endovascular thrombectomy for acute ischemic stroke

From Aaushi
Jump to navigation Jump to search

Indications

* benefit has not been established in randomized clinical trials[7] (MKSAP17) may no longer be so[11][12]

* improves functional outcomes & quality of life[9]

  • benefits sustained for at least 2 years[9]

#[12] describes 1 of 2 trials cited in[11]

Contraindications

Procedure

* aspiration does not require a catheter to pass through a clot, reducing risk of distal emboli during the procedure[2]

Radiology

Management

Notes

More general terms

Additional terms

References

  1. 1.0 1.1 Brekenfeld C et al. Stent placement in acute cerebral artery occlusion: Use of a self-expandable intracranial stent for acute stroke treatment. Stroke 2009 Mar; 40:847. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19182080
  2. 2.0 2.1 2.2 2.3 Physician's First Watch, Feb 7, 2013 Massachusetts Medical Society
    Ciccone A et al Endovascular Treatment for Acute Ischemic Stroke. New Engl J Med. February 6, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23387822 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1213701
  3. 3.0 3.1 Berkhemer OA et al A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke. N Engl J Med. December 17, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25517348 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1411587
    Hacke W Interventional Thrombectomy for Major Stroke - A Step in the Right Direction. N Engl J Med. December 17, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25517349 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1413346
  4. 4.0 4.1 4.2 Goyal M et al Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke. N Engl J Med. February 11, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25671798 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1414905
    Campbell BCV et al Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection. N Engl J Med. February 11, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25671797 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1414792
    Saver J, Goyal M, Bonafe A et al Primary Results. Soltaire <TM> FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke Nashville, TN. February 11, 2015 http://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_471815.pdf
  5. Saver JL et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med 2015 Apr 17; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25882376 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1415061
    Jovin TG et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med 2015 Apr 17 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25882510 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1503780
    Furlan AJ. Endovascular therapy for stroke - it's about time. N Engl J Med 2015 Apr 17; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25882509 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1503217
  6. 6.0 6.1 6.2 6.3 Powers WJ et al 2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment. Stroke. June 29, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26123479 <Internet> http://stroke.ahajournals.org/content/early/2015/06/26/STR.0000000000000074
  7. 7.0 7.1 7.2 Medical Knowledge Self Assessment Program (MKSAP) 17, 19 American College of Physicians, Philadelphia 2015, 2021
  8. 8.0 8.1 8.2 Coutinho JM et al. Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke: A pooled analysis of the SWIFT and STAR studies. JAMA Neurol 2017 Jan 9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28097310
  9. 9.0 9.1 9.2 van den Berg LA, Dijkgraaf MG, Berkhemer OA et al Two-Year Outcome after Endovascular Treatment for Acute Ischemic Stroke. N Engl J Med 2017; 376:1341-1349. April 6, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28379802 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1612136
  10. Dippel DWJ Thrombectomy Options for Acute Ischemic Stroke. Which Way to Go? JAMA Neurol. Published online Jan 2, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29297050 https://jamanetwork.com/journals/jamaneurology/article-abstract/2666951
  11. 11.0 11.1 11.2 11.3 11.4 Powers WJ, Rabinstein AA, Ackerson T et al 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018; Jan 24 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29367334 <Internet> http://stroke.ahajournals.org/content/early/2018/01/23/STR.0000000000000158
    Furie KL, Jayaraman MV 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29367335 <Internet> http://stroke.ahajournals.org/content/early/2018/01/24/STROKEAHA.118.020176
  12. 12.0 12.1 12.2 12.3 Albers GW, Marks MP, Kemp S et al Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med. Jan 24, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29364767 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1713973
  13. 13.0 13.1 Jansen IGH et al Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry). BMJ 2018;360:k949 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29523557 Free PMC Article <Internet> http://www.bmj.com/content/360/bmj.k949
  14. 14.0 14.1 Campbell BCV, Mitchell PJ, Churilov L et al Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. N Engl J Med 2018; 378:1573-1582 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29694815 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1716405
  15. 15.0 15.1 15.2 Powers WJ, Rabinstein AA, Ackerson T et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 Update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/ American Stroke Association. Stroke 2019 Dec; 50:e344. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31662037 https://www.ahajournals.org/doi/10.1161/STR.0000000000000211
  16. 16.0 16.1 Suzuki K, Matsumaru Y, Takeuchi M et al Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke. The SKIP Randomized Clinical Trial. JAMA. 2021;325(3):244-253 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33464334 https://jamanetwork.com/journals/jama/fullarticle/2775278
  17. 17.0 17.1 Langezaal LCM, van der Hoeven EJRJ, Mont'Alverne FJA Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion. N Engl J Med 2021; 384:1910-1920. May 20 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34010530 https://www.nejm.org/doi/full/10.1056/NEJMoa2030297
  18. 18.0 18.1 LeCouffe NE, Kappelhof M, Treurniet KM et al. A randomized trial of intravenous alteplase before endovascular treatment for stroke. N Engl J Med 2021 Nov 11; 385:1833. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34758251 https://www.nejm.org/doi/10.1056/NEJMoa2107727
  19. 19.0 19.1 Hughes S Intensive BP Lowering Harmful in Acute Ischemic Stroke: ENCHANTED2/MT. Medscape. Oct 28, 2022 https://www.medscape.com/viewarticle/983176
    Yang P, Song L, Zhang Y et al Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial. Lancet. 2022. Oct 27. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36341753 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01882-7/fulltext
  20. 20.0 20.1 Lou N Stroke Thrombectomy Beyond the 24-Hour Window: Study Keeps the Door Open. Researchers push the boundaries of how late is too late for intervention. MedPage Today December 27, 2022 https://www.medpagetoday.com/cardiology/strokes/102392
    Sarraj A, Kleinig TJ, Hassan AE et al Association of Endovascular Thrombectomy vs Medical Management With Functional and Safety Outcomes in Patients Treated Beyond 24 Hours of Last Known Well. The SELECT Late Study. JAMA Neurol. Published online December 27, 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36574257 https://jamanetwork.com/journals/jamaneurology/fullarticle/2799619
  21. 21.0 21.1 Lou N BEST-II Throws Cold Water on Already-Tepid BP Lowering After Stroke Thrombectomy. Trial did not show definite harm, but benefit is unlikely. MedPage Today February 10, 2023 https://www.medpagetoday.com/meetingcoverage/isc/103061
  22. 22.0 22.1 Sarraj A et al. Trial of endovascular thrombectomy for large ischemic strokes. N Engl J Med 2023 Feb 10; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36762865 https://www.nejm.org/doi/10.1056/NEJMoa2214403
    Huo X et al. Trial of endovascular therapy for acute ischemic stroke with large infarct. N Engl J Med 2023 Feb 10; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36762852 https://www.nejm.org/doi/10.1056/NEJMoa2213379
  23. 23.0 23.1 Nam HS, Kim YD, Heo J et al Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic StrokeThe OPTIMAL-BP Randomized Clinical Trial. JAMA. 2023;330(9):832-842. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37668619 https://jamanetwork.com/journals/jama/fullarticle/2808993
  24. 24.0 24.1 24.2 Bendszus M et al. Endovascular thrombectomy for acute ischaemic stroke with established large infarct: Multicentre, open-label, randomised trial. Lancet 2023 Oct 11 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37837989 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02032-9/fulltext