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September 27, 2016

Endovascular Thrombectomy for Ischemic Stroke: The Second Quantum Leap in Stroke Systems of Care?

Author Affiliations
  • 1Dell Medical School, University of Texas at Austin, Austin
JAMA. 2016;316(12):1265-1266. doi:10.1001/jama.2016.12266

In 2015, the publication of 5 clinical trials1-5 established the efficacy of endovascular thrombectomy for reducing disability from large artery ischemic stroke, with each trial demonstrating the same superiority of thrombectomy compared with standard care. Endovascular stroke therapy—most recently with the use of stent retrievers to rapidly recanalize the artery during stent deployment and complete the thrombectomy by withdrawing the stent that had engaged the clot during stent deployment—had been practiced prior to that time, despite uncertainty about its uses and benefits. After nearly 2 decades since intravenous tissue plasminogen activator (IV tPA) became the first proven therapy for ischemic stroke, the findings from these trials indicated that major changes in stroke management and stroke systems of care were about to occur.

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