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Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke

Large vessel occlusions (LVOs), variably defined as blockages of the proximal intracranial anterior and posterior circulation, account for approximately 24% to 46% of acute ischemic strokes. Commonly refractory to intravenous tissue plasminogen activator (tPA), LVOs place large cerebral territories...

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Autores principales: Rennert, Robert C, Wali, Arvin R, Steinberg, Jeffrey A, Santiago-Dieppa, David R, Olson, Scott E, Pannell, J Scott, Khalessi, Alexander A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584910/
https://www.ncbi.nlm.nih.gov/pubmed/31197329
http://dx.doi.org/10.1093/neuros/nyz042
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author Rennert, Robert C
Wali, Arvin R
Steinberg, Jeffrey A
Santiago-Dieppa, David R
Olson, Scott E
Pannell, J Scott
Khalessi, Alexander A
author_facet Rennert, Robert C
Wali, Arvin R
Steinberg, Jeffrey A
Santiago-Dieppa, David R
Olson, Scott E
Pannell, J Scott
Khalessi, Alexander A
author_sort Rennert, Robert C
collection PubMed
description Large vessel occlusions (LVOs), variably defined as blockages of the proximal intracranial anterior and posterior circulation, account for approximately 24% to 46% of acute ischemic strokes. Commonly refractory to intravenous tissue plasminogen activator (tPA), LVOs place large cerebral territories at ischemic risk and cause high rates of morbidity and mortality without further treatment. Over the past few years, an abundance of high-quality data has demonstrated the efficacy of endovascular thrombectomy for improving clinical outcomes in patients with LVOs, transforming the treatment algorithm for affected patients. In this review, we discuss the epidemiology, pathophysiology, natural history, and clinical presentation of LVOs as a framework for understanding the recent clinical strides of the endovascular era.
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spelling pubmed-65849102019-06-25 Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke Rennert, Robert C Wali, Arvin R Steinberg, Jeffrey A Santiago-Dieppa, David R Olson, Scott E Pannell, J Scott Khalessi, Alexander A Neurosurgery Breakthroughs in the Endovascular Management of Acute Stroke Large vessel occlusions (LVOs), variably defined as blockages of the proximal intracranial anterior and posterior circulation, account for approximately 24% to 46% of acute ischemic strokes. Commonly refractory to intravenous tissue plasminogen activator (tPA), LVOs place large cerebral territories at ischemic risk and cause high rates of morbidity and mortality without further treatment. Over the past few years, an abundance of high-quality data has demonstrated the efficacy of endovascular thrombectomy for improving clinical outcomes in patients with LVOs, transforming the treatment algorithm for affected patients. In this review, we discuss the epidemiology, pathophysiology, natural history, and clinical presentation of LVOs as a framework for understanding the recent clinical strides of the endovascular era. Oxford University Press 2019-07 2019-06-14 /pmc/articles/PMC6584910/ /pubmed/31197329 http://dx.doi.org/10.1093/neuros/nyz042 Text en © Congress of Neurological Surgeons 2019. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Breakthroughs in the Endovascular Management of Acute Stroke
Rennert, Robert C
Wali, Arvin R
Steinberg, Jeffrey A
Santiago-Dieppa, David R
Olson, Scott E
Pannell, J Scott
Khalessi, Alexander A
Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
title Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
title_full Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
title_fullStr Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
title_full_unstemmed Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
title_short Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
title_sort epidemiology, natural history, and clinical presentation of large vessel ischemic stroke
topic Breakthroughs in the Endovascular Management of Acute Stroke
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584910/
https://www.ncbi.nlm.nih.gov/pubmed/31197329
http://dx.doi.org/10.1093/neuros/nyz042
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