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Patient selection for intra‐arterial cerebral revascularization in acute ischemic stroke
Author(s) -
Lund C. G.,
Aamodt A. H.,
Russell D.
Publication year - 2013
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12052
Subject(s) - medicine , penumbra , revascularization , stroke (engine) , arterial ischemic stroke , clinical trial , cardiology , randomized controlled trial , ischemia , intensive care medicine , mechanical engineering , myocardial infarction , engineering
In acute ischemic stroke, rapid revascularization of the cerebral ‘penumbra volume’ is the key to better patient outcome. The largest and most proximal cerebral thrombotic artery occlusions can in most cases only be opened by intra‐arterial intervention. The use of intra‐arterial revascularization is rapidly expanding throughout E urope and N orth A merica, despite the risk for serious complications and the fact that the benefit of this treatment has not yet been proven in large, randomized clinical trials. Oslo U niversity H ospital has performed approximately 60 intra‐arterial procedures annually in acute ischemic stroke during the last few years. In this paper, we discuss important clinical and ethical aspects learned from our own experience. The future of intra‐arterial cerebral revascularization will depend on an accurate preintervention patient selection.