Imaging in neurointerventional stroke treatment: review of the recent trials and what your neurointerventionalist wants to know from emergency radiologists.
Bhavya RehaniYi ZhangSimon G AmmanuelWade SmithRamon G GonzalezDaniel L CookeSteven W HettsS Andrew JosephsonAnthony KimJ Claude HemphillWilliam DillonPublished in: Emergency radiology (2018)
Stroke is one of the leading causes of death and disability worldwide. Standard treatment for stroke is intravenous (IV) injection of tissue plasminogen activator (t-PA) rapidly after symptom onset. However, there are limitations of IV t-PA treatment, such as a short time window for administration and risk for hemorrhage. Recent trials have demonstrated the benefit of endovascular treatment when added to standard treatment to improve outcomes for patients. Advanced imaging was utilized in some trials to identify patients with proximal intracranial occlusion to target for endovascular reperfusion therapy, and to exclude patients with large infarct cores or poor collateral circulation who would not be expected to benefit from intervention. This article summarizes the use of imaging in recent stroke trials in details, provides a stroke imaging protocol, and provides tips which radiologists should know to help their neurointerventionalists.
Keyphrases
- atrial fibrillation
- high resolution
- randomized controlled trial
- emergency department
- chronic kidney disease
- public health
- stem cells
- heart failure
- type diabetes
- end stage renal disease
- endovascular treatment
- adipose tissue
- blood brain barrier
- low dose
- coronary artery disease
- percutaneous coronary intervention
- combination therapy
- prognostic factors
- metabolic syndrome
- machine learning
- bone marrow
- deep learning
- smoking cessation
- mass spectrometry
- peritoneal dialysis
- fluorescence imaging
- subarachnoid hemorrhage
- cell therapy
- optic nerve
- emergency medical