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Clinical and Translational Neuroscience is published by MDPI from Volume 5 Issue 2 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with SAGE.
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Guidelines

Acute Revascularization in Ischemic Stroke: Updated Swiss Guidelines

by
Patrik Michel
1,*,
Michael Diepers
2,
Pasquale Mordasini
3,
Tilman Schubert
4,
David Bervini
5,
Jean-Daniel Rouvé
6,
Yvan Gasche
7,
Guido Schwegler
8,
Christophe Bonvin
9,
Krassen Nedeltchev
10,
Emmanuel Carrera
11,
Georg Kägi
12,
Carlo Cereda
13,
Thomas Nyffeler
14,
Stephan Wetzel
15,
Susanne Wegener
16,
Henrik Gensicke
16,
Stefan Engelter
17,
Marcel Arnold
18 and
on behalf of the Swiss Stroke Society
1
Neurology Service, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, 1011 Lausanne, Switzerland
2
Neuroradiology Division, Cantonal Hospital Aarau, 5001 Aarau, Switzerland
3
Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern and University of Bern, 3010 Berne, Switzerland
4
Diagnostic and Interventional Neuroradiology, Department of Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland
5
Department of Neurosurgery, Inselspital Bern and University of Bern, 3010 Berne, Switzerland
6
Anesthesiology Service, Lausanne University Hospital, 1011 Lausanne, Switzerland
7
Department of Anesthesiology, Pharmacology, Intensive Care & Emergency Medicine, University of Geneva, 1205 Geneva, Switzerland
8
Division of Neurology, Hospital Limmattal, 8952 Schlieren, Switzerland
9
Division of Neurology and Stroke Unit, Hôpital du Valais, Sion, Switzerland
10
Department of Neurology, Cantonal Hospital Aarau, 5001 Aarau, Switzerland
11
Neurology Service, University Hospitals of Geneva, 1205 Geneva, Switzerland
12
Department of Neurology, Cantonal Hospital, 9000 St. Gallen, Switzerland
13
Department of Neurology, Neurocentro della Svizzera Italiana, Lugano Civic Hospital, 6900 Lugano, Switzerland
14
Neurozentrum, Cantonal Hospital Lucerne, 6004 Lucerne, Switzerland
15
Neuroradiology, Hirslanden Clinic, 8032 Zürich, Switzerland
16
Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland
17
Department of Neurology and Stroke Centre, University Hospital Basel, 4031 Basel, Switzerland
18
Department of Neurology, Inselspital Bern and University of Bern, 3010 Bern, Switzerland
 
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Author to whom correspondence should be addressed.
Clin. Transl. Neurosci. 2021, 5(1), 9; https://doi.org/10.1177/2514183x21999228
Submission received: 13 January 2021 / Accepted: 11 February 2021 / Published: 2 May 2021
Versions Notes

Abstract

In acute ischemic stroke, intravenous thrombolysis (IVT) and acute endovascular therapy (EVT) have been shown to reduce long-term disability in randomized trials. International guidelines are partially not up to date and may not address situations for which there is limited scientific evidence. The goals of the present guidelines are to summarize the current scientific data for acute revascularization treatments to make sure that all Swiss Centers apply a similar, evidence, or consensus-based treatment standard. A multidisciplinary working group of the Swiss Stroke Society (SSS) searched and reviewed the literature on new randomized controlled trials (RCTs), large case series, meta-analyses, and other guidelines since the previous recommendations in 2009 to elaborate the consensus guidelines. The new RCTs have confirmed the effectiveness of IVT in various populations up to 4.5 h and proven the benefit of acute EVT up to approximately 8 h. For patients with unknown onset (including wake-up stroke), IVT and EVT can be effective up to 24 h after last proof of good health if patients are selected with advanced neuroimaging. Multiple case series and meta-analyses allow narrowing down the indications and relative and absolute contraindications to optimize the benefit–risk ratio of acute revascularization.
Keywords: stroke; revascularization; thrombolysis; thrombectomy; guidelines; Swiss stroke; revascularization; thrombolysis; thrombectomy; guidelines; Swiss

Share and Cite

MDPI and ACS Style

Michel, P.; Diepers, M.; Mordasini, P.; Schubert, T.; Bervini, D.; Rouvé, J.-D.; Gasche, Y.; Schwegler, G.; Bonvin, C.; Nedeltchev, K.; et al. Acute Revascularization in Ischemic Stroke: Updated Swiss Guidelines. Clin. Transl. Neurosci. 2021, 5, 9. https://doi.org/10.1177/2514183x21999228

AMA Style

Michel P, Diepers M, Mordasini P, Schubert T, Bervini D, Rouvé J-D, Gasche Y, Schwegler G, Bonvin C, Nedeltchev K, et al. Acute Revascularization in Ischemic Stroke: Updated Swiss Guidelines. Clinical and Translational Neuroscience. 2021; 5(1):9. https://doi.org/10.1177/2514183x21999228

Chicago/Turabian Style

Michel, Patrik, Michael Diepers, Pasquale Mordasini, Tilman Schubert, David Bervini, Jean-Daniel Rouvé, Yvan Gasche, Guido Schwegler, Christophe Bonvin, Krassen Nedeltchev, and et al. 2021. "Acute Revascularization in Ischemic Stroke: Updated Swiss Guidelines" Clinical and Translational Neuroscience 5, no. 1: 9. https://doi.org/10.1177/2514183x21999228

APA Style

Michel, P., Diepers, M., Mordasini, P., Schubert, T., Bervini, D., Rouvé, J. -D., Gasche, Y., Schwegler, G., Bonvin, C., Nedeltchev, K., Carrera, E., Kägi, G., Cereda, C., Nyffeler, T., Wetzel, S., Wegener, S., Gensicke, H., Engelter, S., Arnold, M., & on behalf of the Swiss Stroke Society. (2021). Acute Revascularization in Ischemic Stroke: Updated Swiss Guidelines. Clinical and Translational Neuroscience, 5(1), 9. https://doi.org/10.1177/2514183x21999228

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