Neurointerventional therapy for large vessel occlusion stroke: the new standard of care
Abstract
For the past two decades, intravenous tissue plasminogenactivator (IV tPA) has been the gold standard
treatment of acute ischemic stroke (AIS) for patients
presenting to the hospital in the first 4.5 hours after
symptom onset. However, in patients with AIS due to
intracranial large vessel occlusion (LVO), IV tPA has
very poor recanalization rates. This group of patients
has significantly worse outcomes than those without
LVO. Endovascular therapy has evolved significantly
since the first trial in 1998. With the publication of recent
trials using modern stent-retriever devices and
selection of patients with LVO, endovascular therapy
has become the standard of care for patients with the
most severe ischemic strokes. In this article we outline
the two decade evolution of this therapy.