Rinsho Shinkeigaku (Clinical Neurology)

Symposium 3

Current status of endovascular therapy for acute ischemic stroke

Hiroshi Yamagami, M.D., Ph.D.1) and Nobuyuki Sakai, M.D., D.M.Sc.2)

1)Department of Neurology, National Cerebral and Cardiovascular Center
2)Neurosurgery and KCGH Comprehensive Stroke Center, Kobe City Medical Center General Hospital

Endovascular therapy (EVT) is performed in patients with acute ischemic stroke due to major artery occlusion, if they were ineligible of intravenous (IV) rt-PA or failure to achieve reperfusion by IV rt-PA. In Japan, intra-arterial thrombolysis has been generally performed, and mechanical thrombectomy using Merci retriever and Penumbra system are gradually spreading. In 2013, the results of three randomized trials (IMS 3, SYNTHESIS expansion, and MR RESCUE) were published, and they could not prove the usefulness of EVT in patients with acute ischemic stroke compared with standard therapy including IV rt-PA. However, these trials suggested important issues of EVT. Especially, adequate selection of patients, improvement of reperfusion rate, and shorter onset to reperfusion time are needed to establish the usefulness of EVT.
Full Text of this Article in Japanese PDF (641K)

(CLINICA NEUROL, 53: 1166|1168, 2013)
key words: acute ischemic stroke, endovascular therapy, reperfution therapy, thrombolysis

(Received: 31-May-13)