Stroke: an ongoing revolution.

Abstract

reported that over the last two decades of stroke research only two findings really changed case-fatality and functional depen-dence of IS survivors: the first was the seminal paper “Stroke Unit Trialists”,published by Peter Langhorne in 1997, when it became clear that stroke units not only save lives but also re-duce functional dependence. The second was the discovery of intravenous use of tissue plasminogen activator (tPA) for hyperacute stroke reperfusion in 1995. These breakthroughs buried the nihilist approach to stroke and changed the par-adigm of IS treatment worldwide. The emergence of neuro-hospitalists as crucial professionals for inpatient care has become a reality. However, intravenous thrombolysis is less able than desirable, to open large vessels such as the inter-nal carotid artery or proximal branches of the middle cere-bral artery. In the last 10 years, many randomized clinical tri-als (RCT) of thrombectomy were “negative”. After December 2014, five new randomized controlled trials showed that intra-arterial treatment combined with IV lysis was more ef-fective than IV lysis alone, leading to