Role for Intra-arterial Therapy for Acute Ischemic Stroke

Abstract

Endovascular approach has established itself as a cornerstone in the acute and subacute management of strokes related to large vessel disease. The recent strides achieved in the field of hyperacute interventions have impacted the systems of stroke care and provision. Networks are realigning their triaging protocols, and primary stroke centers are increasingly affiliating with tertiary, thrombectomy-capable centers. There is ongoing debate in the field about the value of systemic thrombolysis in patients with suspected Large Vessel Occlusion (LVO) and an inclination to bypass primary stroke centers in favor of thrombectomy-capable hospitals in these cases. While thrombectomy benefits have been elucidated in large populations, refining patient selection, advancement of procedural techniques, and the prevention of procedural complications continue to be targets of ongoing research. New clot retrieval devices, catheters, Embolic Protection Devices (EPD)s, and implantable stents are being developed and produced at higher rates than ever in the history of this field.