The treatment of stroke caused by intracranial vessel occlusion with intravenous recombinant tissue plasminogen activator (rt-PA) was the only evidence-based treatment option for a long time. Nevertheless the response rate was disappointing in large vessel occlusions. Five studies that evaluated the efficacy of mechanical thrombectomy published in 2015 proved a significant clinical benefit for selected patients suffering from acute ischemic stroke. These results are the basis for extensive technical, institutional, and personal structural changes in the neurovascular field of stroke treatment. This review gives an overview of the current status of mechanical thrombectomy and future expectations and challenges are discussed.
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http://dx.doi.org/10.1177/1756285617742082 | DOI Listing |
PLoS Med
January 2025
Institute for Global Health, University College London, London, United Kingdom.
Background: Cardiovascular disease (CVD) morbidity and mortality is increasing in Africa, largely due to undiagnosed and untreated hypertension. Approaches that leverage existing primary health systems could improve hypertension treatment and reduce CVD, but cost-effectiveness is unknown. We evaluated the cost-effectiveness of population-level hypertension screening and implementation of chronic care clinics across eastern, southern, central, and western Africa.
View Article and Find Full Text PDFQJM
January 2025
School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, United Kingdom.
Background: Contemporary stroke care is moving towards more holistic and patient-centred integrated approaches, however, there is need to develop high quality evidence for interventions that benefit patients as part of this approach.
Aim: This study aims to identify the types of integrated care management strategies that exist for people with stroke, to determine whether stroke management pathways impact patient outcomes, and to identify elements of integrated stroke care that were effective at improving outcomes.
Design: Systematic review with meta-analysis.
Neuroradiol J
January 2025
Department of Neuroradiology, Teaching Hospital of Paracelsius Medical University (PMU), Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy.
Occlusion of the distal internal carotid artery can simulate a proximal occlusion of its cervical tract on CT angiography in patients with acute ischemic stroke, that is, pseudo-occlusion. As true and false carotid occlusions can present similarly on non-invasive imaging in patients undergoing endovascular treatment for stroke, our study aimed to evaluate clinical and technical differences of these conditions and the possible consequences of a misdiagnosis. We retrospectively reviewed consecutive patients who underwent mechanical thrombectomy for acute ischemic stroke at a single center between July 2015 and May 2022 and included patients with absent opacification of the cervical carotid artery on CT-angiography.
View Article and Find Full Text PDFAdv Sci (Weinh)
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Ischemic stroke is the most common cerebrovascular disease and the leading cause of permanent disability worldwide. Recent studies have shown that stroke development and prognosis are closely related to abnormal tryptophan metabolism. Here, significant downregulation of 3-hydroxy-kynurenamine (3-HKA) in stroke patients and animal models is identified.
View Article and Find Full Text PDFPM R
January 2025
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Objective: To review and synthesize existing evidence on the effect of mirror therapy (MT) on motor and functional recovery and the effect of unimanual and bimanual MT in individuals with subacute stroke.
Methodology: PubMed, Physiotherapy Evidence Database, Cochrane, and Airiti Library were searched for relevant studies. Randomized and pilot randomized controlled trials comparing MT with sham MT or conventional therapy were included.
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