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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Bibliographic Details
Published in:BMC neurology Vol. 18; no. 1; pp. 8 - 26
Main Authors: Bhaskar, Sonu, Stanwell, Peter, Cordato, Dennis, Attia, John, Levi, Christopher
Format: Journal Article
Language:English
Published: London BioMed Central 16.01.2018
BioMed Central Ltd
BMC
Subjects:
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 Access:Get full text
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Summary: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.
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ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-017-1007-y