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Review
. 2018 Jun 28:2018:9168731.
doi: 10.1155/2018/9168731. eCollection 2018.

Update in the Early Management and Reperfusion Strategies of Patients with Acute Ischemic Stroke

Aldo A Mendez  1 , Edgar A Samaniego  1   2   3 , Sunil A Sheth  4 , Sudeepta Dandapat  1   2   3 , David M Hasan  2 , Kaustubh S Limaye  1 , Bradley J Hindman  5 , Colin P Derdeyn  3 , Santiago Ortega-Gutierrez  1   2   3
Affiliations
Review

Update in the Early Management and Reperfusion Strategies of Patients with Acute Ischemic Stroke

Aldo A Mendez et al. Crit Care Res Pract. .

Abstract

Acute ischemic stroke (AIS) remains a leading cause of death and long-term disability. The paradigms on prehospital care, reperfusion therapies, and postreperfusion management of patients with AIS continue to evolve. After the publication of pivotal clinical trials, endovascular thrombectomy has become part of the standard of care in selected cases of AIS since 2015. New stroke guidelines have been recently published, and the time window for mechanical thrombectomy has now been extended up to 24 hours. This review aims to provide a focused up-to-date review for the early management of adult patients with AIS and introduce the new upcoming areas of ongoing research.

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Figures

Figure 1
Figure 1
(a) Schematic representation of one of the most common endovascular techniques using a stent retriever to treat an acute left middle cerebral artery stroke secondary to an LVO presenting at 12 hours. (b) Identification of infarct core and potentially salvageable tissue using automated software (RAPID). (c, d) Angiogram demonstrating L MCA occlusion (black arrow) and stent retriever deployment (white arrow).
Figure 2
Figure 2
Prehospital stroke algorithm paradigm.
Figure 3
Figure 3
Comparison of randomized clinical trials of general versus conscious sedation for thrombectomy in acute ischemic stroke (mRS at 90 days).
See this image and copyright information in PMC

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