Review article
https://doi.org/10.21860/medflum2021_264886
Mechanical thrombectomy – new treatment method in acute ischemic stroke
Boris Bezak
; Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Slavica Kovačić
; Klinički bolnički centar Rijeka, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Vladimira Vuletić
; Klinički bolnički centar Rijeka, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Damir Miletić
; Klinički bolnički centar Rijeka, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Lovro Tkalčić
; Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Siniša Knežević
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
David Bonifačić
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Marina Bralić
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Abstract
The paradigm of acute ischemic stroke treatment has changed significantly in the last decade. Clinicians switched from the former passive approach to active treatment that includes intravenous thrombolysis and mechanical thrombectomy. Epiphany of mechanical thrombectomy as a preferable treatment method for acute ischemic stroke started with publication of several multicentred randomized studies (MR CLEAN, ESCAPE, SWIFT PRIME, REVASCAT, THRACE, PISTE), which confirmed the benefits of this method in the year 2015. Today, mechanical thrombectomy is proven to be a favorable and desirable method of treatment for patients with acute ischemic stroke. Further development of new diagnostic devices and standardization of imaging protocols enabled objective estimation of brain damage, which resulted with extension of the time frame in which invasive treatment has potential benefit. Consequently, it is now advised to perform mechanical thrombectomy even 24 hours from symptom onset, which was confirmed by DAWN and DEFUSE 3 studies. The development of new endovascular materials, techniques and trained medical staff resulted with treating more distally located vascular structures, such as occlusions of M2 and M3 segments of the middle cerebral artery and proximal occlusions of anterior and posterior cerebral circulation. Meanwhile, neurointerventional team becamethe crucial link in acute ischemic stroke treatment. With recent implementation of mechanical thrombectomy in every Clinical Hospital Center in Croatia, a modern and up to date treatment of acute ischemic stroke became available to every patient in our country.
Keywords
endovascular procedures; guidelines; stroke; thrombectomy
Hrčak ID:
264886
URI
Publication date:
1.12.2021.
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