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Endovascular Treatment of Stroke 

Endovascular Treatment of Stroke
Chapter:
Endovascular Treatment of Stroke
Author(s):

Mandy J. Binning

and Daniel R. Felbaum

DOI:
10.1093/med/9780190856519.003.0009
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date: 26 June 2019

This chapter will review the main endovascular principles of ischemic stroke treatment. Endovascular therapy has been revolutionized by the advent of modern devices for thrombectomy. Class I evidence in multiple trials has proven that intravenous alteplase plus endovascular thrombectomy is superior to intravenous alteplase alone. The combination of these factors has advanced the standard of care for patients who present with acute ischemic stroke who are also found to have a large vessel occlusion and salvageable brain tissue. The chapter will include information based on recently concluded Class I trials and American Heart Association guidelines. The chapter will review available imaging, current guidelines, controversies surrounding endovascular thrombectomy, recent advances in thrombectomy devices, and recent management principles pertinent to the endovascular treatment of acute ischemic stroke. Cases will be presented regarding diagnosis, management, and treatment paradigms currently being practiced.

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