Endovascular reperfusion therapies for acute ischemic stroke

Dissecting the evidence

Georgios Tsivgoulis, Apostolos Safouris, Christos Krogias, Adam Arthur, Andrei Alexandrov

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Background: Ischemic stroke is a major cause of death and disability and intravenous thrombolysis has been the only approved acute reperfusion therapy (RT) for many years.Methods: Seven randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of endovascular therapy in patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO) have been recently published.Results: These studies have changed the treatment paradigm by establishing mechanical thrombectomy (MT) as the most effective acute stroke therapy for improving functional outcome in anterior circulation ELVO with a NNT of 6.Conclusions: The present review will critically evaluate the results of these RCTs and of the existing meta-analyses investigating the safety and efficacy of endovascular therapy for AIS. Points of debate such as acute stroke imaging, posterior circulation stroke and general anesthesia will be addressed. We will also discuss health policies aiming to increase the availability of endovascular treatment for stroke patients.

Original languageEnglish (US)
Pages (from-to)527-534
Number of pages8
JournalExpert Review of Neurotherapeutics
Volume16
Issue number5
DOIs
StatePublished - May 3 2016

Fingerprint

Reperfusion
Stroke
Therapeutics
Randomized Controlled Trials
Safety
Thrombectomy
Health Policy
General Anesthesia
Meta-Analysis
Cause of Death

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Endovascular reperfusion therapies for acute ischemic stroke : Dissecting the evidence. / Tsivgoulis, Georgios; Safouris, Apostolos; Krogias, Christos; Arthur, Adam; Alexandrov, Andrei.

In: Expert Review of Neurotherapeutics, Vol. 16, No. 5, 03.05.2016, p. 527-534.

Research output: Contribution to journalReview article

@article{167178968a6248e6a8f1918db2555a01,
title = "Endovascular reperfusion therapies for acute ischemic stroke: Dissecting the evidence",
abstract = "Background: Ischemic stroke is a major cause of death and disability and intravenous thrombolysis has been the only approved acute reperfusion therapy (RT) for many years.Methods: Seven randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of endovascular therapy in patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO) have been recently published.Results: These studies have changed the treatment paradigm by establishing mechanical thrombectomy (MT) as the most effective acute stroke therapy for improving functional outcome in anterior circulation ELVO with a NNT of 6.Conclusions: The present review will critically evaluate the results of these RCTs and of the existing meta-analyses investigating the safety and efficacy of endovascular therapy for AIS. Points of debate such as acute stroke imaging, posterior circulation stroke and general anesthesia will be addressed. We will also discuss health policies aiming to increase the availability of endovascular treatment for stroke patients.",
author = "Georgios Tsivgoulis and Apostolos Safouris and Christos Krogias and Adam Arthur and Andrei Alexandrov",
year = "2016",
month = "5",
day = "3",
doi = "10.1586/14737175.2016.1168297",
language = "English (US)",
volume = "16",
pages = "527--534",
journal = "Expert Review of Neurotherapeutics",
issn = "1473-7175",
publisher = "Expert Reviews Ltd.",
number = "5",

}

TY - JOUR

T1 - Endovascular reperfusion therapies for acute ischemic stroke

T2 - Dissecting the evidence

AU - Tsivgoulis, Georgios

AU - Safouris, Apostolos

AU - Krogias, Christos

AU - Arthur, Adam

AU - Alexandrov, Andrei

PY - 2016/5/3

Y1 - 2016/5/3

N2 - Background: Ischemic stroke is a major cause of death and disability and intravenous thrombolysis has been the only approved acute reperfusion therapy (RT) for many years.Methods: Seven randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of endovascular therapy in patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO) have been recently published.Results: These studies have changed the treatment paradigm by establishing mechanical thrombectomy (MT) as the most effective acute stroke therapy for improving functional outcome in anterior circulation ELVO with a NNT of 6.Conclusions: The present review will critically evaluate the results of these RCTs and of the existing meta-analyses investigating the safety and efficacy of endovascular therapy for AIS. Points of debate such as acute stroke imaging, posterior circulation stroke and general anesthesia will be addressed. We will also discuss health policies aiming to increase the availability of endovascular treatment for stroke patients.

AB - Background: Ischemic stroke is a major cause of death and disability and intravenous thrombolysis has been the only approved acute reperfusion therapy (RT) for many years.Methods: Seven randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of endovascular therapy in patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO) have been recently published.Results: These studies have changed the treatment paradigm by establishing mechanical thrombectomy (MT) as the most effective acute stroke therapy for improving functional outcome in anterior circulation ELVO with a NNT of 6.Conclusions: The present review will critically evaluate the results of these RCTs and of the existing meta-analyses investigating the safety and efficacy of endovascular therapy for AIS. Points of debate such as acute stroke imaging, posterior circulation stroke and general anesthesia will be addressed. We will also discuss health policies aiming to increase the availability of endovascular treatment for stroke patients.

UR - http://www.scopus.com/inward/record.url?scp=84964054239&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964054239&partnerID=8YFLogxK

U2 - 10.1586/14737175.2016.1168297

DO - 10.1586/14737175.2016.1168297

M3 - Review article

VL - 16

SP - 527

EP - 534

JO - Expert Review of Neurotherapeutics

JF - Expert Review of Neurotherapeutics

SN - 1473-7175

IS - 5

ER -