Thrombektomie beim akuten Schlaganfall – Schritt für Schritt

Die kathetergestützte Thrombektomie beim akuten Schlaganfall hat sich zu einer Evidenz-basierten Standardbehandlung entwickelt. Die Durchführung erfordert ein standardisiertes Vorgehen, das für drei Standardtechniken beschrieben wird, um das Verständnis für die Abläufe und technische Durchführung bei Neurologen zu erhöhen.

Publication History

Article published online:
11 August 2020

• Literatur

• 1 Goyal M, Menon BK, van Zwam WH. et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016; 387: 1723-1731
• 2 Nogueira RG, Jadhav AP, Haussen DC. et al. for the DAWN Trial Investigators Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. N Engl J Med 2018; 378: 11-21
• 3 Ringleb PA, Veltkamp R. et al. Leitlinie Akuttherapie des ischämischen Schlaganfalls – Ergänzung 2015. Rekanalisierende Therapie AWMF 030 – 140. DGN; 2015 online
• 4 Pexman JH, Barber PA, Hill MD. et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol 2001; 22: 1534-1542
• 5 Tahtali D, Bohmann F, Rostek P. et al. Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide. J Vis Exp 2017; 119
• 6 Schönenberger S, Hendén PL, Simonsen CZ. et al. Association of General Anesthesia vs Procedural Sedation With Functional Outcome Among Patients With Acute Ischemic Stroke Undergoing Thrombectomy: A Systematic Review and Meta-analysis. JAMA 2019; 322: 1283-1293
• 7 Zaidat OO, Mueller-Kronast NH, Hassan AE. et al. Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry. Stroke 2019; 50: 697-704
• 8 Turk AS, Siddiqui A, Fifi JT. et al. Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial. Lancet 2019; 393: 998-1008
• 9 Maus V, Brehm A, Tsogkas I. et al. Stent retriever placement in embolectomy: the choice of the post-bifurcational trunk influences the first-pass reperfusion result in M1 occlusions. J Neurointerv Surg 2019; 11: 237-240
• 10 Jia B, Feng L, Liebeskind DS. et al. Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis. J Neurointerv Surg 2018; 10: 746-750
• 11 Maus V, Behme D, Kabbasch C. et al. Maximizing First-Pass Complete Reperfusion with SAVE. Clin Neuroradiol 2018; 28: 327-338
• 12 Brehm A, Maus V, Tsogkas I. et al. Stent-retriever assisted vacuum-locked extraction (SAVE) versus a direct aspiration first pass technique (ADAPT) for acute stroke: data from the real-world. BMC Neurology 2019; 19: 65
• 13 Osama O, Zaidat OO, Bozorgchami H. et al. Primary Results of the Multicenter ARISE II Study(Analysis of Revascularization in Ischemic Stroke With EmboTrap). Stroke 2018; 49: 1107-1115
• 14 Noser EA, Shaltoni HM, Hall CE. et al. Aggressive mechanical clot disruption: a safe adjunct to thrombolytic therapy in acute stroke?. Stroke 2005; 36: 292-296
• 15 Liebeskind DS, Bracard S, Guillemin F. et al. eTICI reperfusion: defining success in endovascular stroke therapy. J NeuroIntervent Surg 2019; 11: 433-438