Endovascular treatment of acute stroke.

An obvious treatment goal in patients suffering an acute stroke due to an occlusion of a cerebral vessel is restoring blood flow to ischemic tissue. Studies have shown that recanalization of blood vessels can be achieved through endovascular therapy using either thrombolytics or mechanical clot removal. Because the clinical response to intravenous thrombolysis is exquisitely time-dependent, patients should be treated as soon as possible. Intravenous thrombolysis is the initial therapy in patients who present within 3 hours of stroke onset. Endovascular therapy should be considered for patients with large-vessel occlusions who are not candidates for intravenous thrombolysis or who do not recanalize after intravenous thrombolysis.