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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2016 Dicembre;57(6):758-68

lingua: Inglese

Acute stroke endovascular treatment: tips and tricks

Leonardo RANGEL-CASTILLA 1, 2, Gary B. RAJAH 2, Hakeem J. SHAKIR 1, 3, Jason M. DAVIES 1, 3, Kenneth V. SNYDER 1, 3-5, Adnan H. SIDDIQUI 1, 3, 4, 6, 7, Elad I. LEVY 1, 3, 4, 6, L. Nelson HOPKINS 1, 3, 4, 6, 7

1 Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; 2 Department of Neurosurgery, Wayne State School of Medicine, Wayne State University, Detroit, MI, USA; 3 Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA; 4 Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; 5 Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; 6 Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, NY, USA; 7 Jacobs Institute, Buffalo, NY, USA


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Acute ischemic stroke is a leading cause of death and disability in the United States, responsible for 1 of every 20 deaths. The efficacy of intravenous tissue plasminogen activator (tPA) alone for recanalization of large-vessel occlusion (LVO) is low. Several randomized trials have now established endovascular treatment of LVO as a standard of care. Endovascular techniques continue to evolve at a rapid pace. This review seeks to report recent advances in endovascular technology, discuss the correlation between speed of reperfusion and patient outcomes, and present mobile stroke care, shortcoming of the recent technology (such as clot fragmentation), and potential solutions to overcome these drawbacks, as well as anesthetic considerations and cost-effectiveness.

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