A recent review article, published in the Lancet, provided a contemporary update of endovascular therapy for stroke patients. The article authors, researchers from Boston University Chobanian & Avedisian School of Medicine along with international collaborators, reviewed the latest developments in endovascular therapy for stroke patients, crediting the therapy for transforming the management of strokes caused by large vessel occlusion (LVO), a leading cause of disability and death worldwide.
At the same time, the authors wrote, there are “ongoing knowledge gaps” regarding which patients with large ischemic infarcts are most likely to benefit from endovascular therapy.
Pointing to recent advancements in endovascular therapy, which involves minimally invasive procedures within blood vessels, the article authors cite recent clinical trials that led to expanding the treatment window for this therapy from 6 hours to 24 hours after symptom onset, potentially benefiting more patients.
Research further shows that endovascular therapy has proven effective for patients with large ischemic core infarcts and basilar artery occlusions, further broadening its application. These findings suggest that more stroke patients may be eligible for this potentially life-saving treatment.
In addition, the article notes the simplification of patient selection criteria for endovascular therapy. The researchers report that most patients with a National Institutes of Health Stroke Scale (NIHSS) score higher than 5 and anterior circulation occlusion, or those with an NIHSS score of 10 or higher and basilar occlusions, are good candidates for the therapy within the 24-hour window.
However, the authors acknowledge that more studies are needed to definitively understand which patients with large ischemic infarcts are more likely to benefit from endovascular therapy and what its role is for patients with low stroke severity scores or medium to distal vessel occlusions.
“Our paper is a contemporary update of the role of endovascular therapy (clot retrieval, rescue stenting) in the treatment of patients with acute ischemic stroke as well as patient selection criteria,” said corresponding author Thanh Nguyen, MD, professor of neurology, neurosurgery and radiology at Boston University Chobanian & Avedisian School of Medicine.
