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Current concepts in imaging and endovascular treatment of acute ischemic stroke: implications for the clinician

Authors
  • van der Zijden, Thijs1
  • Mondelaers, Annelies1
  • Yperzeele, Laetitia2, 3
  • Voormolen, Maurits1, 4
  • Parizel, Paul M.1, 4
  • 1 Antwerp University Hospital & University of Antwerp, Department of Radiology, Wilrijkstraat 10, Edegem, 2650, Belgium , Edegem (Belgium)
  • 2 Antwerp University Hospital & University of Antwerp, Department of Neurology, Wilrijkstraat 10, Edegem, 2650, Belgium , Edegem (Belgium)
  • 3 University of Antwerp, Department Translational Neurosciences, Universiteitsplein 1, Wilrijk, 2610, Belgium , Wilrijk (Belgium)
  • 4 University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, Wilrijk, 2610, Belgium , Wilrijk (Belgium)
Type
Published Article
Journal
Insights into Imaging
Publisher
Springer-Verlag
Publication Date
Jun 13, 2019
Volume
10
Issue
1
Identifiers
DOI: 10.1186/s13244-019-0744-4
Source
Springer Nature
Keywords
License
Green

Abstract

During the last decade, the management of acute ischemic stroke has changed dramatically, from an expectant bedside “wait and see” attitude towards active treatment, thanks to the continuous improvement of new therapeutic options. In addition to the use of intravenous (IV) thrombolysis in emergent large vessel occlusion (ELVO), endovascular therapy (EVT) has proven to be very efficient in selected acute stroke patients. The indications for EVT have progressed from the era of thrombolysis to individual patient profiling. Recently, several indication parameters, e.g., “treatment time window” or “more distal vessel occlusion,” are under debate for adjustment. In this article, we review the imaging strategies in acute stroke and discuss several EVT indication dogmas, which are subject to change.

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