Endovascular Treatment of an Ischemic Cerebrovascular Event

Stroke is one of the most frequent causes of mortality, morbidity and disability worldwide, especially in developed countries. Acute occlusion of cerebral artery, detectable during the first hours after an onset of symptoms in more than 70% of patients, is the most common cause of acute ischemic stroke. Early recanalization of cerebral artery is associated with a higher chance for independency after three months and lower mortality. In addition to pharmacological methods (systemic, local and combined thrombolysis), endovascular mechanical methods to accelerate recanalization of occluded cerebral arteries are being tested. The paper describes various endovascular instruments and results of studies conducted so far. Results from initial studies showed mechanical devices to be safe and effective with increasing proportion of successful recanalizations and relatively low risk of both periprocedural complications and symptomatic intracranial bleeding. At present, mechanical recanalization methods are indicated especially in patients with acute occlusion of intracranial artery and intravenous thrombolysis failure or contraindication.