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Channel: Stroke & Neurovascular Interventions

Stroke and Neurovascular Interventions Foundation

www.sanif.co.in

AHA/ASA has updated its guidelines on endovascular treatment for acute ischemic stroke June 2015 class 1, level of evidence A

• Role of mechanical recanalization - proved by strongly positive the recently published recent trials •(MR CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, and REVASCAT)•Significantly better outcomes by mechanical recanalization in patients with major vessels occlusion.   

·    Prestroke modified Rankin Scale (mRS) score 0 to 1;·    AIS with receipt of intravenous recombinant tPA within 4.5 hours of onset;·    Causative occlusion of the internal carotid artery or proximal (M1) middle cerebral artery (MCA);·     Age 18 years or older;·    National Institutes of Health Stroke Scale (NIHSS) score of 6 or greater;·     ASPECT score of 6 or greater; and·    Treatment that can be initiated (groin puncture) within 6 hours of symptom onset.

The guidelines state that patients should receive endovascular therapy with a stent retriever if they meet all the following criteria (class 1; level of evidence A)*:

Patients suspected of having had a

Stroke

Patients who meet the eligibility

Criteria*

Receive IV tPA

Receive Endovascular

Treatment

Shift Primary Stroke Centre Immediately

Quickly Transport to Comprehensive Stroke Centre

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