Large Vessel Occlusion in the Acute Stroke Patient: Identification, Treatment, and Management

Abstract

Acute ischemic stroke is a major cause of death and disability in the United States. Historically, acute stroke patients were treated with intravenous (IV) thrombolysis. Patients with large vessel occlusions (LVOs) should be offered mechanical thrombectomy, with or without IV thrombolysis, in an extended window up to 24 hours of last known well. Both treatment options are the standard of care for a patient with an LVO. It is critical that the intensive care unit nurse understand new treatment indications for LVO strokes, and the priorities of nursing care with medical and endovascular intervention.

Keywords: Acute stroke; Angiogram; Intra-arterial thrombolysis; Ischemic stroke; Large vessel occlusion; Mechanical thrombectomy; Stent-retriever; Stroke syndromes.