Intensivmedizin up2date 2014; 10(01): 49-59
DOI: 10.1055/s-0034-1364326
Neuro-Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Neuro-Thrombektomie – Mechanische Rekanalisierung akuter zerebraler Gefäßverschlüsse

Stefan Rohde
,
Olav Jansen
,
Martin Bendszus
Further Information

Publication History

Publication Date:
11 February 2014 (online)

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Kernaussagen

  • Ein gutes klinisches Outcome bei Patienten mit schwerem Schlaganfall ist insbesondere von einer frühen Wiedereröffnung des verschlossenen Gefäßes abhängig.

  • Die i. v. Thrombolyse mit rtPA ist derzeit die einzige zugelassene und nachgewiesenermaßen effektive Behandlung bei Patienten mit akutem Schlaganfall bis 4,5 h nach Symptombeginn. Allerdings ist die i. v. Lyse insbesondere bei Verschlüssen der proximalen Hirngefäße wie der distalen A. carotis interna oder der A. cerebri media nur in unter 30 % der Fälle erfolgreich.

  • Moderne Thrombektomiesysteme können den Anteil erfolgreicher Rekanalisierungen bis weit über 80 % steigern. Hierbei haben sich die Stent-Retriever als besonderes effektiv und sicher erwiesen.

 

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