Impact of mechanical thrombectomy on the prognosis of patients with ischemic stroke: a comprehensive review of the current literature

• DOI: https://doi.org/10.22533/at.ed.1594822402092

• Palavras-chave: Trombectomia; AVC Isquêmico; Terapia Endovascular; Manejo de AVC; Intervenção Aguda para AVC.

• Keywords: Thrombectomy; Ischemic Stroke; Endovascular Therapy; Stroke Management; Acute Stroke Intervention.

• Abstract: INTRODUCTION The introduction outlines the significant burden of ischemic stroke globally, emphasizing the limitations of traditional treatments such as intravenous thrombolysis. It highlights the evolution and clinical adoption of mechanical thrombectomy as a revolutionary endovascular treatment for large vessel occlusions. The discussion includes the importance of early intervention, patient selection based on advanced imaging techniques, and the impact of thrombectomy on the organization of acute stroke care systems. The introduction also touches on ethical considerations and disparities in access to thrombectomy services. OBJETIVE To provide a comprehensive review of the impact of mechanical thrombectomy on the prognosis of patients with ischemic stroke, focusing on functional outcomes, mortality rates, and long-term recovery. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Mechanical Thrombectomy” AND “Ischemic Stroke” OR “Large Vessel Occlusion” OR “Endovascular Treatment” AND “Stroke Outcomes” in the last years. RESULTS AND DISCUSSION The results and discussion sections delve into the efficacy of mechanical thrombectomy in improving functional outcomes and reducing mortality in ischemic stroke patients. The analysis covers the influence of intervention timing, patient demographics, occlusion site, and pre-existing conditions on thrombectomy outcomes. Comparative studies of different thrombectomy devices, anesthesia types, and the role of bridging therapies are examined. The discussion also addresses the impact of thrombectomy on healthcare resource utilization, post-thrombectomy care, and long-term follow-up. Additionally, the section explores the broader public health implications, disparities in access to care, and future research directions. CONCLUSION The conclusion reaffirms the pivotal role of mechanical thrombectomy in transforming stroke care, with significant improvements in patient outcomes and reductions in disability. The success of thrombectomy is closely tied to factors such as patient selection, timing of intervention, and the expertise of the treating team. The conclusion also underscores the need for ongoing research and innovation to address challenges, enhance the efficacy of the procedure, and ensure equitable access to thrombectomy services. Looking forward, mechanical thrombectomy is poised to continue advancing as a key intervention in acute stroke management, with the potential to further reduce the global burden of stroke.