Endovascular recanalization and fast diagnosis improve results of ischemic stroke therapy
Authors:
Antonín Krajina 1; Dagmar Krajíčková 2
Authors place of work:
Radiologická klinika LF UK a FN Hradec Králové
1; Neurologická klinika LF UK a FN Hradec Králové
2
Published in the journal:
Čas. Lék. čes. 2018; 157: 188-194
Category:
Review Article
Summary
The benefit of mechanical thrombectomy over intravenous thrombolysis was definitively proved by several studies in 2015. It is relevant for proximal, large artery occlusions in the anterior circulation with onset of clinical symptoms lasting 6 hours. Two trials published in 2018 showed that in patients who are selected using CT perfusion or MR diffusion weighted imaging, thrombectomy significantly improves outcome even up to 24 hours from onset. The benefit of the vertebrobasilar circulation, where occlusion of large arteries occurs in 7 % cases, has not been proved by randomised studies yet. However, mechanical thrombectomy is performed in this arterial territory because of very poor prognosis of nonrecanalized occlusions there.
Patients with acute ischemic stroke should be transferred to comprehensive stroke centres. These centres should provide parenchymal CT imaging and CT arteriography. These two modalities provide sufficient information to determine eligibility for endovascular treatment in the first 6 hours from stroke onset. Physicians performing endovascular therapy of stroke must be properly trained in clinical neuroscience, neuroimaging and neurointerventions. Success rate of this therapy depends on its organization which includes fast transport of patients, fast clinical and diagnostic evaluation, fast decisions, and availability of trained interventional team.
Keywords:
ischemic stroke, mechanical thrombectomy, stent retriever, neurointervention
Zdroje
1. Jauch EC, Saver JL, Adams HP et al. Guidelines for the early management of patients with acute ischemic stroke. Stroke 2013; 44: 870–947.
2. MZ ČR. Péče o pacienty s cerebrovaskulárním onemocněním v České republice. Věstník MZ ČR 2010, částka 2.
3. Ornello R, Degan D, Tiseo C et al. Distribution and temporal trend from 1993 to 2015 of ischemic stroke subtypes. A systematic review and metaanalysis. Stroke 2018; 49: 814–819.
4. MZ ČR. Péče o pacienty s akutní cévní mozkovou příhodou. Věstník MZ ČR 2012, částka 10.
5. Kolektiv autorů. Doporučení pro rekanalizační léčbu akutního mozkového infarktu – verze 2016. Česká a slovenská neurologie a neurochirurgie 2016; 79/112(2): 231–234.
6. Sussman BJ, Fitch TSP, Plainfield NJ. Thrombolysis with fibrinolysin in cerebral arterial occlusion. JAMA 1958; 167: 1705–1709.
7. Zeumer H, Hacke W, Kolman HL, Poeck K. Lokale Fibrinolysetherapie bei Basilaris Thrombose. Dtsch med Wochenschr 1982; 107(19), 728–731.
8. Furlan A, Higashida R, Wechsler L et al. The PROACT II study: a randomized controlled trial. Prolyse in acute cerebral thromboembolism. JAMA 1999; 282(21): 2003–2011.
9. Barnwell SL, Clark WM, Nguyen TT et al. Safety and efficacy of delayed intraarterial urokinase therapy with mechanical clot disruption for thromboembolic stroke. AJNR 1994; 15(10): 1817–1822.
10. Chopko BW, Kerber C, Wong W, Georgy B. Transcatheter snare removal of acute middle cerebral artery thromboembolism: technical case report. Neurosurgery 2000; 46: 1529–1531.
11. Krajina A, Krajíčková D, Špriňar Z a kol. Mechanická perkutánní extrakce embolu při akutní cévní mozkové příhodě: kasuistika a přehled literatury. Česká a slovenská neurologie a neurochirurgie 2005; 65/101: 51–57.
12. Smith WS, Sung G, Starkman S et al. Safety and efficacy of mechanical embolectomy in acute ischemic stroke. Results of the MERCI trial. Stroke 2005; 36: 1432–1440.
13. Nguyen TN, Malisch T, Castonguay AC et al. Balloon guide catheter improves revascularization and clinical outcomes with the Solitaire device. Analysis of the North American Solitaire Acute Stroke registry. Stroke 2014; 45: 141–145.
14. Nogueira RG, Lutsep HL, Gusta R et al. TREVO versus MERCI retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet 2012; 380: 1231–1240.
15. Power S, Matouk C, Casoubon LK et al. Vessel wall magnetic resonance imaging in acute ischemic stroke. Effects of embolism and mechanical thrombectomy on arterial wall. Stroke 2014; 45: 2330–2334.
16. Turk AS, Spiotta A, Frei D et al. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg 2014; 6 (3): 231–237.
17. Broderick JP, Palesch YY, Demchuk AM et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med 2013; 368: 893–903.
18. Kidwell CS, Jahan R, Saver JL. Endovascular treatment for acute ischemic stroke. N Engl J Med 2013; 368: 2434–2435.
19. Ciccone A, Valvassori L, Nichelatti M et al. Endovascular treatment for acute ischemic stroke. N Engl J Med 2013; 368: 904–913.
20. Berkhemmer OA, Fransen PS, Beumer D et al.; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 2015; 372: 11–20.
21. Goyal M, Demchuk AM, Menon BK et al.; the ESCAPE Trial Investigators. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015; 372: 1019–1030.
22. Campbell BC, Mitchell PJ, Kleinig TJ et al.; EXTEND-IA Investigators. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med 2015; 372: 1009–1018.
23. Saver JL, Goyal M, Bonafe A et al.; SWIFT PRIME Investigators. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med 2015; 372: 2285–95.
24. Jovin TG, Chamorro A, Cobo E et al.; REVASCAT Trial Investigators. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med 2015; 372: 2296–306.
25. Saver JL, Goyal M, van der Lught A et al.; the HERMES Collaborators. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a metaanalysis. JAMA 2016; 316(12): 1279–1288.
26. Goyal M, Menon BK, van Zwam WH et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016; 387 (10029): 1723–1731.
27. Powers WJ, Derdeyn CP, Biller J et al. Focused update of the 2013 Guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015; 46: 3020–3035.
28. Wahlgren N, Moreira T, Michel P et al; ESO-LSU, ESO, ESMINT, ESNR and EAN. Mechanical thrombectomy in acute ischemic stroke: consensus statement by ESO – Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN. Int J Stroke 2016; 11: 134–147.
29. Powers WJ, Rabinstein AA, Ackerson T et al. 2018 Guidelines for the early management of patients with acute ischemic stroke. Stroke 2018; 49: 1–65.
30. Sacks D, Baxter B, Campbell BCV et al. Multisociety consensus quality improvement revised consensus statement for endovascular therapy of acute ischemic stroke. J Vasc Interv Radiol 2018; 29: 441–453.
31. Goldstein LB, Samsa GP. Reliability of the National Institute of Health Stroke Scale. Extension to non-neurologists in the context of a clinical trial. Stroke 1997; 28: 307–310.
32. Dijkland SA, Voormolen DC, Venema E et al. Utility-weighted modified Rankin scale as primary outcome in stroke trials. A simulation study. Stroke 2018; 49: 965–971.
33. Barber PA, Demchuk AM, Zhang J et al. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy: ASPECTS Study Group – Alberta Stroke Programme Early CT Score. Lancet 2000; 355: 1670–1674.
34. Menon BK, d’Esterre CHD, Oazi EM et al. Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology 2015; 275(2): 510–520.
35. Volný O, Cimflová P, Kadlecová P et al. Single-phase versus multiphase CT angiography in middle cerebral artery clot detection – benefits for less experienced radiologists and neurologists. J Stroke Cerebrovasc Dis 2017; 26(1): 19–24.
36. Yoo AJ, Simonsen CZ, Prabhakaran S et al. Cerebral Angiographic Revascularization Grading Collaborators. Refining angiographic biomarkers of revascularization. Improving outcome prediction after intra-arterial therapy. Stroke 2013; 44: 2509–2512.
37. Fiehler J, Cognard C, Gallitelli M et al. European recommendations on organisation of interventional care in acute stroke (EROICAS). Int J Stroke 2016; 11(6): 701–716.
38. Krajina A, Krajíčková D. Role neuroradiologa v léčbě ischemických cévních mozkových příhod. Česká radiologie 2015; 69(2): 87–92.
39. Meyer BC. Telestroke evolution: from maximization to optimization. Stroke 2012; 43: 2029–2030.
40. Zaidat OO, Castonguay AC, Linfante I et al. First pass effect. A new measure for stroke thrombectomy devices. Stroke 2018; 49: 660–666.
41. Chang Y, Kim BM, Band OY et al. Rescue stenting for failed mechanical thrombectomy in acute ischemic stroke. Stroke 2018; 49: 958–964.
42. Fiehler J. Failed thrombectomy in acute ischemic stroke. Return of the stent? Stroke 2018; 49: 811–812.
43. Leishangthem L, Satti SR. Vessel perforation during withdrawal of Trevo ProVue stent retriever during mechanical thrombectomy for acute ischemic stroke. J Neurosurg 2014; 121: 995–998.
44. Behme D, Gondecki L, Fiethen S et al. Complication of mechanical thrombectomy for acute ischemic stroke – a retrospective single-center study of 176 cases. Neuroradiol 2014; 56: 467–476.
45. Binning MJ, Bartolini B, Baxter B et al. Trevo 2000: Results of the largest real-world registry for stent retriever for acute ischemic stroke. Stroke 2018; 49, in press.
46. Schonewille WJ, Wijman CA, Michel P et al.; BASICS Study Group. Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol 2009; 8: 724–730.
47. Gall S, Demchuk A. Clinical and technological approaches to the prehospital diagnosis of large vessel occlusion. Stroke 2018; 49: 1036–1043.
48. Krajíčková D, Krajina A, Vítková E a kol. Zabezpečí současná logistika nemocným s akutním uzávěrem velké tepny v přední cirkulaci stejnou šanci na dobrý výsledek? Česká a slovenská neurologie a neurochirurgie 2018; 81/114(3): 338–344.
49. Albers GW, Marks MP, Kemp S et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med 2018; 378: 708–718.
50. Nogueira RG, Jadhav AP, Haussen DC et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018; 378: 11–21.
51. Jadhav A P, Desa SM, Kenmuir CL et al. Eligibility for endovascular trial enrollment in the 6- to 24-hour time window. Stroke 2018; 49: 1015–1017.
52. Saposnik G, Strbian D. Enlightenment and challenges offered by DAWN Trial (DWI or CTP assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with Trevo). Stroke 2018; 49: 498–500.
53. Ribo M, Molina CA, Cobo E et al. Association between time to reperfusion and outcome is primarily driven by the time from imaging to reperfusion. Stroke 2016; 47: 999–1004.
54. Fiehler J. The time-reset effect. Thrombectomy trials challenge the existence of a time window. Clin Neuroradiol 2017; 27: 3–5.
55. Bendszus M, Bonekamp S, Berge E et al. A randomized controlled trial to test efficacy and safety of thrombectomy in stroke with extended lesion and extended time window (TENSION). Int J Stroke 2018, in press.
56. Volný O, Krajina A, Belasková S et al. Mechanical thrombectomy performs similarly in real world practice: a 2016 nationwide study from the Czech Republic. J Neurointervent Surg 2018; 10(8): 741–745.
57. Krajina A, Roček M, Köcher M a kol. Vývoj počtu endovaskulárních neurointervenčních metod v České republice v letech 2013–2016. Česká radiologie 2017; 71(2): 110–115.
58. Lapergue B, Blanc R, Gory B et al. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion. The ASTER randomized clinical trial. JAMA 2017; 318(5): 443–452.
59. Fischer U, Kaesmacher J, Molina C A et al. Primary thrombectomy in tPA (tissue-type plasminogen activator) eligible stroke patients with proximal intracranial occlusions. Stroke 2018; 49: 265–269.
60. Saber Tehrani AS, Kattah JC, Kerber KA et al. Diagnosing stroke in acute dizziness and vertigo. Pitfalls and pearls. Stroke 2018; 49: 788–795.
61. De Meyer SF, Andersson T, Baxter B et al. Analyses of thrombi in acute ischemic stroke: A consensus statement on current knowledge and future directions. Int J Stroke 2017; 12(6): 606–614.
62. Krajičková D, Krajina A, Šteiner I et al. Fibrin clot architecture in acute ischemic stroke treated with mechanical thrombectomy with stent-retrievers – cohort study. Circ J 2018; 82: 866–873.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistČlánok vyšiel v časopise
Journal of Czech Physicians
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
- Hybrid imaging PET/MR in prostatic carcinoma
- Coronary CT angiography – current options and future perspectives in the diagnosis of coronary artery disease
- Contrast-enhanced ultrasonography
- Interventional radiology therapies for liver cancer