Published online before print April 3, 2008, doi: 10.1161/STROKEAHA.107.510263
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(Stroke. 2008;39:1663.)
© 2008 American Heart Association, Inc.
Editorials |
Interventional Management of Stroke
From the Department of Neurosurgery, Medical University of Vienna, Austria.
Correspondence to Andreas Gruber, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria 1090. E-mail andreas.gruber@ meduniwien.ac.at
Key Words: stroke management • neurointervention
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
See related article, pages 1770–1773.
Intravenous thrombolysis has become generally accepted and is currently the only FDA approved medical therapy for treatment of patients with acute ischemic stroke. Its use is associated with improved outcomes of patients who can be treated within 3 hours of stroke onset.1 A higher concentration of thrombolytic agents delivered directly into the thrombus has led to the promotion of intra-arterial thrombolysis, although the possible clinical benefits may be counterbalanced by delays to initiating treatment.2,3
With the evolving concept of interventional management of stroke, several options of multimodal reperfusion therapy are being evaluated. Options include emergency angioplasty and stenting as well as mechanical disruption or extraction of the thrombus.4–6 Such mechanical interventions are usually performed in combination with either intravenous or intra-arterial thrombolysis. Among these, placement of both balloon-mounted and self-expanding stents has been successfully performed in conjunction with thrombolytic therapy, the rationale for acute stenting being the prevention of vessel reocclusions occurring after recanalization with other modalities7; recent reports have established stent placement as an independent predictor of recanalization of both intracranial and extracranial acute cerebrovascular occlusions.8 Ongoing improvements of the neurointerventional materials available have led to the introduction of self-expanding stents for intracranial applications; these can be navigated easier through the cerebral vasculature when compared to balloon-mounted stents and can be deployed savely with sufficient radial force but at significantly lower pressures than balloon expandable stent devices.9 More recently, a new self-expanding reconstrainable nitinol stent system for intracranial use has been
Related Article:
Stroke 2008 39: 1770-1773.