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Endovascular thrombectomy following acute ischemic stroke: a single-center case series and critical review of the literature.

Sussman E, Kellner C, McDowell M, Yang P, Nelson E, Greenberg S, Sahlein D, Lavine S, Meyers P, Connolly ES - Brain Sci (2013)

Bottom Line: Acute ischemic stroke (AIS) due to thrombo-embolic occlusion in the cerebral vasculature is a major cause of morbidity and mortality in the United States and throughout the world.Although the prognosis is poor for many patients with AIS, a variety of strategies and devices are now available for achieving recanalization in patients with this disease.In order to demonstrate the progression of this treatment strategy over the past decade, we will also present a single-center case series of AIS patients treated with endovascular thrombectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Surgery, Columbia University Medical Center, 710 West 168th Street, New York, NY 10032, USA. esuss11@gmail.com.

ABSTRACT
Acute ischemic stroke (AIS) due to thrombo-embolic occlusion in the cerebral vasculature is a major cause of morbidity and mortality in the United States and throughout the world. Although the prognosis is poor for many patients with AIS, a variety of strategies and devices are now available for achieving recanalization in patients with this disease. Here, we review the treatment options for cerebrovascular thromboembolic occlusion with a focus on the evolution of strategies and devices that are utilized for achieving endovascular clot extraction. In order to demonstrate the progression of this treatment strategy over the past decade, we will also present a single-center case series of AIS patients treated with endovascular thrombectomy.

No MeSH data available.


Related in: MedlinePlus

(A) Percentage of AIS patients treated by endovascular intervention each year who underwent mechanical thrombectomy. (B) Percentage AIS patients treated by endovascular intervention each year who received IAF.
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brainsci-03-00521-f005: (A) Percentage of AIS patients treated by endovascular intervention each year who underwent mechanical thrombectomy. (B) Percentage AIS patients treated by endovascular intervention each year who received IAF.

Mentions: Beginning in 2008, we observed an increase in the proportion of endovascularly-managed AIS patients who were treated with mechanical thrombectomy. This shift coincided with increasing evidence in the literature, suggesting higher rates of recanalization with proximally deployed devices [51,52,53]. It is therefore not surprising that in 2008, a proximal-approach to mechanical thrombectomy began to supplant the distal-approach at our institution. In fact, due to the growing evidence of improved rates of recanalization with the Penumbra aspiration device, this management technique became the status quo for AIS patients at our institution by 2009. Interestingly, between 2008 and 2009, we also observed a sharp decrease in percentage of patients treated with IAF, likely reflective of the increased recanalization rates that were achievable with the Penumbra aspiration device alone (Figure 5).


Endovascular thrombectomy following acute ischemic stroke: a single-center case series and critical review of the literature.

Sussman E, Kellner C, McDowell M, Yang P, Nelson E, Greenberg S, Sahlein D, Lavine S, Meyers P, Connolly ES - Brain Sci (2013)

(A) Percentage of AIS patients treated by endovascular intervention each year who underwent mechanical thrombectomy. (B) Percentage AIS patients treated by endovascular intervention each year who received IAF.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061858&req=5

brainsci-03-00521-f005: (A) Percentage of AIS patients treated by endovascular intervention each year who underwent mechanical thrombectomy. (B) Percentage AIS patients treated by endovascular intervention each year who received IAF.
Mentions: Beginning in 2008, we observed an increase in the proportion of endovascularly-managed AIS patients who were treated with mechanical thrombectomy. This shift coincided with increasing evidence in the literature, suggesting higher rates of recanalization with proximally deployed devices [51,52,53]. It is therefore not surprising that in 2008, a proximal-approach to mechanical thrombectomy began to supplant the distal-approach at our institution. In fact, due to the growing evidence of improved rates of recanalization with the Penumbra aspiration device, this management technique became the status quo for AIS patients at our institution by 2009. Interestingly, between 2008 and 2009, we also observed a sharp decrease in percentage of patients treated with IAF, likely reflective of the increased recanalization rates that were achievable with the Penumbra aspiration device alone (Figure 5).

Bottom Line: Acute ischemic stroke (AIS) due to thrombo-embolic occlusion in the cerebral vasculature is a major cause of morbidity and mortality in the United States and throughout the world.Although the prognosis is poor for many patients with AIS, a variety of strategies and devices are now available for achieving recanalization in patients with this disease.In order to demonstrate the progression of this treatment strategy over the past decade, we will also present a single-center case series of AIS patients treated with endovascular thrombectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Surgery, Columbia University Medical Center, 710 West 168th Street, New York, NY 10032, USA. esuss11@gmail.com.

ABSTRACT
Acute ischemic stroke (AIS) due to thrombo-embolic occlusion in the cerebral vasculature is a major cause of morbidity and mortality in the United States and throughout the world. Although the prognosis is poor for many patients with AIS, a variety of strategies and devices are now available for achieving recanalization in patients with this disease. Here, we review the treatment options for cerebrovascular thromboembolic occlusion with a focus on the evolution of strategies and devices that are utilized for achieving endovascular clot extraction. In order to demonstrate the progression of this treatment strategy over the past decade, we will also present a single-center case series of AIS patients treated with endovascular thrombectomy.

No MeSH data available.


Related in: MedlinePlus