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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2018; 02(03): 169-183
DOI: 10.1055/s-0038-1675882
Review Article
Indian Society of Vascular and Interventional Radiology

Acute Ischemic Stroke: A Review of Imaging, Patient Selection, and Management in the Endovascular Era. Part II: Patient Selection, Endovascular Thrombectomy, and Postprocedure Management

Sharath Kumar G G
1   Department of Diagnostic and Interventional Neuroradiology, Apollo Hospitals, Bangalore, Karnataka, India
,
Chinmay P. Nagesh
1   Department of Diagnostic and Interventional Neuroradiology, Apollo Hospitals, Bangalore, Karnataka, India
› Author Affiliations
Further Information

Publication History

Received: 04 May 2018

Accepted after revision: 29 June 2018

Publication Date:
06 December 2018 (online)

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Abstract

Appropriate patient selection and expedient recanalization are the mainstay of modern management of acute ischemic stroke (AIS). Only a minority of patients (7–15%) of patients are eligible for endovascular therapy. Patient selection may be time based or perfusion based. Central to both paradigms is the selection of a patient with a small core, a significant penumbra that can be differentiated from areas of oligemia. A brief review of patient selection methods is presented. Endovascular thrombectomy techniques using stentrievers or aspiration catheters have now become the treatment of choice for AIS with large vessel occlusion. A range of devices, each with its own advantages and disadvantages, are available in the market for the neurointerventionist to choose. Techniques vary between devices and between operators, but standardization and protocolization are important within each center. Complications must be anticipated to be avoided. Once reperfusion is achieved, outcomes must be safeguarded with competent postprocedure management to prevent secondary brain injury. These aspects are reviewed in this article.

Keywords

stroke - mechanical thrombectomy - aspiration thrombectomy
 

  • References

  • 1 El Tawil S, Cheripelli B, Huang X. et al. How many stroke patients might be eligible for mechanical thrombectomy?. Eur Stroke J 2016; 1 (04) 264-271
    PubMedGoogle Scholar
  • 2 McMeekin P, White P, James MA, Price CI, Flynn D, Ford GA. Estimating the number of UK stroke patients eligible for endovascular thrombectomy. Eur Stroke J 2017; 2 (04) 319-326
    PubMedGoogle Scholar
  • 3 Tsivgoulis G, Goyal N, Mikulik R. et al. Eligibility for mechanical thrombectomy in acute ischemic stroke: a phase IV multi-center screening log registry. J Neurol Sci 2016; 371: 96-99
    CrossrefPubMedGoogle Scholar
  • 4 Powers WJ, Rabinstein AA, Ackerson T. et al; American Heart Association Stroke Council. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49 (03) e46-e110
    CrossrefPubMedGoogle Scholar
  • 5 Anderson CS, Robinson T, Lindley RI. et al; ENCHANTED Investigators and Coordinators. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. N Engl J Med 2016; 374 (24) 2313-2323
    CrossrefPubMedGoogle Scholar
  • 6 Sila C. Finding the right t-PA dose for Asians with acute ischemic stroke. N Engl J Med 2016; 374 (24) 2389-2390
    CrossrefPubMedGoogle Scholar
  • 7 Huang X, Cheripelli BK, Lloyd SM. et al. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol 2015; 14 (04) 368-376
    CrossrefPubMedGoogle Scholar
  • 8 Campbell BCV, Mitchell PJ, Churilov L. et al; EXTEND-IA TNK Investigators. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med 2018; 378 (17) 1573-1582
    CrossrefPubMedGoogle Scholar
  • 9 Emberson J, Lees KR, Lyden P. et al; Stroke Thrombolysis Trialists’ Collaborative Group. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet 2014; 384 9958 1929-1935
    CrossrefPubMedGoogle Scholar
  • 10 Bhatia R, Hill MD, Shobha N. et al. Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke: real-world experience and a call for action. Stroke 2010; 41 (10) 2254-2258
    CrossrefPubMedGoogle Scholar
  • 11 Meairs S. Sonothrombolysis. Front Neurol Neurosci 2015; 36: 83-93
    PubMedGoogle Scholar
  • 12 Alexandrov AV, Molina CA, Grotta JC. et al; CLOTBUST Investigators. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med 2004; 351 (21) 2170-2178
    CrossrefPubMedGoogle Scholar
  • 13 Nacu A, Kvistad CE, Naess H. et al. NOR-SASS (Norwegian Sonothrombolysis in Acute Stroke Study): randomized controlled contrast-enhanced sonothrombolysis in an unselected acute ischemic stroke population. Stroke 2017; 48 (02) 335-341
    CrossrefPubMedGoogle Scholar
  • 14 Reinhard M, Taschner CA, Hörsch N. et al. Endovascular treatment versus sonothrombolysis for acute ischemic stroke. Cerebrovasc Dis 2015; 40 (05) (06) 205-214
    CrossrefPubMedGoogle Scholar
  • 15 Aaron S, Mani S, Prabhakar AT. et al. Sonothrombolysis for acute ischemic stroke—break on through to the other side. Neurol India 2017; 65 (01) 52-57
    PubMedGoogle Scholar
  • 16 Barreto AD, Alexandrov AV, Shen L. et al. CLOTBUST-Hands Free: pilot safety study of a novel operator-independent ultrasound device in patients with acute ischemic stroke. Stroke 2013; 44 (12) 3376-3381
    CrossrefPubMedGoogle Scholar
  • 17 Mistry EA, Mistry AM, Nakawah MO. et al. Mechanical thrombectomy outcomes with and without intravenous thrombolysis in stroke patients: a meta-analysis. Stroke 2017; 48 (09) 2450-2456
    CrossrefPubMedGoogle Scholar
  • 18 Mazighi M, Meseguer E, Labreuche J, Amarenco P. Bridging therapy in acute ischemic stroke: a systematic review and meta-analysis. Stroke 2012; 43 (05) 1302-1308
    CrossrefPubMedGoogle Scholar
  • 19 Bellwald S, Weber R, Dobrocky T. et al. Direct mechanical intervention versus bridging therapy in stroke patients eligible for intravenous thrombolysis: a pooled analysis of 2 registries. Stroke 2017; 48 (12) 3282-3288
    CrossrefPubMedGoogle Scholar
  • 20 Raza SA, Rangaraju S. A review of pre-intervention prognostic scores for early prognostication and patient selection in endovascular management of large vessel occlusion stroke. Interv Neurol 2018; 7 (03) (04) 171-181
    PubMedGoogle Scholar
  • 21 Rangaraju S, Aghaebrahim A, Streib C. et al. Pittsburgh Response to Endovascular therapy (PRE) score: optimizing patient selection for endovascular therapy for large vessel occlusion strokes. J Neurointerv Surg 2015; 7 (11) 783-788
    CrossrefPubMedGoogle Scholar
  • 22 Goyal M, Fargen KM, Menon BK. Acute stroke, Bayes’ theorem and the art and science of emergency decision-making. J Neurointerv Surg 2014; 6 (04) 256-259
    CrossrefPubMedGoogle Scholar
  • 23 Saver JL, Goyal M, Bonafe A. et al; SWIFT PRIME Investigators. Solitaire™ with the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke (SWIFT PRIME) trial: protocol for a randomized, controlled, multi-center study comparing the Solitaire revascularization device with IV tPA with IV tPA alone in acute ischemic stroke. Int J Stroke 2015; 10 (03) 439-448
    PubMedGoogle Scholar
  • 24 Berkhemer OA, Fransen PS, Beumer D. et al; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 2015; 372 (01) 11-20
    CrossrefPubMedGoogle Scholar
  • 25 Pfaff JAR, Schönenberger S, Nagel S. et al. Effect of general anesthesia versus conscious sedation for stroke thrombectomy on angiographic workflow in a randomized trial: a post hoc analysis of the SIESTA trial. Radiology 2018; 286 (03) 1016-1021
    CrossrefPubMedGoogle Scholar
  • 26 Brinjikji W, Pasternak J, Murad MH. et al. Anesthesia-related outcomes for endovascular stroke revascularization: a systematic review and meta-analysis. Stroke 2017; 48 (10) 2784-2791
    CrossrefPubMedGoogle Scholar
  • 27 Bekelis K, Missios S, MacKenzie TA, Tjoumakaris S, Jabbour P. Anesthesia technique and outcomes of mechanical thrombectomy in patients with acute ischemic stroke. Stroke 2017; 48 (02) 361-366
    CrossrefPubMedGoogle Scholar
  • 28 Anastasian ZH. Anaesthetic management of the patient with acute ischaemic stroke. Br J Anaesth 2014; 113 (Suppl. 02) ii9-ii16
    CrossrefPubMedGoogle Scholar
  • 29 Schönenberger S, Uhlmann L, Hacke W. et al. Effect of conscious sedation vs general anesthesia on early neurological improvement among patients with ischemic stroke undergoing endovascular thrombectomy: a randomized clinical trial. JAMA 2016; 316 (19) 1986-1996
    CrossrefPubMedGoogle Scholar
  • 30 Fandino W. The anesthesiologist, rather than the anesthesia, may influence the outcomes following stroke thrombectomy. AJNR Am J Neuroradiol 2018; 39 (02) E35
    CrossrefPubMedGoogle Scholar
  • 31 Nahab F, Walker GA, Dion JE, Smith WS. Safety of periprocedural heparin in acute ischemic stroke endovascular therapy: the multi MERCI trial. J Stroke Cerebrovasc Dis 2012; 21 (08) 790-793
    CrossrefPubMedGoogle Scholar
  • 32 Furlan A, Higashida R, Wechsler L. et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in acute cerebral thromboembolism. JAMA 1999; 282 (21) 2003-2011
    CrossrefPubMedGoogle Scholar
  • 33 Alshekhlee A, Pandya DJ, English J. et al. Merci mechanical thrombectomy retriever for acute ischemic stroke therapy: literature review. Neurology 2012; 79 (13) (Suppl. 01) S126-S134
    CrossrefPubMedGoogle Scholar
  • 34 Smith WS, Sung G, Saver J. et al; Multi MERCI Investigators. Mechanical thrombectomy for acute ischemic stroke: final results of the multi MERCI trial. Stroke 2008; 39 (04) 1205-1212
    CrossrefPubMedGoogle Scholar
  • 35 Smith WS, Sung G, Starkman S. et al; MERCI Trial Investigators. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke 2005; 36 (07) 1432-1438
    CrossrefPubMedGoogle Scholar
  • 36 Hussain SI, Zaidat OO, Fitzsimmons BF. The Penumbra system for mechanical thrombectomy in endovascular acute ischemic stroke therapy. Neurology 2012; 79 (13) (Suppl. 01) S135-S141
    CrossrefPubMedGoogle Scholar
  • 37 Penumbra Pivotal Stroke Trial Investigators. The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke 2009; 40 (08) 2761-2768
    CrossrefPubMedGoogle Scholar
  • 38 Campbell BC, Mitchell PJ, Kleinig TJ. et al; EXTEND-IA Investigators. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med 2015; 372 (11) 1009-1018
    CrossrefPubMedGoogle Scholar
  • 39 Goyal M, Demchuk AM, Menon BK. et al; ESCAPE Trial Investigators. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015; 372 (11) 1019-1030
    CrossrefPubMedGoogle Scholar
  • 40 Jovin TG, Chamorro A, Cobo E. et al; REVASCAT Trial Investigators. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med 2015; 372 (24) 2296-2306
    CrossrefPubMedGoogle Scholar
  • 41 Bracard S, Ducrocq X, Mas JL. et al; THRACE investigators. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial. Lancet Neurol 2016; 15 (11) 1138-1147
    CrossrefPubMedGoogle Scholar
  • 42 Boyle K, Joundi RA, Aviv RI. An historical and contemporary review of endovascular therapy for acute ischemic stroke. Neurovascular Imaging 2017; 3 (01) 1
    CrossrefPubMedGoogle Scholar
  • 43 Raychev R, Jahan R, Saver JL. et al. Microcatheter contrast injection in stent retriever neurothrombectomy is safe and useful: insights from SWIFT PRIME. J Neurointerv Surg. 2017
    PubMedGoogle Scholar
  • 44 Haussen DC, Rebello LC, Nogueira RG. Optimizating clot retrieval in acute stroke: the push and fluff technique for closed-cell stentrievers. Stroke 2015; 46 (10) 2838-2842
    CrossrefPubMedGoogle Scholar
  • 45 Haussen DC, Al-Bayati AR, Grossberg JA. et al. Longer stent retrievers enhance thrombectomy performance in acute stroke. J Neurointerv Surg. 2018 neurintsurg-2018-013918
    PubMedGoogle Scholar
  • 46 Kannath SK, Rajan JE, Sylaja PN. et al. Dwell time of stentriever influences complete revascularization and first-pass TICI 3 revascularization in acute large vessel occlusive stroke. World Neurosurg 2018; 110: 169-173
    CrossrefPubMedGoogle Scholar
  • 47 Wadood A. Brief overview on Nitinol as biomaterial. Adv Mater Sci Eng 2016; 20 (16) 9
    PubMedGoogle Scholar
  • 48 Gralla J, Schroth G, Remonda L, Nedeltchev K, Slotboom J, Brekenfeld C. Mechanical thrombectomy for acute ischemic stroke: thrombus-device interaction, efficiency, and complications in vivo. Stroke 2006; 37 (12) 3019-3024
    CrossrefPubMedGoogle Scholar
  • 49 Sacks D, Baxter B, Campbell BCV. et al. Multisociety consensus quality improvement revised consensus statement for endovascular therapy of acute ischemic stroke: From the American Association of Neurological Surgeons (AANS), American Society of Neuroradiology (ASNR), Cardiovascular and Interventional Radiology Society of Europe (CIRSE), Canadian Interventional Radiology Association (CIRA), Congress of Neurological Surgeons (CNS), European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), European Stroke Organization (ESO), Society for Cardiovascular Angiography and Interventions (SCAI), Society of Interventional Radiology (SIR), Society of NeuroInterventional Surgery (SNIS), and World Stroke Organization (WSO). J Vasc Interv Radiol 2018; 29 (04) 441-453
    CrossrefPubMedGoogle Scholar
  • 50 Zerna C, Assis Z, d'Esterre CD, Menon BK, Goyal M. Imaging, intervention, and workflow in acute ischemic stroke: the Calgary approach. AJNR Am J Neuroradiol 2016; 37 (06) 978-984
    CrossrefPubMedGoogle Scholar
  • 51 Mokin M, Setlur NageshSV, Ionita CN, Levy EI, Siddiqui AH. Comparison of modern stroke thrombectomy approaches using an in vitro cerebrovascular occlusion model. AJNR Am J Neuroradiol 2015; 36 (03) 547-551
    CrossrefPubMedGoogle Scholar
  • 52 Pereira VM, Narata AP, Gonzalez AM, Sztajzel R, Lovblad KO. Use of stentrievers in acute stroke: tips, tricks, and current results. Tech Vasc Interv Radiol 2012; 15 (01) 68-77
    CrossrefPubMedGoogle Scholar
  • 53 Kang DH, Hwang YH, Kim YS, Park J, Kwon O, Jung C. Direct thrombus retrieval using the reperfusion catheter of the penumbra system: forced-suction thrombectomy in acute ischemic stroke. AJNR Am J Neuroradiol 2011; 32 (02) 283-287
    CrossrefPubMedGoogle Scholar
  • 54 Turk AS, Spiotta A, Frei D. et al. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg 2014; 6 (03) 231-237
    CrossrefPubMedGoogle Scholar
  • 55 Turk AS, Frei D, Fiorella D. et al. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg 2014; 6 (04) 260-264
    CrossrefPubMedGoogle Scholar
  • 56 Yoo AJ, Andersson T. Thrombectomy in acute ischemic stroke: challenges to procedural success. J Stroke 2017; 19 (02) 121-130
    CrossrefPubMedGoogle Scholar
  • 57 Alawieh A, Pierce AK, Vargas J. et al. The golden 35 min of stroke intervention with ADAPT: effect of thrombectomy procedural time in acute ischemic stroke on outcome. J Neurointerv Surg 2018; 10 (03) 213-220
    CrossrefPubMedGoogle Scholar
  • 58 Lapergue B, Blanc R, Gory B. et al; ASTER Trial Investigators. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the ASTER randomized clinical trial. JAMA 2017; 318 (05) 443-452
    CrossrefPubMedGoogle Scholar
  • 59 Humphries W, Hoit D, Doss VT. et al. Distal aspiration with retrievable stent assisted thrombectomy for the treatment of acute ischemic stroke. J Neurointerv Surg 2015; 7 (02) 90-94
    CrossrefPubMedGoogle Scholar
  • 60 Delgado AlmandozJE, Kayan Y, Young ML. et al. Comparison of clinical outcomes in patients with acute ischemic strokes treated with mechanical thrombectomy using either Solumbra or ADAPT techniques. J Neurointerv Surg 2016; 8 (11) 1123-1128
    CrossrefPubMedGoogle Scholar
  • 61 Stampfl S, Pfaff J, Herweh C. et al. Combined proximal balloon occlusion and distal aspiration: a new approach to prevent distal embolization during neurothrombectomy. J Neurointerv Surg 2017; 9 (04) 346-351
    CrossrefPubMedGoogle Scholar
  • 62 Maegerlein C, Mönch S, Boeckh-Behrens T. et al. PROTECT: PRoximal balloon Occlusion TogEther with direCt Thrombus aspiration during stent retriever thrombectomy - evaluation of a double embolic protection approach in endovascular stroke treatment. J Neurointerv Surg. 2017 neurintsurg-2017-013558
    PubMedGoogle Scholar
  • 63 Kallmes DF, Siddiqui AH, Ansari SA, Liebeskind DS, Zaidat OO. Aspiring to an improved aspiration literature. J Neurointerv Surg. 2018 neurintsurg-2018-014046
    PubMedGoogle Scholar
  • 64 Fargen KM, Mocco J, Gobin YP. The Lazarus Funnel: a blinded prospective randomized in vitro trial of a novel CE-marked thrombectomy assist device. J Neurointerv Surg 2016; 8 (01) 66-68
    CrossrefPubMedGoogle Scholar
  • 65 Mokin M, Setlur NageshSV, Ionita CN, Mocco J, Siddiqui AH. Stent retriever thrombectomy with the Cover accessory device versus proximal protection with a balloon guide catheter: in vitro stroke model comparison. J Neurointerv Surg 2016; 8 (04) 413-417
    CrossrefPubMedGoogle Scholar
  • 66 Duffy S, Farrell M, McArdle K. et al. Novel methodology to replicate clot analogs with diverse composition in acute ischemic stroke. J Neurointerv Surg 2017; 9 (05) 486-491
    CrossrefPubMedGoogle Scholar
  • 67 De Meyer SF, Andersson T, Baxter B. et al; Clot Summit Group. Analyses of thrombi in acute ischemic stroke: a consensus statement on current knowledge and future directions. Int J Stroke 2017; 12 (06) 606-614
    CrossrefPubMedGoogle Scholar
  • 68 Kim SK, Yoon W, Kim TS, Kim HS, Heo TW, Park MS. Histologic analysis of retrieved clots in acute ischemic stroke: correlation with stroke etiology and gradient-echo MRI. AJNR Am J Neuroradiol 2015; 36 (09) 1756-1762
    CrossrefPubMedGoogle Scholar
  • 69 Boeckh-Behrens T, Kleine JF, Zimmer C. et al. Thrombus histology suggests cardioembolic cause in cryptogenic stroke. Stroke 2016; 47 (07) 1864-1871
    CrossrefPubMedGoogle Scholar
  • 70 Boeckh-Behrens T, Schubert M, Förschler A. et al. The impact of histological clot composition in embolic stroke. Clin Neuroradiol 2016; 26 (02) 189-197
    CrossrefPubMedGoogle Scholar
  • 71 Brinjikji W, Duffy S, Burrows A. et al. Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review. J Neurointerv Surg 2017; 9 (06) 529-534
    CrossrefPubMedGoogle Scholar
  • 72 Li Q, Davis S, Mitchell P, Dowling R, Yan B. Proximal hyperdense middle cerebral artery sign predicts poor response to thrombolysis. PLoS One 2014; 9 (05) e96123
    CrossrefPubMedGoogle Scholar
  • 73 Khatri P, Neff J, Broderick JP, Khoury JC, Carrozzella J, Tomsick T. IMS-I Investigators. Revascularization end points in stroke interventional trials: recanalization versus reperfusion in IMS-I. Stroke 2005; 36 (11) 2400-2403
    CrossrefPubMedGoogle Scholar
  • 74 Mori E, Yoneda Y, Tabuchi M. et al. Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 1992; 42 (05) 976-982
    CrossrefPubMedGoogle Scholar
  • 75 Suh SH, Cloft HJ, Fugate JE, Rabinstein AA, Liebeskind DS, Kallmes DF. Clarifying differences among thrombolysis in cerebral infarction scale variants: is the artery half open or half closed?. Stroke 2013; 44 (04) 1166-1168
    CrossrefPubMedGoogle Scholar
  • 76 Qureshi AI. New grading system for angiographic evaluation of arterial occlusions and recanalization response to intra-arterial thrombolysis in acute ischemic stroke. Neurosurgery 2002; 50 (06) 1405-1414 discussion 1414–1415
    PubMedGoogle Scholar
  • 77 Dargazanli C, Consoli A, Barral M. et al. Impact of modified TICI 3 versus modified TICI 2b reperfusion score to predict good outcome following endovascular therapy. AJNR Am J Neuroradiol 2017; 38 (01) 90-96
    CrossrefPubMedGoogle Scholar
  • 78 Kim YW, Hong JM, Park DG. et al. Effect of intracranial atherosclerotic disease on endovascular treatment for patients with acute vertebrobasilar occlusion. AJNR Am J Neuroradiol 2016; 37 (11) 2072-2078
    CrossrefPubMedGoogle Scholar
  • 79 Lee JS, Hong JM, Kim JS. Diagnostic and therapeutic strategies for acute intracranial atherosclerosis-related occlusions. J Stroke 2017; 19 (02) 143-151
    CrossrefPubMedGoogle Scholar
  • 80 Chimowitz MI, Lynn MJ, Derdeyn CP. et al; SAMMPRIS Trial Investigators. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med 2011; 365 (11) 993-1003
    CrossrefPubMedGoogle Scholar
  • 81 Yoon W, Kim SK, Park MS, Kim BC, Kang HK. Endovascular treatment and the outcomes of atherosclerotic intracranial stenosis in patients with hyperacute stroke. Neurosurgery 2015; 76 (06) 680-686 discussion 686
    CrossrefPubMedGoogle Scholar
  • 82 Moon KimB. Refractory occlusion to stentriever thrombectomy: etiological considerations and suggested solutions. In: Acute Ischemic Stroke. Singapore: Springer Singapore; 2017: 213-226
    Google Scholar
  • 83 Kim YW, Son S, Kang DH, Hwang YH, Kim YS. Endovascular thrombectomy for M2 occlusions: comparison between forced arterial suction thrombectomy and stent retriever thrombectomy. J Neurointerv Surg 2017; 9 (07) 626-630
    CrossrefPubMedGoogle Scholar
  • 84 Patro SN, Iancu D. Dual-stent retrieval for mechanical thrombectomy of refractory clot in acute stroke as a rescue technique. CMAJ 2017; 189 (17) E634-E637
    CrossrefPubMedGoogle Scholar
  • 85 Nah HW, Kim DH, Kang M, Choi JH, Park HS, Cha JK. Thrombolysis in large diffusion-weighted imaging lesions: lower chance but still a chance. J Stroke Cerebrovasc Dis 2018; 27 (06) 1511-1516
    CrossrefPubMedGoogle Scholar
  • 86 Gautheron V, Xie Y, Tisserand M. et al. Outcome after reperfusion therapies in patients with large baseline diffusion-weighted imaging stroke lesions: a THRACE trial (Mechanical Thrombectomy After Intravenous Alteplase Versus Alteplase Alone After Stroke) subgroup analysis. Stroke 2018; 49 (03) 750-753
    CrossrefPubMedGoogle Scholar
  • 87 Haussen DC, Bouslama M, Grossberg JA. et al. Too good to intervene?. Thrombectomy for large vessel occlusion strokes with minimal symptoms: an intention-to-treat analysis. J Neurointerv Surg 2017; 9 (10) 917-921
    CrossrefPubMedGoogle Scholar
  • 88 Dargazanli C, Arquizan C, Gory B. et al; ETIS REGISTRY Investigators. Mechanical thrombectomy for minor and mild stroke patients harboring large vessel occlusion in the anterior circulation: a multicenter cohort study. Stroke 2017; 48 (12) 3274-3281
    CrossrefPubMedGoogle Scholar
  • 89 Zhang R, Zhou Y, Yan S, Zhang S, Ding X, Lou M. Slow collateral flow is associated with thrombus extension in patients with acute large-artery occlusion. AJNR Am J Neuroradiol 2018; 39 (06) 1088-1092
    CrossrefPubMedGoogle Scholar
  • 90 Haussen DC, Lima FO, Bouslama M. et al. Thrombectomy versus medical management for large vessel occlusion strokes with minimal symptoms: an analysis from STOP Stroke and GESTOR cohorts. J Neurointerv Surg 2018; 10 (04) 325-329
    CrossrefPubMedGoogle Scholar
  • 91 Rangel-Castilla L, Rajah GB, Shakir HJ. et al. Management of acute ischemic stroke due to tandem occlusion: should endovascular recanalization of the extracranial or intracranial occlusive lesion be done first?. Neurosurg Focus 2017; 42 (04) E16
    PubMedGoogle Scholar
  • 92 Wilson MP, Murad MH, Krings T. et al. Management of tandem occlusions in acute ischemic stroke—intracranial versus extracranial first and extracranial stenting versus angioplasty alone: a systematic review and meta-analysis. J Neurointerv Surg. 2018 neurintsurg-2017-013707
    PubMedGoogle Scholar
  • 93 Park J. Surgical embolectomy for acute ischemic stroke. In: Park J. ed. Acute Ischemic Stroke: Medical, Endovascular, and Surgical Techniques. Singapore: Springer Singapore; 2017: 229-245
    Google Scholar
  • 94 Kim JE, Jeon JP, Cho WS. Bypass Surgery. In: Park J. ed. Acute Ischemic Stroke: Medical, Endovascular, and Surgical Techniques. Singapore: Springer Singapore; 2017: 247-254
    Google Scholar
  • 95 Balami JS, White PM, McMeekin PJ, Ford GA, Buchan AM. Complications of endovascular treatment for acute ischemic stroke: prevention and management. Int J Stroke 2018; 13 (04) 348-361
    CrossrefPubMedGoogle Scholar
  • 96 Behme D, Gondecki L, Fiethen S, Kowoll A, Mpotsaris A, Weber W. Complications of mechanical thrombectomy for acute ischemic stroke-a retrospective single-center study of 176 consecutive cases. Neuroradiology 2014; 56 (06) 467-476
    CrossrefPubMedGoogle Scholar
  • 97 Akpinar SH, Yilmaz G. Periprocedural complications in endovascular stroke treatment. Br J Radiol 2016; 89 1057 20150267
    CrossrefPubMedGoogle Scholar
  • 98 Gupta R. Arterial vasospasm during mechanical thrombectomy for acute stroke. J Neuroimaging 2009; 19 (01) 61-64
    CrossrefPubMedGoogle Scholar
  • 99 Davis MC, Deveikis JP, Harrigan MR. Clinical presentation, imaging, and management of complications due to neurointerventional procedures. Semin Intervent Radiol 2015; 32 (02) 98-107
    Article in Thieme ConnectPubMedGoogle Scholar
  • 100 Yub LeeS, Won YounS, Kyun KimH, Rok DoY. Inadvertent detachment of a retrievable intracranial stent: review of manufacturer and user facility device experience. Neuroradiol J 2015; 28 (02) 172-176
    CrossrefPubMedGoogle Scholar
  • 101 Castaño C, Dorado L, Remollo S. et al. Unwanted detachment of the Solitaire device during mechanical thrombectomy in acute ischemic stroke. J Neurointerv Surg. 2016 neurintsurg-2015-012156
    PubMedGoogle Scholar
  • 102 Masoud H, Nguyen TN, Martin CO. et al. Inadvertent stent retriever detachment: a multicenter case series and review of device experience FDA reports. Interv Neurol 2016; 4 (03) (04) 75-82
    PubMedGoogle Scholar
  • 103 Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. Stroke Unit Trialists’ Collaboration. BMJ 1997; 314 7088 1151-1159
    CrossrefPubMedGoogle Scholar
  • 104 Christoforidis GA, Vakil P, Ansari SA, Dehkordi FH, Carroll TJ. Impact of pial collaterals on infarct growth rate in experimental acute ischemic stroke. AJNR Am J Neuroradiol 2017; 38 (02) 270-275
    CrossrefPubMedGoogle Scholar
  • 105 Leslie-Mazwi T, Chen M, Yi J. et al; Standards and Guidelines committee of the Society of NeuroInterventional Surgery (SNIS). Post-thrombectomy management of the ELVO patient: guidelines from the Society of NeuroInterventional Surgery. J Neurointerv Surg 2017; 9 (12) 1258-1266
    CrossrefPubMedGoogle Scholar
  • 106 Rordorf G, Koroshetz WJ, Ezzeddine MA, Segal AZ, Buonanno FS. A pilot study of drug-induced hypertension for treatment of acute stroke. Neurology 2001; 56 (09) 1210-1213
    CrossrefPubMedGoogle Scholar
  • 107 Hacke W, Kaste M, Fieschi C. et al; Second European-Australasian Acute Stroke Study Investigators. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet 1998; 352 9136 1245-1251
    CrossrefPubMedGoogle Scholar
  • 108 Trouillas P, von Kummer R. Classification and pathogenesis of cerebral hemorrhages after thrombolysis in ischemic stroke. Stroke 2006; 37 (02) 556-561
    CrossrefPubMedGoogle Scholar
  • 109 Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R. ‘Malignant’ middle cerebral artery territory infarction: clinical course and prognostic signs. Arch Neurol 1996; 53 (04) 309-315
    CrossrefPubMedGoogle Scholar
  • 110 Vahedi K, Hofmeijer J, Juettler E. et al; DECIMAL, DESTINY, and HAMLET investigators. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 2007; 6 (03) 215-222
    CrossrefPubMedGoogle Scholar
  • 111 Davoli A, Motta C, Koch G. et al. Pretreatment predictors of malignant evolution in patients with ischemic stroke undergoing mechanical thrombectomy. J Neurointerv Surg. 2017
    PubMedGoogle Scholar
  • 112 Krieger DW, Demchuk AM, Kasner SE, Jauss M, Hantson L. Early clinical and radiological predictors of fatal brain swelling in ischemic stroke. Stroke 1999; 30 (02) 287-292
    CrossrefPubMedGoogle Scholar
  • 113 Thomalla G, Hartmann F, Juettler E. et al; Clinical Trial Net of the German Competence Network Stroke. Prediction of malignant middle cerebral artery infarction by magnetic resonance imaging within 6 hours of symptom onset: A prospective multicenter observational study. Ann Neurol 2010; 68 (04) 435-445
    CrossrefPubMedGoogle Scholar
  • 114 He J, Zhang Y, Xu T. et al; CATIS Investigators. Effects of immediate blood pressure reduction on death and major disability in patients with acute ischemic stroke: the CATIS randomized clinical trial. JAMA 2014; 311 (05) 479-489
    CrossrefPubMedGoogle Scholar
  • 115 Brinjikji W, Rabinstein A, Cloft HJ, Lanzino G, Kallmes DF. Recently published stroke trials: what the radiologist needs to know. Radiology 2015; 276 (01) 8-11
    CrossrefPubMedGoogle Scholar
  • 116 Zaidi SF, Aghaebrahim A, Urra X. et al. Final infarct volume is a stronger predictor of outcome than recanalization in patients with proximal middle cerebral artery occlusion treated with endovascular therapy. Stroke 2012; 43 (12) 3238-3244
    CrossrefPubMedGoogle Scholar
  • 117 Krongold M, Almekhlafi MA, Demchuk AM, Coutts SB, Frayne R, Eilaghi A. Final infarct volume estimation on 1-week follow-up MR imaging is feasible and is dependent on recanalization status. Neuroimage Clin 2014; 7: 1-6
    PubMedGoogle Scholar
  • 118 Gaudinski MR, Henning EC, Miracle A, Luby M, Warach S, Latour LL. Establishing final infarct volume: stroke lesion evolution past 30 days is insignificant. Stroke 2008; 39 (10) 2765-2768
    CrossrefPubMedGoogle Scholar
  • 119 Lavine SD, Cockroft K, Hoh B. et al. Training guidelines for endovascular ischemic stroke intervention: an international multi-society consensus document. AJNR Am J Neuroradiol 2016; 37 (04) E31-E34
    CrossrefPubMedGoogle Scholar