Expandindo o uso da trombectomia mecânica no acidente vascular cerebral isquêmico: uma revisão de literatura

• Autor(a) principal: Feitosa, Arthur Basto Madeira
• Data de Publicação: 2022
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/4145
• topic: Acidente Vascular Cerebral Isquêmico; Trombectomia; Reperfusão; CNPQ::CIENCIAS DA SAUDE::MEDICINA

Ischemic stroke accounts for 87% of all cerebrovascular events and is a major cause of disability and mortality worldwide. In view of this, stroke from middle vessel occlusions, i.e., occlusions of segments M2 and M3 of the middle cerebral artery, segments A2 and A3 of the anterior cerebral artery, and segments P2 and P3 of the posterior cerebral artery, account for 25% to 40% of all acute stroke cases. The current standard management, with intravenous thrombolysis, has at best a moderate clinical outcome for cases of stroke with middle vessel occlusion. Thus, these vessels have been increasingly targeted for mechanical thrombectomy, especially with the improvement of technologies and growing literature in the area. Thus, this review aims to describe the findings on the use of mechanical thrombectomy in patients with ischemic stroke with middle vessel occlusion. This research was an exploratory literature review, with qualitative analysis of the data obtained. Thirty articles were selected, dated from 2016 to 2021, with the theme in question, through the databases: Virtual Health Library and United States National Library of Medicine. For the advanced search, the descriptors were used: "Ischemic Stroke", "Thrombectomy" and "Reperfusion" combined with each other by the Boolean operator AND. Thus, it was observed that there are still no ideal clinical and imaging criteria for selection of patients with mid-vessel occlusion stroke. Moreover, most studies showed good clinical, reperfusion, and safety results, although most of them did not use the ideal parameters for mid-vessel occlusion ischemic stroke, but the parameters already used for endovascular treatment in large-vessel occlusions. Moreover, some articles bring the differences in the results generated by different techniques used in mechanical thrombectomy, but there is still a lack of larger studies that allow a comprehensive and unbiased comparison on the subject. We conclude that there are a limited but promising number of data showing the safety and efficacy of mechanical thrombectomy for medium vessel occlusion strokes, and many neurointerventionalists are already routinely offering this type of treatment, despite the lack of guidance and recommendation from guidelines.