Endovascular Stroke Therapy: Devices and Different Approaches
Pp. 122-151 (30)
Daniele G. Romano, Samuele Cioni and Sandra Bracco
Acute ischemic stroke (AIS) is a significant medical disease with relevant
mortality and morbidity associated, that, especially in recent years, has undergone a
major development of drugs and devices used for its treatment. A poor number of
patients respects the criteria for treatment with intravenous drug (IVT) with
recombinant tissue plasminogen activator, and the efficacy of this treatment in large
vessel occlusion is percentually low. Recently, incresead percentage number of patients
with AIS are treated with mechanical embolectomy if IVT is ineffective or
controindicated. An important technological upgrading of devices used for the
endovascular treatment of AIS, has allowed a significant increase in rates of
recanalization and neurological improvement of patients treated, completely replacing
the old device. Furthermore the use of these new devices has not caused an increase in
intracerebral hemorragic (ICH). This chapter highlights the devices used in current
practice for endovascular treatment of AIS, the different endovascular approaches and a
brief review about the recent randomized trials, which have evaluated the efficacy of
these new devices.
Acute Ischemic Stroke, Endovascular treatment, Large Vessel
Occlusion, Mechanical Thrombectomy, Stentriviers, Tromboaspiration.
Unit of Neurointerventional, Division of Neuroradiology, Department of Neurological and Neurosensorial Sciences, University Hospital of Siena, Italy.