Neuroendovascular rescue: Interventional treatment of acute ischemic stroke

Abstract

Stroke continues to be a major health problem for our society. Despite the proven effectiveness of intravenous tissue plasminogen activator (t-PA) for the treatment of acute ischemic stroke, only a minority of patients qualify for this type of therapy. Furthermore, the existing literature has demonstrated that t-PA is not as effective in the treatment of occlusion of large cerebral arteries. The benefit-to-risk assessment of this subpopulation of stroke patients makes them the best candidates for neuroendovascular rescue. This term refers to the intra-arterial application of techniques designed to promote arterial recanalization, and includes intra-arterial thrombolysis and antithrombotic agents, direct mechanical disruption, angioplasty, stenting, embolectomy, and vasoactive pharmacologic intervention. The timing and choice of these procedures, as well as the care of the patient prior to, during, and after the intervention, requires a highly focused and expert approach.

The Penumbra System: A Mechanical Device for the Treatment of Acute Stroke due to Thromboembolism

“…Participating centers principal investigator (PI) and coinvestigator(s) (Co) in order of enrollment (n): Robert Janker Klinik, Bonn, Germany: Hans Henkes, MD (PI), and Stefan Lowens, MD (Co) (6) …”

“…5,6 The Penumbra System (PS; Penumbra, Alameda, Calif) is a new embolectomy device specifically designed to remove the thrombus in acute ischemic stroke secondary to large vessel thromboembolism. The device removes the thrombus through 2 mechanisms: aspiration and extraction.…”

Endovascular management of intracerebral and subarachnoid hemorrhage

“…This is rapidly changing as instrumentation and techniques in interventional neuroradiology have begun to mature. In this continuing series of updates on the endovascular role in acute stroke management [3,4], we provide an overview of some of the common treatment options available today for the most common causes of intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH).…”

Vergleich der neuen Generation der Flachdetektor CT (FDCT) mit der Multidetektor CT (MDCT) bezüglich der Detektion von ischämischen und hämorrhagischen intrakraniellen Läsionen

“…Durch den Schutz der gefährdeten Bereiche können das Auftreten neurologischer Defizite, die Mortalität sowie Morbidität gesenkt werden, wodurch das klinische Outcome deutlich verbessert werden kann (Gomez et al 2002;Leary et al 2003). Dadurch wird einerseits die Zeit bis zur Reperfusion reduziert, zum anderen werden durch die Umlagerung bedingte Komplikationen reduziert (Doerfler et al 2015).…”