|Original language||English (US)|
|Title of host publication||Stroke|
|Subtitle of host publication||Pathophysiology, Diagnosis, and Management|
|Number of pages||22|
|State||Published - Mar 31 2011|
ASJC Scopus subject areas
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Stroke: Pathophysiology, Diagnosis, and Management. Elsevier, 2011. p. 1204-1225.
Research output: Chapter in Book/Report/Conference proceeding › Chapter
TY - CHAP
T1 - Interventional neuroradiologic therapy of atherosclerotic disease and vascular malformations
AU - Mocco, J.
AU - Kim, Stanley H.
AU - Bendok, Bernard R.
AU - Boulos, Alan S.
AU - Hopkins, L. Nelson
AU - Levy, Elad I.
N1 - Funding Information: The authors have the following financial relationships to disclose: Dr. Bendok has received research funding from Cordis; Dr. Mocco serves as a consultant to Actelion, Nfocus, and Lazarus Effect; his employer, The University of Florida, receives research funding from AccessClosure and Codman Neurovascular. Dr. Hopkins receives research study grants from Abbott (ACT 1 Choice), Boston Scientific (CABANA), Cordis (SAPPHIRE WW), and ev3/Covidien Vascular Therapies (CREATE) and a research grant from Toshiba (for the Toshiba Stroke Research Center); has an ownership/financial interest in AccessClosure, Boston Scientific, Cordis, Micrus, and Valor Medical; serves on the Abbott Vascular Speakers’ Bureau; receives honoraria from Bard, Boston Scientific, Cordis, and from the following for speaking at conferences—Complete Conference Management, Cleveland Clinic, and SCAI; receives royalties from Cordis (for the AngioGuard device), serves as a consultant to or on the advisory board for Abbott, AccessClosure, Bard, Boston Scientific, Cordis, Gore, Lumen Biomedical, Micrus, and Toshiba; and serves as the conference director for Nurcon Conferences/Strategic Medical Seminars LLC. Dr. Levy receives research grant support (principal investigator: Stent-Assisted Recanalization in acute Ischemic Stroke, SARIS), other research support (devices), and honoraria from Boston Scientific and research support from Micrus Endovascular and ev3/Covidien Vascular Therapies; has ownership interests in Intratech Medical Ltd. and Mynx/AccessClosure; serves as a consultant on the board of Scientific Advisors to Codman & Shurtleff, Inc.; serves as a consultant per project and/or per hour for Micrus Endovascular, ev3/Covidien Vascular Therapies, and TheraSyn Sensors, Inc.; and receives fees for carotid stent training from Abbott Vascular and ev3/Covidien Vascular Therapies. Dr. Levy receives no consulting salary arrangements. All consulting is per project, per hour, or both. Funding Information: In 1996, the FDA approved the use of intravenous (IV) recombinant tissue plasminogen activator (rt-PA, alteplase) in patients who present within 3 hours of the onset of acute ischemic stroke. This approval was based on the positive results of the National Institute of Neurological Disorders and Stroke (NINDS) study. 1 Currently, IV administration of t-PA within the 3-hour time window is the only treatment for acute ischemic stroke that is supported by level 1 evidence, recommended by the American Heart Association (AHA), and approved by the FDA. However, two major clinical trials and one prospective observational registry have reported outcomes of death or more than 50% functional dependency at the 3-month follow-up evaluation ( Table 61-1 ). 1-3 Moreover, six randomized trials failed to demonstrate a significant benefit for IV thrombolytic therapy initiated within 3 to 6 hours of stroke onset. 3-8 Several randomized trials have evaluated the safety and efficacy of IA thrombolysis administered 3 to 6 hours from symptom onset. 9,10 Additionally, a single-arm, prospective trial funded by the National Institutes of Health (NIH) of IA thrombolysis performed within 6 hours following a bridging dose (2/3 of normal) of IV t-PA within 3 hours demonstrated a benefit in comparison with results in the NINDS-NIH–funded t-PA trial control population and a suggestion of benefit in comparison with results in the NINDS-NIH–funded t-PA trial treatment population. 11,12 In several case series, IA thrombolysis alone or in combination with mechanical thrombolysis has been reported as an alternative modality for treatment of acute ischemic stroke in a select group of patients. 13-19 A randomized study is justified to determine whether IA thrombolysis with or without mechanical thrombectomy is superior to IV thrombolysis for acute ischemic stroke.
PY - 2011/3/31
Y1 - 2011/3/31
UR - http://www.scopus.com/inward/record.url?scp=85136982780&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85136982780&partnerID=8YFLogxK
U2 - 10.1016/B978-1-4160-5478-8.10061-2
DO - 10.1016/B978-1-4160-5478-8.10061-2
M3 - Chapter
AN - SCOPUS:85136982780
SN - 9781437737806
SP - 1204
EP - 1225
BT - Stroke
PB - Elsevier