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C-2122 - Endovascular stroke treatment: an up-to-date review

G. Fatania, A. Qureshi, T. Booth; London/UK Type: Educational Exhibit
Area of Interests: Interventional vascular, Neuroradiology brain
Imaging Techniques: CT-Angiography, Catheter arteriography
Procedures: Arterial access, Recanalisation, Thrombolysis
Special Focus: Embolism / Thrombosis
Please note: This poster is part of the session VoE 56 - Neuro on Saturday, March 4, 13:00 - 14:00 Add poster to my schedule In your schedule (remove)

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Learning objectives: Since 2015 there has been mounting class Ia evidence that mechanical thrombectomy is superior to thrombolysis alone for acute ischaemic stroke.   We provide a review of this evidence to update clinical practice and demonstrate the subgroups for which the evidence is strongest.  

Background: Immediate treatment of ischaemic stroke aims to restore perfusion to the ischaemic brain. The gold standard of care at present (in those that are eligible) consists of thrombolysis using intra-venous tissue plasminogen activator (IV-tPA). Approximately 11.5% of ischaemic strokes receive this treatme[...]

Findings and procedure details: Methods:   Systematic review of RCTs and subsequent meta-analyses comparing endovascular thrombectomy in acute stroke to standard care alone since 2015. In total 10 RCTs and 2 meta-analyses were deemed appropriate after multiple author review. A further discussion of relevant supplementary rese[...]

Conclusion: There is a growing body of class Ia evidence that thrombectomy in addition to standard care is superior to standard care involving thrombolysis alone. Clinical outcomes measured using the mRS show a clear benefit in these trials.   The most robust data is delivered by the HERMES15 meta-analysis[...]

Personal information: G. Fatania, Department of Radiology, Imperial College Healthcare NHS Trust, London, UK. A. Qureshi, Department of Neuroradiology, King's College Hospital NHS Trust, London, UK. T.C. Booth, Department of Neuroradiology, King's College Hospital NHS Trust, London, UK.

References: 1: Royal College of Physicians (2014) . Sentinel Stroke National Audit Programme (SSNAP)ClinicalAuditJanuary-March2014PublicReport. https://www.strokeaudit.org/results/national-results.aspx. 2: Saqqur et al (2007). Site of arterial occlusion identified by transcranial doppler predicts the response[...]

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