Reperfusion therapy in acute ischemic stroke: dawn of a new era?

Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, re...

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Veröffentlicht in:BMC neurology Jg. 18; H. 1; S. 8 - 26
Hauptverfasser: Bhaskar, Sonu, Stanwell, Peter, Cordato, Dennis, Attia, John, Levi, Christopher
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 16.01.2018
BioMed Central Ltd
BMC
Schlagworte:
Brain Ischemia - therapy
Care and treatment
Cerebrovascular disease and stroke
Development and progression
Endovascular Procedures
Endovascular treatment
Fibrinolytic Agents - therapeutic use
Health aspects
Humans
Medical research
Medicine
Medicine & Public Health
Neurochemistry
Neurointervention
Neurology
Neurosurgery
Patient Selection
Prognosis
Reperfusion (Physiology)
Reperfusion - methods
Reperfusion therapy
Review
Stroke
Stroke - therapy
Thrombolytic Therapy - methods
Treatment Outcome
Stroke
Reperfusion therapy
Prognosis
Endovascular treatment
Neurointervention
ISSN:1471-2377, 1471-2377
Online-Zugang:Volltext
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Abstract Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.
AbstractList Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.
Abstract Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes. Keywords: Stroke, Reperfusion therapy, Prognosis, Endovascular treatment, Neurointervention
ArticleNumber 8
Audience Academic
Author Bhaskar, Sonu
Cordato, Dennis
Stanwell, Peter
Levi, Christopher
Attia, John
Author_xml – sequence: 1
  givenname: Sonu
  orcidid: 0000-0002-9783-3628
  surname: Bhaskar
  fullname: Bhaskar, Sonu
  email: Sonu.Bhaskar@health.nsw.gov.au
  organization: Western Sydney University (WSU), School of Medicine, South West Sydney Clinical School, Liverpool Hospital, Department of Neurology & Neurophysiology, The Sydney Partnership for Health, Education, Research & Enterprise (SPHERE), Stroke & Neurology Research Group, Ingham Institute for Applied Medical Research, Department of Neurology, John Hunter Hospital, Priority Research Centre for Stroke & Brain Injury, Faculty of Health & Medicine, Hunter Medical Research institute (HMRI) and School of Medicine & Public Health, University of Newcastle
– sequence: 2
  givenname: Peter
  surname: Stanwell
  fullname: Stanwell, Peter
  organization: Priority Research Centre for Stroke & Brain Injury, Faculty of Health & Medicine, Hunter Medical Research institute (HMRI) and School of Medicine & Public Health, University of Newcastle
– sequence: 3
  givenname: Dennis
  surname: Cordato
  fullname: Cordato, Dennis
  organization: Liverpool Hospital, Department of Neurology & Neurophysiology, Stroke & Neurology Research Group, Ingham Institute for Applied Medical Research, School of Medicine, University of New South Wales (UNSW)
– sequence: 4
  givenname: John
  surname: Attia
  fullname: Attia, John
  organization: Priority Research Centre for Stroke & Brain Injury, Faculty of Health & Medicine, Hunter Medical Research institute (HMRI) and School of Medicine & Public Health, University of Newcastle, Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, University of Newcastle
– sequence: 5
  givenname: Christopher
  surname: Levi
  fullname: Levi, Christopher
  email: Christopher.Levi@unsw.edu.au
  organization: Western Sydney University (WSU), School of Medicine, South West Sydney Clinical School, Liverpool Hospital, Department of Neurology & Neurophysiology, The Sydney Partnership for Health, Education, Research & Enterprise (SPHERE), Stroke & Neurology Research Group, Ingham Institute for Applied Medical Research, School of Medicine, University of New South Wales (UNSW), Department of Neurology, John Hunter Hospital
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29338750$$D View this record in MEDLINE/PubMed
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Issue 1
Keywords Stroke
Reperfusion therapy
Prognosis
Endovascular treatment
Neurointervention
Language English
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Snippet Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients...
Abstract Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of...
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SubjectTerms Brain Ischemia - therapy
Care and treatment
Cerebrovascular disease and stroke
Development and progression
Endovascular Procedures
Endovascular treatment
Fibrinolytic Agents - therapeutic use
Health aspects
Humans
Medical research
Medicine
Medicine & Public Health
Neurochemistry
Neurointervention
Neurology
Neurosurgery
Patient Selection
Prognosis
Reperfusion (Physiology)
Reperfusion - methods
Reperfusion therapy
Review
Stroke
Stroke - therapy
Thrombolytic Therapy - methods
Treatment Outcome
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Title Reperfusion therapy in acute ischemic stroke: dawn of a new era?
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