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Hyperacute Management of Ischemic Strokes: JACC Focus Seminar |
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| Institution: | 1. Departments of Neurological Surgery, Rutgers University-New Jersey Medical School, Newark, New Jersey;2. Department of Neurology and Neurological Surgery, Jackson Memorial & University of Miami Hospitals, University of Miami Miller School of Medicine, Miami, Florida |
| Abstract: | Acute ischemic stroke is the leading cause of disability and among the leading causes of mortality worldwide. Intravenous tissue plasminogen activator has been a cornerstone for treatment of acute ischemic stroke for more than 20 years; however, its use is limited due to a narrow therapeutic window, several contraindications, and low efficacy to recanalize the artery in large vessel occlusion. Recently, the addition of endovascular mechanical thrombectomy of large artery occlusion has revolutionized the stroke treatment for most disabling strokes. The paper reviews updates to the thrombolytic treatment as well as catheter-based treatment, and results from recent trials in the selection of patients in an extended time window using perfusion imaging. |
| Keywords: | acute ischemic stroke imaging in acute stroke IV-rtPA mechanical thrombectomy mechanical thrombectomy in extended time window AIS"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"acute ischemic stroke(s) CTA"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"computed tomography angiography/angiogram IV-rtPA"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"intravenous recombinant tissue plasminogen activator mRS"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"modified Rankin score MT"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"mechanical thrombectomy NIHSS"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"National Institutes of Health Stroke Scale sICH"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"symptomatic intracranial hemorrhage TICI"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"Thrombolysis In Cerebral Infarction |
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