Send to

Choose Destination
See comment in PubMed Commons below
J Stroke Cerebrovasc Dis. 2014 May-Jun;23(5):e295-8. doi: 10.1016/j.jstrokecerebrovasdis.2013.12.039. Epub 2014 Mar 14.

Endovascular treatment of acute ischemic stroke: Honolulu shock and thereafter.

Author information

Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. Electronic address:
Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.


Recently, use of mechanical clot retrievers for acute stroke has gradually spread. However, 3 recent randomized controlled trials failed to show superiority of endovascular treatment compared to intravenous recombinant tissue plasminogen activator (IV rt-PA) alone or standard care. On the other hand, a Japanese nationwide survey demonstrated the efficacy of endovascular treatment in the IV rt-PA failed and ineligible patients, especially with the proximal artery occlusion such as the internal carotid artery. Earlier initiation and higher reperfusion of endovascular treatment seemed to be the main reason for the better result in this survey compared with the reported randomized studies. Because next-generation devices such as stent retrievers have been shown to provide better effects in terms of clinical outcomes compared with the Merci retriever, the efficacy of endovascular treatment is expected to be confirmed again by randomized controlled trials in the near future.


Acute stroke; clot retriever; randomized trial; tissue plasminogen activator

[Indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center