Abstract

The endovascular clot retrieval in combination with intravenous recombinant tissue plasminogen activator (rtPA) has been established as the 1st choice therapy for the treatment of acute arterial ischemic stroke (AIS) in case of large vessel occlusion. While the results of this therapy in ischemic insults in the anterior stromal region are clearly positive, the results for mechanical thrombectomy in posterior circulation are controversially discussed. In addition, the indication is made by the time window, sizing of the ischemic area, and various scores. The aim of the article is to review the available reports on the use of thromboelastography in acute ischemic stroke patients.

Highlights

  • After publication of the 5 HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke) studies, endovascular clot retrieval in combination with intravenous recombinant tissue plasminogen activator, if possible, has become the therapy of choice in treatment of acute arterial ischemic stroke (AIS) in case of large vessel occlusion (LVO) of the anterior circulation, based on positive randomized controlled trials [1-11]

  • The practical implementation of mechanical thrombectomy can be of great benefit in the case of dissections of the A. carotis comm

  • The best results are obtained in a time window of 4-5 hours

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Summary

Introduction

After publication of the 5 HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke) studies, endovascular clot retrieval in combination with intravenous recombinant tissue plasminogen activator (rtPA), if possible, has become the therapy of choice in treatment of acute arterial ischemic stroke (AIS) in case of large vessel occlusion (LVO) of the anterior circulation, based on positive randomized controlled trials [1-11]. Very good results between 35% and 42% were achieved within 4.5 hours of therapeutic windows and with the use of modern devices [4-7]

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