How effective are percutaneous vascular interventions in patients with acute ischaemic stroke?
The interventions significantly increased the risk of symptomatic intracranial haemorrhage within 24 hours of treatment. Given the evidence women respond more favourably to thrombolysis than men,¹ the overall excess of women in the treatment group compared with the control group may have exaggerated the overall treatment effect. It was not clear from the studies what the time window is within which treatment is beneficial; what types of arterial blockage are most likely to respond; whether mechanical devices are effective, and whether any of these treatments are better than standard thrombolytic drugs. 1. Kent DM et al. Stroke 2005;36:62–65.
Most disabling strokes are due to thrombosis of a large artery. Prompt removal of the blockage with intra-arterial thrombolytic drugs or mechanical devices, or both, can restore blood flow before major brain damage has occurred, leading to improved recovery.