Thrombectomy: indications and use
Evidence-based neurology checklist on thrombectomy: indications and use: General indications Large vessel occlusion (LVO): internal carotid (ICA) or proximal middle cerebral artery (MCA) Pre-stroke modified Rankin (mRS) score of 0-1 Age ≥ 18 years NIHSS score ≥ 6 ASPECTS score ≥ 6 Timing…
General indications
- Large vessel occlusion (LVO): internal carotid (ICA) or proximal middle cerebral artery (MCA)
- Pre-stroke modified Rankin (mRS) score of 0-1
- Age ≥ 18 years
- NIHSS score ≥ 6
- ASPECTS score ≥ 6
Timing indications
Advantages of adding thrombolysis to thrombectomy
Advantages of Tenecteplase over Alteplase thrombolysis pre-thrombectomy
Indications for thrombectomy without thrombolysis
Advantages of general anaesthesia for thrombectomy
References
- Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ 2020; 368:l6983.
- Bracard S, Ducrocq X, Mas JL, et al; THRACE investigators. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial. Lancet Neurol 2016; 15:1138-1147.
- Natarajan SK, Snyder KV, Siddiqui AH. Ionita CC, Hopkins N, Levy EI. Safety and effectiveness of endovascular therapy after 8 hours of acute ischemic stroke onset and wake-up strokes. Stroke 2009; 40:3269-3274.
- Saver JL, Goyal M, van der Lugt A, et al; HERMES Collaborators. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA 2016; 316:1279-1288.
- Motyer R, Kok HK, Asadi H, et al. Outcomes of endovascular treatment for acute large-vessel ischaemic stroke more than 6 h after symptom onset. J Intern Med 2017; 282:537-545.
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