Abstract
Intra-arterial stroke therapy aims to restore perfusion of the distal arterial bed by recanalizing the primary arterial occlusive lesion [1]. Successful recanalization positively correlates with improved longterm functional outcomes [2-4]. The PROACT II4 trial published in 1999 demonstrated a clear benefit from administering prourokinase via a catheter-based approach directly into the occlusive lesion.
Highlights
Intra-arterial stroke therapy aims to restore perfusion of the distal arterial bed by recanalizing the primary arterial occlusive lesion [1]
Some of the studies might have failed to demonstrate the superiority of mechanical thrombectomy due to an inaccurate evaluation of arterial recanalization by TIMI score after endovascular treatment [10,11,12]
Within the mechanical thrombectomy arm, eligible patients were treated with intra-venous thrombolysis and thrombectomy up to 6 hours from symptom onset and stentrievers were utilised in 81.5% of cases
Summary
Intra-arterial stroke therapy aims to restore perfusion of the distal arterial bed by recanalizing the primary arterial occlusive lesion [1]. SWIFT [5] and TREVO 2 [6] published in 2012 were randomised controlled trials which demonstrated the superiority of secondgeneration retrieval devices (stentrievers) as compared to the Merci device (a first-generation device). Mechanical thrombectomy was shown not to be superior to intravenous rt-PA in three randomised controlled studies published in the New England Journal of Medicine in 2013.
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