Frontiers in Neurosurgery

Author(s): Daniele G. Romano, Samuele Cioni and Sandra Bracco

DOI: 10.2174/9781681083094116030008

Endovascular Stroke Therapy: Devices and Different Approaches

Pp: 122-151 (30)

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Abstract

SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.

Abstract

Acute ischemic stroke (AIS) is a significant medical disease with relevant mortality and morbidity associated, that, especially in recent years, has undergone a major development of drugs and devices used for its treatment. A poor number of patients respects the criteria for treatment with intravenous drug (IVT) with recombinant tissue plasminogen activator, and the efficacy of this treatment in large vessel occlusion is percentually low. Recently, incresead percentage number of patients with AIS are treated with mechanical embolectomy if IVT is ineffective or controindicated. An important technological upgrading of devices used for the endovascular treatment of AIS, has allowed a significant increase in rates of recanalization and neurological improvement of patients treated, completely replacing the old device. Furthermore the use of these new devices has not caused an increase in intracerebral hemorragic (ICH). This chapter highlights the devices used in current practice for endovascular treatment of AIS, the different endovascular approaches and a brief review about the recent randomized trials, which have evaluated the efficacy of these new devices.

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