Endovascular Treatment of Acute Stroke: Evolution and Selection of Techniques and Instruments Based on Thrombus Imaging.

Liebig, T; Gralla, Jan; Schroth, Gerhard (2015). Endovascular Treatment of Acute Stroke: Evolution and Selection of Techniques and Instruments Based on Thrombus Imaging. Clinical neuroradiology, 25(2 Suppl), pp. 299-306. Springer 10.1007/s00062-015-0435-6

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Mechanical thrombectomy provides higher recanalization rates than intravenous or intra-arterial thrombolysis. Finally this has been shown to translate into improved clinical outcome in six multicentric randomized controlled trials. However, within cohorts the clinical outcomes may vary, depending on the endovascular techniques applied. Systems aiming mainly for thrombus fragmentation and lacking a protection against distal embolization have shown disappointing results when compared to recent stent-retriever studies or even to historical data on local arterial fibrinolysis. Procedure-related embolic events are usually graded as adverse events in interventional neuroradiology. In stroke, however, the clinical consequences of secondary emboli have so far mostly been neglected and attributed to progression of the stroke itself. We summarize the evolution of instruments and techniques for endovascular, image-guided, microneurosurgical recanalization in acute stroke, and discuss how to avoid procedure-related embolic complications.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Gralla, Jan and Schroth, Gerhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1869-1439

Publisher:

Springer

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

05 Oct 2015 09:06

Last Modified:

05 Oct 2015 09:06

Publisher DOI:

10.1007/s00062-015-0435-6

PubMed ID:

26216652

Uncontrolled Keywords:

NIRS; Near-infrared spectroscopy; Stent retriever; Stroke; Thrombus imaging

BORIS DOI:

10.7892/boris.72160

URI:

https://boris.unibe.ch/id/eprint/72160

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