Endovascular treatments for ischemic stroke

Abstract

Highlights. Mechanical thrombectomy is the “gold standard” treatment of patients with large-vessel occlusions. Five randomized trials conducted in 2015 made a significant contribution to the development and introduction of mechanical thrombectomy into clinical practice. The DAWN and DEFUSE-3 trials have provided new insights into the pathophysiology of ischemic stroke and ensured the advancement in the therapeutic field.Abstract. Stroke is one of the leading causes of death and disability worldwide. The general strategy for the treatment of ischemic stroke is aimed at restoring blood flow to the ischemic regions of the brain. Intravenous thrombolysis has been the treatment for acute ischemic stroke since 1996. However, since 2015, as a result of 5 randomized trials, endovascular mechanical thrombectomy has become the gold standard for the treatment of patients with large cerebral artery occlusion. The DAWN and DEFUSE 3 trials have provided new insights into the pathophysiology of ischemic stroke, shifting the paradigm from “time = brain” to “collaterals = brain”. In this article, the authors will consider development of endovascular devices, modern mechanical thrombectomy techniques, and directions for further research of endovascular treatment for ischemic stroke.