Review Article
Syeda Nadia Nadeem and Alakend
Abstract
Background: Acute ischemic stroke is the second leading cause of death worldwide. It creates a massive burden not only on the patient’s life but society as a whole. There has been much advancement in stroke management over the past few decades but 2015 has shown giant leaps in this. Up till now, thrombolysis was the main stroke treatment but recently several randomized controlled trials have emerged to demonstrate the efficacy behind using thrombectomy and how it will lead us into the future by treating ischemic stroke quicker and more effectively than ever before. Aim: To perform a systematic review of the new trials that compare thrombectomy to best medical-care. Furthermore, to critically analyze the current thrombectomy guidelines across UK and Europe in order to develop a thrombectomy best practice protocol that can be used as a guide worldwide. Method: Numerous articles which highlight the use of thrombectomy compared to thrombolysis alone in acute ischemic stroke were reviewed. Most recent UK and Europe guidelines for thrombectomy use were compared and critically appraised. Results and conclusion: Results show that thrombectomy used with thrombolysis reduces mortality rates and improves patients' functional independence and vessel reperfusion rates significantly from 37% to 100% compared to thrombolysis alone. Current European recommendations complies with these results and forms relevant guidance whereas, the UKs guidelines are incompatible, lacking structure and recent evidence. As a result, this review has created a new protocol which encompasses the trial results and European recommendations, in the hope to assist physicians worldwide.