Neurointervention.  2021 Jul;16(2):91-110. 10.5469/neuroint.2020.00339.

Factors Contributing to an Efficacious Endovascular Treatment for Acute Ischemic Stroke in Asian Population

Affiliations
  • 1Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
  • 3Department of Neurology, Keimyung University Dongsan Hospital, Kyemyung University School of Medicine, Daegu, Korea

Abstract

Although randomized control trials about endovascular treatment (EVT) of emergent large vessel occlusion (LVO) have demonstrated the success of mechanical thrombectomy as the choice of treatment, a wide range of caveats remain unaddressed. Asian patients were rarely included in the trials, thereby raising the question of whether the treatment could be generalized. In addition, there remains a concern on the feasibility of the method with respect to its application against intracranial atherosclerosis (ICAS)-related LVO, frequently observed in the Asian population. It is important to include evidence on ICAS LVO from Asian countries in the future for a comprehensive understanding of LVO etiology. Besides the issues with EVT, prognostic concerns in diabetes patients, acute kidney injury following EVT, neuroprotective management against reperfusion injury, and other peri-EVT issues should be considered in clinical practice. In the current article, we present an in-depth review of the literature that revises information pertaining to such concerns.

Keyword

Cerebral infarction; Endovascular procedures; Intracranial atherosclerosis; Diabetes mellitus; Acute kidney injury; Reperfusion injury
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