The role of endovascular treatment in acute ischemic stroke - a multidisciplinary approach

Since its clinical introduction in 2015, endovascular treatment has become the standard method of reperfusion thera<br /> py in acute ischaemic stroke with largevessel occlusion. Endovascular treatment requires a multidisciplinary appro<br /> ach, which can be achieved mainly in comprehensive stroke centres. The former stroke chain of survival has been<br /> extended: interhospital transport has become necessary, neurointervention and anaesthesia teams have joined the<br /> stroke care. Today, advanced radiological diagnostics include multimodal imaging, rapid data transfer and software<br /> decision support. The primary goal of therapeutic efforts is revascularization within the time window. Reperfusion<br /> therapy beyond the standard time window can be performed in selected cases with penumbra imaging. The tempora<br /> ry viability of the penumbra is ensured by a variable collateral circulation. In reperfusion therapy, intravenous throm<br /> bolysis has retained its previous role and its indications have been broadened. Endovascular treatment is clearly an<br /> effective method in cases of confirmed largevessel occlusion, but its availability is limited and the success of its exe<br /> cution is influenced by personal, institutional and organisational factors as well as anaesthetic considerations. The<br /> clinical role of endovascular treatment, its true importance and the organisational changes in heathcare system are<br /> poorly understood in the general medical community