Is mechanical embolectomy a safe and efficacious treatment strategy in patients with acute ischemic stroke?
Nirav A Vora* and Lawrence R Wechsler
Correspondence *Department of Neurology, University of Pittsburgh Medical Center, 200 Lothrop Street Suite C400, Pittsburgh, PA 15213, USA
Email vorana@upmc.edu
This article has no abstract so we have provided the first paragraph of the full text.
Endovascular treatment is a major development in AIS. In the PROACT II study, intra-arterial prourokinase administered within 6 h of stroke onset enhanced recanalization and improved outcomes in patients with middle cerebral artery occlusions.1 Many stroke centers now treat acute stroke patients presenting with large vessel occlusions with intra-arterial thrombolytics; however, experience has revealed several limitations. As in PROACT II, major arteries or branches are often only partially recanalized despite infusion times of 1–2 h. Furthermore, reocclusion can occur even after successful intra-arterial treatment.2 The time to recanalization is prolonged by the time taken to reach the angiography suite and prepare the patient, and the interval from arrival in the angiography suite to completion of the procedure is often 2–3 h. These drawbacks and the risk of intracerebral hemorrhage necessitate the need for alternative options.
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