Stroke units

Babikian, Viken L.; Schwarze, Jens

doi:10.1016/s1052-3057(10)80273-3

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…During the end of the 20th century, reduced stroke recurrence was achieved by treatment of risk factors, the start of an era marked by the hallmark Antiplatelet Trialists' Collaboration (1988) and SALT trials [1,2]. Simultaneously, dedicated stroke units [3,4] and stroke rehabilitation programs [5] improved survival and the functional outcome of stroke patients. However, not until 1995 was intravenous thrombolytics (IVT) demonstrated as curative stroke treatment [6,7], inspired by the successful treatment of myocardial infarction [8].…”

Section: Evolution Of Stroke Treatmentmentioning

confidence: 99%

Endovascular thrombectomy for acute ischemic stroke

et al. 2022

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This review describes the evolution of endovascular treatment for acute ischemic stroke, current state of the art, and the challenges for the next decade. The rapid development of endovascular thrombectomy (EVT), from the first attempts into standard of care on a global scale, is one of the major achievements in modern medicine. It was possible thanks to the establishment of a scientific framework for patient selection, assessment of stroke severity and outcome, technical development by dedicated physicians and the MedTech industry, including noninvasive imaging for patient selection, and radiological outcome evaluation. A series of randomized controlled trials on EVT in addition to intravenous thrombolytics, with overwhelmingly positive results for anterior circulation stroke within 6 h of onset regardless of patient characteristics with a number needed to treat of less than 3 for any positive shift in outcome, paved the way for a rapid introduction of EVT into clinical practice. Within the “extended” time window of 6–24 h, the effect has been even greater for patients with salvageable brain tissue according to perfusion imaging with a number needed to treat below 2. Even so, EVT is only available for a small portion of stroke patients, and successfully recanalized EVT patients do not always achieve excellent functional outcome. The major challenges in the years to come include rapid prehospital detection of stroke symptoms, adequate clinical and radiological diagnosis of severe ischemic stroke cases, enabling effective recanalization by EVT in dedicated angiosuites, followed by personalized post‐EVT stroke care.

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