Acute ischemic stroke is a dreaded neurological emergency with significant mortality and morbidity. The treatment of this condition had not progressed much upuntil the last decade. Though intravenous thrombolytics are efficient in lysing the clot when administered within the time window , the risk of hemorrhagic complications is significant.The advent of neurointerventional hardware has brought the treatment of this disease to the tipping point now, when the doctors finally have mechanical thrombectomy as an option in their arsenal.
Multiple clinical trials have now concluded without any doubt that mechanical thrombectomy performed within the recommended time window (6 hrs)has a definitive therapeutic effect in the management of the dreaded acute ischemic stroke due to large vessel occlusion.
Though the techniques for clot extraction have existed since the development of Merci device, earlier trials were not unanimous in the efficacy of mechanical thrombectomy in treating large vessel occlusion. This was mainly due to nonstandardisation of the patient selection criteria and clot removal techniques. However the development of stentretrievers revolutionised this field forever.
The stent retrievers are extremely efficient in clot retrieval. First Pass aspiration techniques are also being widely used in clot extraction.
The critical factor for treatment outcomes however still rests largely on systemic efficiency. The patient attendants need to quickly identify a stroke and rush to a centre with the facility for mechanical thrombectomy. When performed well within the time window this treatment can also reverse the stroke miraculously .Leave a reply