Thrombolysis and thrombectomy for acute ischaemic stroke

El Tawil, S. and Muir, K. W. (2017) Thrombolysis and thrombectomy for acute ischaemic stroke. Clinical Medicine, 17(2), pp. 161-165. (doi: 10.7861/clinmedicine.17-2-161) (PMID:28365630)

Abstract

The likelihood of disability-free recovery after acute ischemic stroke is significantly improved by reperfusion either by intravenous thrombolytic drug treatment or with endovascular mechanical thrombectomy in selected cases. The use of intravenous thrombolysis is limited by the short treatment window and you need to assess individual balance of benefit and risk of symptomatic intracranial haemorrhage. Benefit is greater for shorter onset-to-reperfusion time intervals, requiring optimisation of pre-hospital and in-hospital pathways. Symptomatic haemorrhage is more likely with more severe strokes, but a greater proportion of patients are left free of disability than suffer a treatment-related haemorrhage at all levels of severity. Extracranial haemorrhage and orolingual angioedema are less common complications. Endovascular mechanical thrombectomy can be used in selected patients with imaging-proven large artery occlusion. Successful therapy depends on well-organised services that can deliver treatment within a short time window at centres with adequate expertise to perform the procedure.

• Item Type: Articles
• Keywords: Cerebrovascular disease, endovascular treatment, stroke, thrombectomy, thrombolysis.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: El Tawil, Dr Salwa and Muir, Professor Keith
• Authors: El Tawil, S., and Muir, K. W.
• College/School: College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: Clinical Medicine
• Publisher: Royal College of Physicians
• ISSN: 1470-2118
• ISSN (Online): 1473-4893
• Copyright Holders: Copyright © 2017 Royal College of Physicians
• First Published: First published in Clinical Medicine 17(2):161-165
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher