Acute Ischemic Stroke Intervention

Priyank Khandelwal, Dileep R. Yavagal, Ralph L. Sacco

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations


Acute ischemic stroke (AIS) is the leading cause of disability worldwide and among the leading causes of mortality. Although intravenous tissue plasminogen activator (IV-rtPA) was approved nearly 2 decades ago for treatment of AIS, only a minority of patients receive it due to a narrow time window for administration and several contraindications to its use. Endovascular approaches to recanalization in AIS developed in the 1980s, and recently, 5 major randomized trials showed an overwhelming superior benefit of combining endovascular mechanical thrombectomy with IV-rtPA over IV-rtPA alone. In this paper, we discuss the evolution of catheter-based treatment from first-generation thrombectomy devices to the game-changing stent retrievers, results from recent trials, and the evolving stroke systems of care to provide timely access to acute stroke intervention to patients in the United States.

Original languageEnglish (US)
Pages (from-to)2631-2644
Number of pages14
JournalJournal of the American College of Cardiology
Issue number22
StatePublished - Jun 7 2016


  • large vessel occlusion
  • mechanical thrombectomy
  • stent retrievers
  • stroke systems

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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