ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE
Aim: To review literature about endovascular approaches to acute ischemic stroke and provide Indian perspective about managing these cases. Brief Summary: In acute ischemic stroke cases, intravenous thrombolysis (IVT) with altepase within 4.5 hours has been the standard of care. Due to certain li...
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| Format: | Article |
| Language: | English |
| Published: |
Prathima Institute of Medical Sciences
2019-12-01
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| Series: | Perspectives In Medical Research |
| Subjects: | |
| Online Access: | http://www.pimr.org.in/2019-vol7-issue-3/DhondeP_v3.pdf |
| _version_ | 1797462480216129536 |
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| author | Pramod Dhonde MD DM 1, Nikhil Kadam MD DM 2 |
| author_facet | Pramod Dhonde MD DM 1, Nikhil Kadam MD DM 2 |
| author_sort | Pramod Dhonde MD DM 1, Nikhil Kadam MD DM 2 |
| collection | DOAJ |
| description | Aim: To review literature about endovascular approaches to acute ischemic stroke and provide
Indian perspective about managing these cases.
Brief Summary: In acute ischemic stroke cases, intravenous thrombolysis (IVT) with altepase
within 4.5 hours has been the standard of care. Due to certain limitations of IVT, in pooled patientlevel data from 5 trials (HERMES [Highly Effective Reperfusion Evaluated in Multiple
Endovascular Stroke Trials], which included the 5 trials MR CLEAN, ESCAPE, REVASCAT,
SWIFT PRIME, and EXTEND-IA), mechanical thrombectomy (MT) is indicated for patients with
acute ischemic stroke due to a large artery occlusion (LVO) in the anterior circulation who can be
treated within 24 hours of the time last known to be well (ie, at neurologic baseline), regardless of
whether they received intravenous alteplase for the same ischemic stroke event. The maximum
benefit can be achieved within 6 hours of onset of symptoms. There are studies suggesting the
benefit of MT in posterior circulation stroke as well as in distal arteries. We are going to review the
methodology of endovascular techniques in brief alongwith Indian perspective on feasibility of
this treatment approach in AIS.
Conclusion: Mechnicalthrombectomy is certainly an effective modality of treatment in large
vessel occlusion in anterior circulation within 24 hours. More awareness regarding the approach
in India, can reduce the stroke morbidity and mortality in many of the cases in future. |
| first_indexed | 2024-03-09T17:37:11Z |
| format | Article |
| id | doaj.art-cd5977bdc438432ba4cdc6eafe09c350 |
| institution | Directory Open Access Journal |
| issn | 2348-1447 2348-229X |
| language | English |
| last_indexed | 2024-03-09T17:37:11Z |
| publishDate | 2019-12-01 |
| publisher | Prathima Institute of Medical Sciences |
| record_format | Article |
| series | Perspectives In Medical Research |
| spelling | doaj.art-cd5977bdc438432ba4cdc6eafe09c3502023-11-24T11:52:42ZengPrathima Institute of Medical SciencesPerspectives In Medical Research2348-14472348-229X2019-12-0173714ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVEPramod Dhonde MD DM 1, Nikhil Kadam MD DM 20 Grant Medical CollegeAim: To review literature about endovascular approaches to acute ischemic stroke and provide Indian perspective about managing these cases. Brief Summary: In acute ischemic stroke cases, intravenous thrombolysis (IVT) with altepase within 4.5 hours has been the standard of care. Due to certain limitations of IVT, in pooled patientlevel data from 5 trials (HERMES [Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials], which included the 5 trials MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, and EXTEND-IA), mechanical thrombectomy (MT) is indicated for patients with acute ischemic stroke due to a large artery occlusion (LVO) in the anterior circulation who can be treated within 24 hours of the time last known to be well (ie, at neurologic baseline), regardless of whether they received intravenous alteplase for the same ischemic stroke event. The maximum benefit can be achieved within 6 hours of onset of symptoms. There are studies suggesting the benefit of MT in posterior circulation stroke as well as in distal arteries. We are going to review the methodology of endovascular techniques in brief alongwith Indian perspective on feasibility of this treatment approach in AIS. Conclusion: Mechnicalthrombectomy is certainly an effective modality of treatment in large vessel occlusion in anterior circulation within 24 hours. More awareness regarding the approach in India, can reduce the stroke morbidity and mortality in many of the cases in future.http://www.pimr.org.in/2019-vol7-issue-3/DhondeP_v3.pdfendovascularischemicstroke |
| spellingShingle | Pramod Dhonde MD DM 1, Nikhil Kadam MD DM 2 ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE Perspectives In Medical Research endovascular ischemic stroke |
| title | ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE |
| title_full | ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE |
| title_fullStr | ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE |
| title_full_unstemmed | ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE |
| title_short | ENDOVASCULARAPPROACHES TOACUTE ISCHEMIC STROKE- INDIAN PERSPECTIVE |
| title_sort | endovascularapproaches toacute ischemic stroke indian perspective |
| topic | endovascular ischemic stroke |
| url | http://www.pimr.org.in/2019-vol7-issue-3/DhondeP_v3.pdf |
| work_keys_str_mv | AT pramoddhondemddm1nikhilkadammddm2 endovascularapproachestoacuteischemicstrokeindianperspective |