Efficacy and safety of emergent microsurgery in acute ischaemic
stroke patients after intravenous thrombolysis and mechanical
thrombectomy failures-a systematic review

J 2025

Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures-a systematic review

GRUBHOFFER, M.; Jiří FIEDLER; Simona SLEZÁKOVÁ; M. BOMBIC; M. KLUGAR et al.

Základní údaje

Originální název

Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures-a systematic review

Autoři

GRUBHOFFER, M.; Jiří FIEDLER; Simona SLEZÁKOVÁ; M. BOMBIC a M. KLUGAR

Vydání

Ceska a slovenska neurologie a neurochirurgie, PRAGUE, CZECH MEDICAL SOC, 2025, 1210-7859

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30210 Clinical neurology

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 0.400 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

stroke; microsurgery; thrombolysis; thrombectomy

Štítky

14110224, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 27. 2. 2026 09:16, Mgr. Tereza Miškechová

Anotace

V originále

Aim: This systematic review aimed to verify the role of emergent microsurgical embolectomy and extracranial-intracranial bypass as third-line treatments in cases of intracranial large-vessel occlusion after failure of standard treatment. Materials and methods: We extensively searched eight sources of published and unpublished literature. Two reviewers independently performed titles, abstracts, and full text analyses, and then performed critical appraisal and data extraction from selected studies using standardised tools. We narratively synthesised the findings of the included studies. Results: The search identified eight relevant articles, including 12 patients with emergent large-vessel occlusion (carotid terminus or middle cerebral artery), and standard treatment failure who underwent microsurgery within 24 h from symptom onset. Microsurgical embolectomy was performed in four cases (33%), extracranial-intracranial bypass in five cases (42%), their combination in two cases (16%), and manipulative intraoperative recanalization in one case (8%). National Institutes of Health Stroke Scale score ranged pre-operatively from 7 to 25 points and postoperatively (1-7 days after surgery) from 1-18 points. Functional independence (modified Rankin Scale score 0-2) was achieved in nine patients (75%) at 3-12 months postoperatively. Conclusion: Emergent microsurgical embolectomy, extracranial-intracranial bypass, or a combination of these methods appear to be a safe and potentially effective third-line treatment for patients with emergent occlusion of large vessels in the anterior cerebral circulation.

Citovat

GRUBHOFFER, M.; Jiří FIEDLER; Simona SLEZÁKOVÁ; M. BOMBIC a M. KLUGAR. Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures-a systematic review. Ceska a slovenska neurologie a neurochirurgie. PRAGUE: CZECH MEDICAL SOC, 2025, roč. 88, č. 2, s. 83-88. ISSN 1210-7859. Dostupné z: https://doi.org/10.48095/cccsnn202583.

@article{2557103,
   author = {Grubhoffer, M. and Fiedler, Jiří and Slezáková, Simona and Bombic, M. and Klugar, M.},
   article_location = {PRAGUE},
   article_number = {2},
   doi = {https://doi.org/10.48095/cccsnn202583},
   keywords = {stroke; microsurgery; thrombolysis; thrombectomy},
   language = {eng},
   issn = {1210-7859},
   journal = {Ceska a slovenska neurologie a neurochirurgie},
   title = {Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures-a systematic review},
   url = {https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2025-2-9/effi-cacy-and-safety-of-emergent-microsurgery-in-acute-ischaemic-stroke-patients-after-intravenous-thrombolysis-and-mechanical-thrombectomy-failures-a-systematic-review-},
   volume = {88},
   year = {2025}
}

TY  - JOUR
ID  - 2557103
AU  - Grubhoffer, M. - Fiedler, Jiří - Slezáková, Simona - Bombic, M. - Klugar, M.
PY  - 2025
TI  - Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures-a systematic review
JF  - Ceska a slovenska neurologie a neurochirurgie
VL  - 88
IS  - 2
SP  - 83-88
EP  - 83-88
PB  - CZECH MEDICAL SOC
SN  - 12107859
KW  - stroke
KW  - microsurgery
KW  - thrombolysis
KW  - thrombectomy
UR  - https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2025-2-9/effi-cacy-and-safety-of-emergent-microsurgery-in-acute-ischaemic-stroke-patients-after-intravenous-thrombolysis-and-mechanical-thrombectomy-failures-a-systematic-review-
N2  - Aim: This systematic review aimed to verify the role of emergent microsurgical embolectomy and extracranial-intracranial bypass as third-line treatments in cases of intracranial large-vessel occlusion after failure of standard treatment. Materials and methods: We extensively searched eight sources of published and unpublished literature. Two reviewers independently performed titles, abstracts, and full text analyses, and then performed critical appraisal and data extraction from selected studies using standardised tools. We narratively synthesised the findings of the included studies. Results: The search identified eight relevant articles, including 12 patients with emergent large-vessel occlusion (carotid terminus or middle cerebral artery), and standard treatment failure who underwent microsurgery within 24 h from symptom onset. Microsurgical embolectomy was performed in four cases (33%), extracranial-intracranial bypass in five cases (42%), their combination in two cases (16%), and manipulative intraoperative recanalization in one case (8%). National Institutes of Health Stroke Scale score ranged pre-operatively from 7 to 25 points and postoperatively (1-7 days after surgery) from 1-18 points. Functional independence (modified Rankin Scale score 0-2) was achieved in nine patients (75%) at 3-12 months postoperatively. Conclusion: Emergent microsurgical embolectomy, extracranial-intracranial bypass, or a combination of these methods appear to be a safe and potentially effective third-line treatment for patients with emergent occlusion of large vessels in the anterior cerebral circulation.
ER  -

GRUBHOFFER, M.; Jiří FIEDLER; Simona SLEZÁKOVÁ; M. BOMBIC a M. KLUGAR. Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures-a systematic review. \textit{Ceska a slovenska neurologie a neurochirurgie}. PRAGUE: CZECH MEDICAL SOC, 2025, roč.~88, č.~2, s.~83-88. ISSN~1210-7859. Dostupné z: https://doi.org/10.48095/cccsnn202583.

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