Current clinical recommendations for endovascular treatment of patients with acute ischemic stroke

Abstract

The aim of the study. To evaluate the effectiveness of endovascular technologies in the treatment of acute ischemic stroke in the conditions of a multispecialized hospital. Material and methods. To achieve the goal, a review of literature sources over the past 15 years was conducted using medical databases MEDLINE, Google Scholar, Researchgate, dedicated to the diagnosis and treatment of patients with acute ischemic stroke in the carotid system. An analysis of the results of mechanical thrombectomies performed during the years 2015-2021 in 98 patients who were receiving inpatient treatment at the Lviv Medical Center (now St. Panteleimon Hospital 1 RMA, Lviv) was also analyzed. Results. In 75.5% of patients with acute ischemic stroke with thrombotic occlusions of extracranial and proximal segments of intracranial arteries, in which mechanical thrombectomy (primary or after thromboaspiration) was performed with the use of stent-retrievers, satisfactory reperfusion was achieved, provided that current instructions were clearly followed, which was manifested by the achievement satisfactory angiographic result (according to mTICI 2b/3). Conclusions Endovascular treatment of ischemic stroke has high safety and generally recognized effectiveness. Provided the instructions were clearly followed, it was accompanied by the achievement of a satisfactory degree of recanalization of the mTICI 2b/3 artery in 75.5% of our patients with thrombotic occlusions of extracranial and proximal segments of intracranial arteries, who underwent thromboaspiration and thrombectomy using stent-retrievers. For the effective treatment of acute ischemic stroke, round-the-clock work of the X-ray surgical department in a specialized center with angiosurgical equipment and experienced certified specialists is necessary.