Neuroendovascular management of emergent large vessel occlusion: update on the technical aspects and standards of practice by the Standards and Guidelines Committee of the Society of NeuroInterventional Surgery
Year: 2018
Type: article
Abstract: Acute ischemic stroke (AIS) is the fifth leading cause of death, and remains the leading cause of disability in the USA.1 There are an estimated 680 000 new strokes per year in the USA, with a mortality rate of 53–94%, and with an even greater morbidity.2 It is estimated that 3–22% of these patients are candidates for endovascular therapy.3–6 In addition to baseline stroke severity, emergent large vessel occlusion (ELVO) has been shown to be an independent predictor of poor outcome at 6 months.3 4 While intravenous recombinant tissue plasminogen activator (IV r-tPA) has proven efficacious predominantly for small cerebral vessel occlusions, endovascular therapies, including stent retriever based, aspiration based mechanical thrombectomy techniques, and intra-arterial administration of thrombolytic agents, have been shown to achieve higher rates of recanalization in patients with ELVO.7–10 The purpose of this document is to provide an update and critical assessment of technical aspects of the mechanical thrombectomy procedure.
Authors: Chirag D Gandhi, Fawaz Al Mufti, I Paul Singh, Todd Abruzzo, Barbara Albani, Sameer A Ansari, Adam S Arthur, Mark Bain, Blaise W Baxter, Ketan R Bulsara, Justin M Caplan, Michael Chen, Guilherme Dabus, Don Frei, Steven W Hetts, M Shazam Hussain, Mahesh V Jayaraman, Yasha Kayan, Richard P Klucznik, Seon-Kyu Lee, William J Mack, Thabele Leslie-Mazwi, Ryan A McTaggart, Philip M Meyers, Maxim Mokin, Athos T Patsalides, Charles J Prestigiacomo, G Lee Pride, Robert M Starke, Peter J Sunenshine, Justin F Fraser
Institutions: Westchester Medical Center, New York Medical College, Rutgers, The State University of New Jersey, Robert Wood Johnson University Hospital, Mount Sinai Hospital, University of Cincinnati, Christiana Care Health System, Northwestern University, Semmes Murphey Foundation, Cleveland Clinic, Erlanger Health System, University of Connecticut, UConn Health, Johns Hopkins University, Johns Hopkins Medicine, Rush University Medical Center, Baptist Hospital of Miami, University of California, San Francisco, Brown University, Abbott Northwestern Hospital, Houston Methodist, University of Chicago, University of Southern California, Massachusetts General Hospital, Columbia University, University of South Florida, NewYork–Presbyterian Hospital, Weill Cornell Medicine, The University of Texas Southwestern Medical Center, University of Miami, Banner Health, Banner - University Medical Center Phoenix, University of Kentucky
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2783301983