Intravenous Thrombolysis and Endovascular Thrombectomy in Acute Ischemic Stroke with Minor Symptom
Journal of the Korean Neurological Association
; : 10-18, 2021.
Article
em Ko
| WPRIM
| ID: wpr-875043
Biblioteca responsável:
WPRO
ABSTRACT
More than 50% of all patients with ischemic stroke initially present with mild symptoms. Despite the mild clinical presentation, a high percentage of these patients develop stroke progression with consequent disability, recurrent stroke, or death at follow-up. Intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 hours has been proven to be an effective treatment for acute ischemic stroke, but the risk-benefit ratio of this therapeutic approach remains still unclear in patients with mild stroke. Many patients with mild stroke are frequently excluded from thrombolysis. Large artery occlusion is an important predictor of early neurological deterioration or poor outcomes in patients with mild ischemic stroke. However, current guidelines do not recommend endovascular thrombectomy in patients with National Institutes of Health Stroke Scale score of <6 points. Some previous retrospective cohort studies have reported that endovascular thrombectomy showed promising results in cases of acute mild ischemic stroke with large vessel occlusion. Treatment decisions in patients with mild ischemic stroke should be individualized depending on clinical and radiological features. In this review, we discuss the prognosis of mild strokes, efficacy of intravenous thrombolysis and endovascular thrombectomy, and the role of neurovascular imaging in treatment decision making in this patient population.
Texto completo:
1
Índice:
WPRIM
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
Idioma:
Ko
Revista:
Journal of the Korean Neurological Association
Ano de publicação:
2021
Tipo de documento:
Article