Neuro-Interventional Management of Acute Ischemic Stroke

Lotfi Hacein-Bey; Jeremy J Heit; Angelos A Konstas

doi:10.1016/j.nic.2018.06.011

Neuro-Interventional Management of Acute Ischemic Stroke

Neuroimaging Clin N Am. 2018 Nov;28(4):625-638. doi: 10.1016/j.nic.2018.06.011.

Authors

Lotfi Hacein-Bey¹, Jeremy J Heit², Angelos A Konstas³

Affiliations

¹ Interventional Neuroradiology and Neuroradiology, Department of Medical Imaging, Sutter Health, Sacramento, CA 95815, USA; Radiology Department, University of California Davis Medical School of Medicine, 4860 Y Street, Sacramento, CA 95817, USA. Electronic address: lhaceinbey@yahoo.com.
² Division of Neuroimaging and Neurointervention, Stanford Healthcare, 300 Pasteur Drive, Grant S047, Stanford, CA 94305, USA.
³ Interventional Neuroradiology and Neuroradiology, Department of Radiology, Huntington Memorial Hospital, 100 West California Boulevard, Pasadena, CA 91105, USA.

PMID: 30322598
DOI: 10.1016/j.nic.2018.06.011

Abstract

Restoration of cerebral blood flow is the most important step in preventing irreversible damage to hypoperfused brain cells after ischemic stroke from large-vessel occlusion. For those patients who do not respond to (or are not eligible for) intravenous thrombolysis, endovascular therapy has become standard of care. A shift is currently taking place from rigid time windows for intervention (time is brain) to physiology-driven paradigms that rely heavily on neuroimaging. At this time, one can reasonably anticipate that more patients will be treated, and that outcomes will keep improving. This article discusses in detail recent advances in endovascular stroke therapy.

Keywords: Acute stroke; Endovascular; Ischemia; Neuro-interventional management; Thrombectomy.

Publication types

Review

MeSH terms

Brain Ischemia / complications
Brain Ischemia / therapy*
Endovascular Procedures / methods*
Humans
Mechanical Thrombolysis / methods*
Neuroprotection*
Stroke / complications
Stroke / therapy*