Thrombectomy in Medium to Large Ischemic Core

In 2015, 5 randomized clinical trials irrefutably established the benefit of thrombectomy for the treatment of acute ischemic stroke due to large-vessel occlusions, marking the beginning of the era of endovascular thrombectomy (EVT) as a therapy for cerebral ischemia. This treatment was successful by achieving high rates of timely reperfusion that saved brain from infarction. Cerebral ischemic injury results from a critical imbalance of cerebral blood flow and energy demand, leading to irreversible infarction. Tissue already so severely injured as to be irretrievably destined to infarct is defined as ischemic core, while ischemic penumbra refers to tissue that remains temporarily viable but is hypoperfused below a level that allows for electrical function of neurons. Such penumbral tissue will proceed to infarct if timely reperfusion is not achieved (ie, “tissue at risk”). These key concepts provide the rationale for emphasizing timely reperfusion—to salvage as much “tissue at risk” as possible.
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research