Current status of endovascular therapy for acute ischemic stroke
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- Yamagami Hiroshi
- Department of Neurology, National Cerebral and Cardiovascular Center
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- Sakai Nobuyuki
- Neurosurgery and KCGH Comprehensive Stroke Center, Kobe City Medical Center General Hospital
Bibliographic Information
- Other Title
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- 脳卒中の脳血管内治療の最前線
Abstract
Endovascular therapy (EVT) is performed in patients with acute ischemic stroke due to major artery occlusion, if they were ineligible of intravenous (IV) rt-PA or failure to achieve reperfusion by IV rt-PA. In Japan, intra-arterial thrombolysis has been generally performed, and mechanical thrombectomy using Merci retriever and Penumbra system are gradually spreading. In 2013, the results of three randomized trials (IMS 3, SYNTHESIS expansion, and MR RESCUE) were published, and they could not prove the usefulness of EVT in patients with acute ischemic stroke compared with standard therapy including IV rt-PA. However, these trials suggested important issues of EVT. Especially, adequate selection of patients, improvement of reperfusion rate, and shorter onset to reperfusion time are needed to establish the usefulness of EVT.
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 53 (11), 1166-1168, 2013
Societas Neurologica Japonica
