Book contents
- Acute Stroke Care
- Acute Stroke Care
- Copyright page
- Contents
- Preface to the Third Edition
- Abbreviations
- Chapter 1Stroke in the Emergency Department
- Chapter 2What to Do First
- Chapter 3Ischemic Stroke
- Chapter 4Stroke Radiology
- Chapter 5Intravenous Thrombolysis
- Chapter 6Endovascular Therapy
- Chapter 7Neurological Deterioration in Acute Ischemic Stroke
- Chapter 8Ischemic Stroke Etiology and Secondary Prevention
- Chapter 9Transient Ischemic Attack
- Chapter 10Less Common Causes of Stroke
- Chapter 11Cerebral Venous Sinus Thrombosis
- Chapter 12Intracerebral Hemorrhage
- Chapter 13Subarachnoid Hemorrhage
- Chapter 14Organization of Stroke Care
- Chapter 15Stroke Rehabilitation
- Chapter 16Transition to Outpatient Stroke Care
- Book part
- Further In-Depth Reading
- Index
- Plate Section (PDF Only)
- References
Chapter 6 - Endovascular Therapy
Published online by Cambridge University Press: 28 October 2019
Book contents
- Acute Stroke Care
- Acute Stroke Care
- Copyright page
- Contents
- Preface to the Third Edition
- Abbreviations
- Chapter 1Stroke in the Emergency Department
- Chapter 2What to Do First
- Chapter 3Ischemic Stroke
- Chapter 4Stroke Radiology
- Chapter 5Intravenous Thrombolysis
- Chapter 6Endovascular Therapy
- Chapter 7Neurological Deterioration in Acute Ischemic Stroke
- Chapter 8Ischemic Stroke Etiology and Secondary Prevention
- Chapter 9Transient Ischemic Attack
- Chapter 10Less Common Causes of Stroke
- Chapter 11Cerebral Venous Sinus Thrombosis
- Chapter 12Intracerebral Hemorrhage
- Chapter 13Subarachnoid Hemorrhage
- Chapter 14Organization of Stroke Care
- Chapter 15Stroke Rehabilitation
- Chapter 16Transition to Outpatient Stroke Care
- Book part
- Further In-Depth Reading
- Index
- Plate Section (PDF Only)
- References
Summary
When used alone, intravenous and intra-arterial thrombolysis have yielded low recanalization rates of proximal large-vessel occlusions (LVO). The endovascular trials utilizing first-generation devices such as the Merci retriever and the Penumbra aspiration system were essentially neutral and failed to demonstrate superiority of mechanical thrombectomy over IV tPA (MR RESCUE, SYNTHESIS, IMS-III). In 2015, however, six trials – MR CLEAN, EXTEND-IA, SWIFT PRIME, ESCAPE, REVASCAT, and THRACE – led to a fundamental shift in how we acutely manage LVOs today. All six trials compared endovascular thrombectomy (EVT) to IV tPA alone and demonstrated clear superiority of thrombectomy in patients presenting within 6 hours from the time they were last known well (LKW) if they met specific imaging criteria.
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- Acute Stroke Care , pp. 80 - 100Publisher: Cambridge University PressPrint publication year: 2019
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