cerebral
/
Reperfusão
/
Procedimentos Endovasculares
/
AVC Isquêmico
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Neurol Res
Ano de publicação:
2021
Tipo de documento:
Article