Endovascular treatment of acute ischemic stroke: The end or just the beginning?

Maxim Mokin, Alexander A. Khalessi, J. Mocco, Giuseppe Lanzino, Travis M. Dumont, Ricardo A. Hanel, Demetrius K. Lopes, Richard D. Fessler, Andrew J. Ringer, Bernard R. Bendok, Erol Veznedaroglu, Adnan H. Siddiqui, L. Nelson Hopkins, Elad I. Levy

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Various endovascular intraarterial approaches are available for treating patients with acute ischemic stroke who present with severe neurological deficits. Three recent randomized trials-Interventional Management of Stroke (IMS) III, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE), and Synthesis Expansion: A Randomized Controlled Trial on Intra-Arterial Versus Intravenous Thrombolysis in Acute Ischemic Stroke (SYNTHESIS Expansion)-evaluated the efficacy of endovascular treatment of acute ischemic stroke and, after failing to demonstrate any significant clinical benefit of endovascular therapies, raised concerns and questions in the medical community regarding the future of endovascular treatment for acute ischemic stroke. In this paper, the authors review the evolution of endovascular treatment strategies for the treatment of acute stroke and provide their interpretation of findings and potential limitations of the three recently published randomized trials. The authors discuss the advantage of stent-retriever technology over earlier endovascular approaches and review the current status and future directions of endovascular acute stroke studies based on lessons learned from previous trials.

Original languageEnglish (US)
Article numberE5
Pages (from-to)1-10
Number of pages10
JournalNeurosurgical focus
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Acute ischemic stroke
  • Endovascular procedure
  • Large-vessel occlusion
  • Mechanical thrombectomy
  • Neuroimaging
  • Stent retriever

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Mokin, M., Khalessi, A. A., Mocco, J., Lanzino, G., Dumont, T. M., Hanel, R. A., Lopes, D. K., Fessler, R. D., Ringer, A. J., Bendok, B. R., Veznedaroglu, E., Siddiqui, A. H., Hopkins, L. N., & Levy, E. I. (2014). Endovascular treatment of acute ischemic stroke: The end or just the beginning? Neurosurgical focus, 36(1), 1-10. [E5]. https://doi.org/10.3171/2013.10.FOCUS13374