Mechanical Thrombolysis and Stenting in Acute Ischemic Stroke

A cute ischemic stroke is one of the major sources of morbidity and mortality in the industrialized countries. The lifetime risk of stroke is estimated to be 1 in 5 for middle-aged women and 1 in 6 for men according to the Framingham Study. 1 Outcome depends on the length of time between onset of symptoms and revascularization, the recanalization rate, and on whether or not intracranial hemorrhage occurs. 2 A meta-analysis of 52 studies on thrombolysis outcome in 2066 patients showed that the chance of an independent life after stroke increases 4.4 times for patients with successful recanalization compared with patients without recanalization; mortality rate decreases 4-fold. However, the time window for treatment and the recanalization rate of both approaches are limited, The success of recanalization, furthermore, depends on the occlusion site; proximal occlusions of large vessels such as the internal carotid artery have a poor recanalization rate after either IV tPA or IAT. ecent studies have examined whether mechanical recanalization techniques can accelerate the process of recanalization, increase the recanalization rate, and even expand the window of opportunity.