Beyond tissue plasminogen activator: Mechanical intervention in acute stroke

Megan C. Leary, Jeffrey L. Saver, Y. Pierre Gobin, Reza Jahan, Gary R. Duckwiler, Fernando Vinuela, Stella Kidwell, John Frazee, Sidney Starkman

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Mechanical interventions in acute ischemic stroke promise to provide emergency physicians with tools to treat patients in whom conventional thrombolysis might be ineffective or contraindicated, including most patients with stroke who arrive at the emergency department beyond the 3-hour time window for intravenous tissue plasminogen activator. A systematic MEDLINE literature review was performed. Endovascular interventions currently in early human clinical trials include the use of lasers, ultrasonography, angioplasty, microsnares, and a variety of clot-retrieval devices. Potential advantages of these approaches include more rapid recanalization of occluded vessels, reduced or no exposure to fibrinolytic agents, and a longer treatment window. Early safety trials are promising, with serial improvements in device design to minimize trauma to cerebrovascular endothelium and accelerate vessel recanalization. The purpose of this review is to provide the emergency medicine community with an understanding of these promising and emerging approaches to acute stroke therapy.

Original languageEnglish (US)
Pages (from-to)838-846
Number of pages9
JournalAnnals of Emergency Medicine
Volume41
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Fingerprint

Tissue Plasminogen Activator
Stroke
Cerebrovascular Trauma
Laser Angioplasty
Equipment Design
Fibrinolytic Agents
Emergency Medicine
MEDLINE
Endothelium
Hospital Emergency Service
Ultrasonography
Emergencies
Clinical Trials
Physicians
Safety
Equipment and Supplies
Therapeutics

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Leary, M. C., Saver, J. L., Gobin, Y. P., Jahan, R., Duckwiler, G. R., Vinuela, F., ... Starkman, S. (2003). Beyond tissue plasminogen activator: Mechanical intervention in acute stroke. Annals of Emergency Medicine, 41(6), 838-846. https://doi.org/10.1067/mem.2003.194

Beyond tissue plasminogen activator : Mechanical intervention in acute stroke. / Leary, Megan C.; Saver, Jeffrey L.; Gobin, Y. Pierre; Jahan, Reza; Duckwiler, Gary R.; Vinuela, Fernando; Kidwell, Stella; Frazee, John; Starkman, Sidney.

In: Annals of Emergency Medicine, Vol. 41, No. 6, 01.06.2003, p. 838-846.

Research output: Contribution to journalArticle

Leary, MC, Saver, JL, Gobin, YP, Jahan, R, Duckwiler, GR, Vinuela, F, Kidwell, S, Frazee, J & Starkman, S 2003, 'Beyond tissue plasminogen activator: Mechanical intervention in acute stroke', Annals of Emergency Medicine, vol. 41, no. 6, pp. 838-846. https://doi.org/10.1067/mem.2003.194
Leary MC, Saver JL, Gobin YP, Jahan R, Duckwiler GR, Vinuela F et al. Beyond tissue plasminogen activator: Mechanical intervention in acute stroke. Annals of Emergency Medicine. 2003 Jun 1;41(6):838-846. https://doi.org/10.1067/mem.2003.194
Leary, Megan C. ; Saver, Jeffrey L. ; Gobin, Y. Pierre ; Jahan, Reza ; Duckwiler, Gary R. ; Vinuela, Fernando ; Kidwell, Stella ; Frazee, John ; Starkman, Sidney. / Beyond tissue plasminogen activator : Mechanical intervention in acute stroke. In: Annals of Emergency Medicine. 2003 ; Vol. 41, No. 6. pp. 838-846.
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