Endovascular Thrombectomy for Anterior Circulation Large Vessel Occlusion Stroke: An Evolution of Trials

Natalia Starikova; Silja Räty; Daniel Strbian; Daniel P. O. Kaiser; Johannes C. Gerber; Xiaochuan Huo; Zhongming Qiu; Hui-Sheng Chen; Johannes Kaesmacher; Lars-Peder Pallesen; Kristian Barlinn; Dapeng Sun; Mohamad Abdalkader; Thanh N. Nguyen; Simon Nagel; Zhongrong Miao; Volker Puetz

doi:10.1055/s-0043-1771454

Seminars in Neurology, Table of Contents

Semin Neurol 2023; 43(03): 397-407
DOI: 10.1055/s-0043-1771454

Review Article

Endovascular Thrombectomy for Anterior Circulation Large Vessel Occlusion Stroke: An Evolution of Trials

Authors

Natalia Starikova

¹Department of Neurology, University Clinic of Odessa National Medical University, Odessa, Ukraine

²TeleHealth Consulting Service, Medical Center “Expert Health,” Odessa, Ukraine
Silja Räty

³Department of Neurology, Helsinki University Hospital and University of Helsinki, Finland
Daniel Strbian

³Department of Neurology, Helsinki University Hospital and University of Helsinki, Finland
Daniel P. O. Kaiser

⁴Institute of Neuroradiology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany

⁵Dresden Neurovascular Center, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
Johannes C. Gerber

⁴Institute of Neuroradiology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany

⁵Dresden Neurovascular Center, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
Xiaochuan Huo

⁶Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
Zhongming Qiu

⁷Department of Neurology, The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China
Hui-Sheng Chen

⁸Department of Neurology, General Hospital of Northern Theatre Command, Shenyang, China
Johannes Kaesmacher

⁹Interventional Neuroradiology, Bern University Hospital, University of Bern, Bern, Switzerland
Lars-Peder Pallesen

⁵Dresden Neurovascular Center, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany

¹⁰Department of Neurology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
Kristian Barlinn

⁵Dresden Neurovascular Center, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany

¹⁰Department of Neurology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
Dapeng Sun

⁶Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
Mohamad Abdalkader

¹¹Department of Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
Thanh N. Nguyen

¹¹Department of Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts

¹²Department of Neurology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
Simon Nagel

¹³Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany

¹⁴Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
Zhongrong Miao

⁶Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
Volker Puetz

⁵Dresden Neurovascular Center, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany

¹⁰Department of Neurology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany

Abstract

The last decade's progress in demonstrating the clinical benefit of endovascular thrombectomy (EVT) in patients with large vessel occlusion stroke has transformed the paradigm of care for these patients. This review presents the milestones in implementing EVT as standard of care, demonstrates the current state of evidence, provides guidance for identifying the candidate patient for EVT, and highlights unsolved and controversial issues. Ongoing trials investigate broadening of EVT indications for patients who present with large core infarction, adjunctive intra-arterial thrombolysis, medium vessel occlusion, low NIHSS, and tandem occlusion.

Keywords

anterior circulation LVO stroke - mechanical thrombectomy - medium vessel occlusion - large ischemic core - large infarct - outcome - clinical trial

Full Text

References

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