
Endovascular stroke therapy is a treatment for acute ischaemic stroke, which is caused by a blood clot in the brain. The treatment involves placing a catheter into the brain and removing the clot. Endovascular therapy must be performed within six to eight hours of the onset of a stroke, depending on the location. The procedure takes around two hours and involves threading a thin wire tube with a wire mesh (called a stent retriever) through an artery in the patient’s groin and using X-ray and contrast dye to guide the tube up into the brain until it reaches the blocked vessel. The stent retriever is then expanded to grab the clot, which is removed as the tube is pulled out.
Characteristics | Values |
---|---|
Time window | Within 6 to 8 hours of the onset of a stroke |
Treatment | Endovascular thrombectomy |
Procedure time | 2 hours |
Eligibility | Patients must be at least 18 years old, score 6 or higher on the NIHSS, have received IV thrombolytic treatment within 4.5 hours of the onset of symptoms, and have a proven large arterial blockage on imaging |
What You'll Learn
- Endovascular therapy must be performed within six to eight hours of the onset of a stroke
- Endovascular therapy is a treatment for acute ischemic stroke
- Endovascular therapy involves endovascular thrombectomy, a procedure that involves placing a catheter into the brain to remove a blood clot
- Endovascular therapy is also known as neurointerventional therapy
- Endovascular therapy is considered only for patients who are at least 18 years old
Endovascular therapy must be performed within six to eight hours of the onset of a stroke
Endovascular therapy is a treatment for acute ischaemic stroke, which is caused by a blood clot in the brain. The treatment involves placing a catheter into the brain and removing the clot. It must be performed within six to eight hours of the onset of a stroke, depending on the location. This is because, for every minute of blocked blood flow, an increasing number of neurons die.
Endovascular therapy is a relatively new treatment for eligible patients experiencing acute ischaemic stroke. It is also known as neurointerventional therapy. The procedure takes around two hours and involves a physician threading a thin wire tube with a wire mesh (called a stent retriever) through an artery in the patient’s groin. The physician uses X-ray and contrast dye to guide the tube up into the brain until it reaches the blocked vessel. Once the tube is pushed into the clot, the physician expands the stent retriever to grab the clot, which is then removed as the tube is pulled out.
Endovascular therapy is only considered for patients who:
- Are at least 18 years old
- Score 6 or higher on the National Institutes of Health Stroke Scale (NIHSS)
- Have received IV thrombolytic treatment within 4.5 hours of the onset of symptoms
- Have a proven large arterial blockage on imaging
- Are eligible to receive endovascular therapy within 6 to 8 hours of the onset of stroke symptoms, depending on location
Endovascular therapy is not suitable for all patients experiencing ischaemic stroke. It is only considered when the above criteria are met.
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Endovascular therapy is a treatment for acute ischemic stroke
Endovascular therapy must be performed within six to eight hours of the onset of a stroke, depending on the location. The procedure takes about two hours and can restore blood flow within minutes. However, not all patients experiencing ischemic stroke are eligible for endovascular therapy. To be eligible, patients must be at least 18 years old, score 6 or higher on the National Institutes of Health Stroke Scale (NIHSS), have received IV thrombolytic treatment within 4.5 hours of the onset of symptoms, and have a proven large arterial blockage on imaging.
Endovascular therapy is a promising treatment approach for acute ischemic stroke, with the potential to reduce procedure time and improve recanalization rates. It is a rapidly growing field with constantly improving tools and evolving indications. Recanalization rates have been increasing in more recent studies compared to earlier ones. The available data on stent retrievers, a type of endovascular mechanical treatment device, show good results with improved and quicker recanalization rates and comparable mortality and intracerebral hemorrhage (ICH) rates to those of earlier neurointerventional studies.
Overall, endovascular therapy is a safe and effective treatment for acute ischemic stroke, offering improved clinical outcomes and higher rates of recanalization compared to intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). It is now considered the standard of care for selected patients with acute ischemic stroke and large vessel occlusion, with guidelines recommending its use within six hours of symptom onset. However, recent trials have extended the time window for endovascular therapy up to 24 hours in select patient populations, leading to improved functional outcomes.
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Endovascular therapy involves endovascular thrombectomy, a procedure that involves placing a catheter into the brain to remove a blood clot
Endovascular thrombectomy is a procedure that involves the insertion of a catheter (a long, thin tube) into an artery in the groin or wrist. The procedure is used to treat acute ischemic stroke and must be performed within six to eight hours of the onset of stroke symptoms, depending on the location of the blockage.
During the procedure, the patient is given a local anesthetic to numb the area where the catheter is inserted. The catheter is then guided through the blood vessels to the site of the blocked artery in the brain, using X-ray imaging for guidance. Once the catheter reaches the blocked artery, a small device called a stent retriever is inserted through it and guided to the blockage. The stent retriever then expands to capture the clot, and the clot is removed as the catheter is withdrawn.
Endovascular thrombectomy is typically performed by a team of specialized doctors and nurses in a hospital setting. Before the procedure, the patient undergoes a series of tests to confirm the diagnosis of acute ischemic stroke and determine the location of the blood clot. After the procedure, the patient is monitored in the hospital for several days to ensure there are no complications.
The entire procedure usually takes between one and two hours, depending on the location and size of the blood clot. Endovascular thrombectomy is a minimally invasive procedure that carries fewer risks than open surgery. It has been shown to improve outcomes for eligible patients when performed within the recommended time window.
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Endovascular therapy is also known as neurointerventional therapy
Endovascular therapy, also known as neurointerventional therapy, neurointerventional surgery, endovascular neurosurgery, or interventional neuroradiology, is a highly demanding medical subspecialty. It involves the treatment of diseases of the head, neck, and spine using minimally invasive image-based technologies and procedures. This type of surgery is performed by a neurosurgeon or neuroradiologist with specialised training in neurointerventional surgery.
Endovascular therapy is a minimally invasive procedure that uses thin tubes called catheters and small tools that are inserted into the blood vessels, as opposed to open surgery, which requires larger incisions. The surgeon uses radiology images to guide them during the procedure, allowing them to see the area being treated.
One of the key applications of endovascular therapy is the treatment of acute ischemic stroke, which is caused by a blood clot in the brain. This procedure must be performed within six to eight hours of the onset of a stroke, as urgent medical attention is crucial for restoring blood flow and saving at-risk brain tissue. During the procedure, a catheter is inserted into the brain through an artery in the patient's groin, and a stent retriever is guided to the site of the clot. The stent is then opened to grab the clot, which is removed as the catheter is withdrawn.
Endovascular therapy has evolved alongside advancements in brain imaging methods, allowing physicians to determine which patients are most likely to benefit from this treatment. Clinical trials have demonstrated the effectiveness of endovascular therapy, particularly when combined with intravenous thrombolytic treatment, in improving patient outcomes compared to medical therapy alone.
In addition to stroke treatment, endovascular therapy is used to treat various conditions, including brain aneurysms, arteriovenous malformations, atherosclerosis, vascular malformations, tumours, and spinal problems. It is a highly specialised field that requires a deep understanding of disease, anatomy, clinical skills, and manual dexterity, making it a challenging area of practice for physicians.
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Endovascular therapy is considered only for patients who are at least 18 years old
Endovascular therapy is a relatively new treatment for acute ischemic stroke, caused by a blood clot in the brain. The treatment involves placing a catheter into the brain and removing the clot. It is a highly effective treatment, restoring blood flow within minutes. However, it must be performed within six to eight hours of the onset of a stroke, depending on the location.
Endovascular therapy is not suitable for all patients. It is considered only for patients who meet certain criteria. One of the key criteria is age. Endovascular therapy is only considered for patients who are at least 18 years old. This age restriction is in place because the treatment is typically considered for patients with a proven large arterial blockage. Younger patients are less likely to have severe blockages in their arteries.
In addition to age, there are several other factors that determine whether a patient is eligible for endovascular therapy. Firstly, the patient must have received IV thrombolytic treatment within 4.5 hours of the onset of symptoms. This treatment helps to break down the blood clot causing the stroke. Secondly, the patient must score 6 or higher on the National Institutes of Health Stroke Scale (NIHSS). This scale assesses the severity of the stroke, and a score of 6 or higher indicates that the patient's condition is serious enough to warrant endovascular therapy. Finally, the patient must be eligible to receive endovascular therapy within 6 to 8 hours of the onset of stroke symptoms, depending on the location. This timing is crucial because the effectiveness of the treatment decreases as time passes.
Endovascular therapy is a complex and highly specialised procedure. It is typically performed by a neurosurgeon or neurointerventional radiologist. The procedure involves threading a thin wire tube with a wire mesh, called a stent retriever, through an artery in the patient's groin. The physician uses X-ray and contrast dye to guide the tube up into the brain until it reaches the blocked vessel. Once the tube is in place, the physician expands the stent retriever to grab the clot, and the clot is removed as the tube is pulled out. The procedure usually takes about 2 hours.
Endovascular therapy is a life-saving treatment for eligible patients experiencing acute ischemic stroke. However, it is important to emphasise that not all patients are suitable candidates for this treatment. Age is a critical factor, and endovascular therapy is typically only considered for patients who are 18 years of age or older.
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Frequently asked questions
The procedure takes about 2 hours.
Endovascular therapy must be done within six to eight hours of the onset of a stroke, depending on the location.
Endovascular therapy involves placing a catheter into the brain and removing the clot that's causing the stroke.