Stroke is the most prevalent cerebrovascular emergency, impacting an estimated 15 million people worldwide every year. Endovascular treatment (EVT) of ischemic stroke has expanded at an unforeseen pace, with EVT the most common neurointerventional procedure performed at most large centers. Endovascular Management of Ischemic Stroke: A Case-Based Approach by renowned stroke pioneer Vitor Mendes Pereira and distinguished co-editors features contributions from a “who’s who” of global experts. This practical resource provides straightforward guidance for clinicians who need to learn and master state-of-the-art endovascular interventions reflecting the new, evidenced-based treatment paradigm for acute stroke.

This carefully crafted reference takes readers on a journey from the early building blocks that led to modern stroke interventions to meticulous step-by-step descriptions of the latest approaches. Fifty high-yield cases mirror real-life scenarios trainees and professionals are likely to encounter in clinical practice. Seven sections encompass a full spectrum of diverse patient presentations, anatomical variations, advanced techniques, complex pathologies, complications, and stroke mimics.

Key Highlights

• Discussion of emerging techniques likely to stand the test of time such as SAVE, ARTS, transradial access, and transcarotid access
• Stroke mimics important for differential diagnoses, including hemiplegic migraine, MELAS, RCVS, seizure, and more
• An appendix that covers fundamental terms, trials, and tools

This cutting-edge resource is essential reading for trainee and early-career interventionalists, as well as seasoned practitioners in interventional radiology, neuroradiology, endovascular neurosurgery, and interventional neurology.

Contents

۱ Intra-arterial Tissue Plasminogen Activator: The First Steps
۲ Transcatheter MERCI Clot Retrieval: The Early Generation
۳ Penumbra Clot Aspiration Technique: The Dark Days
۴ Trevo Stent-Retriever Thrombectomy: Light on the Horizon
۵ Solitaire Stent-Retriever Thrombectomy: Building the Evidence
۶ Timing in Stroke and the Tissue Clock
۷ Role of Leptomeningeal Collaterals
۸ Importance of Clot Burden and Clot Location
۹ ASPECTS: When Not to Treat
۱۰ Microbleeds Are Not a Contraindication to Thrombolysis in Acute Stroke
۱۱ Stroke Etiologies: Hemodynamic, Embolic, and Perforator Stroke
۱۲ Endovascular Therapy in a Patient with a Proximal MCA Occlusion and No Neurological Deficits
۱۳ MRI in Stroke (Core Size, Mismatch, and New Advances)
۱۴ The Classical Setup: Carotid-T with Balloon
۱۵ M1 Anatomy and Role of Perforators in Outcome
۱۶ Basilar Artery Occlusion
۱۷ ADAPT Technique for Acute Ischemic Stroke Thrombectomy
۱۸ General Anesthesia in Thrombectomy
۱۹ Conscious Sedation in Thrombectomy
۲۰ Endovascular Therapy for Patients with an Isolated M2 Occlusion
۲۱ Percutaneous Radial Arterial Access for Thrombectomy
۲۲ Percutaneous Transcarotid Endovascular Thrombectomy for Acute Ischemic Stroke
۲۳ Distal Access Catheter Technique without Balloon Assistance
۲۴ Tandem Lesions
۲۵ Pseudo-occlusion
۲۶ Underlying Intracranial Stenosis
۲۷ Intracranial Dissection
۲۸ Hyperacute Extracranial Angioplasty and Stenting: When and How
۲۹ Failed Mechanical Thrombectomy: What to Do Next
۳۰ Rescue Permanent Stenting
۳۱ Acute Dissection with Hemodynamic Infarctions
۳۲ The SAVE Technique
۳۳ Aspiration-Retriever Technique for Stroke (ARTS)
۳۴ Clot Migration with Emboli to Distal Territories
۳۵ Endothelial Damage
۳۶ Management of Vessel Perforation during Stroke Intervention
۳۷ Arterial Access Complications
۳۸ Intraprocedural Vasospasm during Thrombectomy
۳۹ Hemorrhagic Transformation after Endovascular Stroke Therapy
۴۰ Endovascular Treatment of Cerebral Venous Thrombosis
۴۱ Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke
۴۲ Hemiplegic Migraine
۴۳ Intra-arterial Contrast Injection during Computed Tomography Angiography
۴۴ Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS)
۴۵ Reversible Cerebral Vasoconstriction Syndrome
۴۶ Acute Ischemic Stroke Secondary to Cardiac Myxoma Embolus
۴۷ Seizure
۴۸ Cerebral Amyloid Angiopathy
۴۹ Contrast Staining Masquerading as Hemorrhage
۵۰ HaNDL
۵۱ Appendix: Essential Terms, Trials, and Tools