New opportunities in the use of endovascular methods of recanalization in the management of ischemic stroke

Cover Page

Abstract

Currently, there is a limited number of treatments for ischemic stroke. Intravenous thrombolytic therapy is the most effective method. However, its efficacy is very low in the case of stroke caused by occlusion of large intracranial arteries. Previous studies of endovascular recanalization methods in the treatment of stroke, particularly randomized controlled trials (RCTs), such as IMS-3, SYNTHESIS Expansion, and MR RESCUE, have shown negative results. The results of other RCTs (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) published in 2015 have shown that, in the case of careful selection of patients with verified occlusion of large intracranial arteries, endovascular recanalization significantly improves stroke outcomes.

About the authors

M. A. Kutlubaev

G.G. Kuvatov’s Republican Clinical Hospital, Ufa

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

L. R. Akhmadeeva

Bashkir State Medical University, Ufa

Email: platonova@neurology.ru
Russian Federation

References

  1. Володюхин М.Ю. Тромбэктомия при остром ишемическом инсульте – современное состояние проблемы. Нейрохирургия 2013; 2: 102–107.
  2. Суслина З.А., Пирадов М.А., Домашенко М.А. Инсульт: оценка проблемы (15 лет проблемы). Журн. неврол и психиат. 2014; 11:5–13.
  3. Berkhemer O.A., Fransen P.S., Beumer D. et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015; 372 (1): 11–20. doi: 10.1056/NEJMoa1411587. PMID: 25517348.
  4. Beumer D., Saiedie G., Fonvile S. et al. Intra-arterial occlusion in acute ischemic stroke: relative frequency in an unselected population. Cerebrovasc Dis 2013; 35: Suppl: 66.
  5. Broderick J.P., Palesch Y.Y., Demchuk A.M. et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med. 2013; 368: 893–903. doi: 10.1056/NEJMoa1214300. PMID: 23390923.
  6. Campbell B.C., Mitchell P.J., Kleinig T.J. et al. Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection. N Engl J Med. 2015; 372: 1009–1018. doi: 10.1056/NEJMoa1414792. PMID: 25671797.
  7. Campbell B.C., Donnan G.A., Lees K.R. et al. Endovascular stent thrombectomy: the new standard of care for large vessel ischaemic stroke. Lancet Neurol. 2015; 14: 846–854. doi: 10.1016/S1474-4422(15)00140-4. PMID: 26119323.
  8. Ciccone A., Valvassori L, Nichelatti M. et al. Endovascular treatment for acute ischemic stroke. doi: 10.1056/NEJMoa1213701. PMID: 23387822.
  9. Furlan A., Higashida R., Wechsler L. et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA. 1999; 282:2003–2011. PMID: 10591382.
  10. Goyal M., Demchuk A.M., Menon B.K. et al. Randomized Assessment
  11. of Rapid Endovascular Treatment of Ischemic Stroke. N Engl J Med. 2015; 372: 1019–1030. doi: 10.1056/NEJMoa1414905. PMID: 25671798.
  12. Grotta J.C., Hacke W. Stroke Neurologist’s Perspective on the New Endovascular Trials. Stroke. 2015; 46: 1447–1452. DOI: 10.1161/ STROKEAHA.115.008384. PMID: 25944328.
  13. Jovin T.G., Chamorro A., Cobo E. et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015; 372: 2296–2306. doi: 10.1056/NEJMoa1503780. PMID: 25882510.
  14. Kidwell C.S., Jahan R., Gornbein J. et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med. 2013; 368: 914–923. doi: 10.1056/NEJMoa1212793. PMID: 23394476.
  15. Lima F.O., Furie K.L., Silva G.S. et al. Prognosis of untreated strokes due to anterior circulation proximal intracranial arterial occlusions detected by use of computed tomography angiography. JAMA Neurol. 2014; 71: 151–157. doi: 10.1001/jamaneurol.2013.5007. PMID: 24323077.
  16. Mokin M., Khalessi A.A., Mocco J. et al. Endovascular treatment of acute ischemic stroke: the end or just the beginning? Neurosurg Focus. 2014; 36: E5. doi: 10.3171/2013.10.FOCUS13374. doi: 10.3171/2013.10.FOCUS13374. PMID: 24380482.
  17. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group: Tissue plasminogen activator for acute ischemicstroke. N Engl J Med. 1995; 333: 1581–1587. DOI: 10.1056/ NEJM199512143332401. PMID: 7477192.
  18. Nogueira R.G., Lutsep H.L., Gupta R. et al. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet 2012; 380: 1231–1240. doi: 10.1016/S0140-6736(12)61299-9. PMID: 22932714.
  19. Saver J.L., Goyal M., Bonafe A. et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015; 372: 2285–2295. doi: 10.1056/NEJMoa1415061. PMID: 25882376.
  20. Saqqur M., Uchino K., Demchuk A.M. et al. Site of arterial occlusion identified by transcranial Doppler predicts the response to intravenous thrombolysis for stroke. Stroke 2007; 38: 948–954. doi: 10.1161/01. STR.0000257304.21967.ba.
  21. Saver J.L., Jahan R., Levy E.I. et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet 2012; 380: 1241–1249. doi: 10.1016/S0140-6736(12)61384-1. PMID: 22932715.
  22. Sillanpää N., Saarinen J.T., Rusanen H. et al. Location of the clot and outcome of perfusion defects in acute anterior circulation stroke treated with intravenous thrombolysis. AJNR Am J Neuroradiol. 2013; 34: 100–106. doi: 10.3174/ajnr.A3149. PMID: 22723067.
  23. Toyoda K., Koga M., Hayakawa M., Yamagami H. Acute reperfusion therapy and stroke care in Asia after successful endovascular trials. Stroke 2015; 46: 1474–1481. doi: 10.1161/STROKEAHA.115.008781. PMID: 25944322

Statistics

Views

Abstract: 895

PDF (Russian): 619

Article Metrics

Metrics Loading ...

Dimensions

PlumX


Copyright (c) 2016 Kutlubaev M.A., Akhmadeeva L.R.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies