Main description:

A case-based guide to the interventional management of stroke from leading international experts!

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.

This book includes complimentary access to a digital copy on https://medone.thieme.com.

Contents:

I Evolution of Endovascular Management

1 Intra-arterial Tissue Plasminogen Activator: The First Steps

2 Transcatheter MERCI Clot Retrieval: The Early Generation

3 Penumbra Clot Aspiration Technique: The Dark Days

4 Trevo Stent-Retriever Thrombectomy: Light on the Horizon

5 Solitaire Stent-Retriever Thrombectomy: Building the Evidence

II Case Selection

6 Timing in Stroke and the Tissue Clock

7 Role of Leptomeningeal Collaterals

8 Importance of Clot Burden and Clot Location

9 ASPECTS: When Not to Treat

10 Microbleeds Are Not a Contraindication to Thrombolysis in Acute Stroke

11 Stroke Etiologies: Hemodynamic, Embolic, and Perforator Stroke

12 Endovascular Therapy in a Patient with a Proximal MCA Occlusion and No Neurological Deficits

13 MRI in Stroke (Core Size, Mismatch, and New Advances)

III Fundaments and Standard Approaches

14 The Classical Setup: Carotid-T with Balloon

15 M1 Anatomy and Role of Perforators in Outcome

16 Basilar Artery Occlusion

17 ADAPT Technique for Acute Ischemic Stroke Thrombectomy

18 General Anesthesia in Thrombectomy

19 Conscious Sedation in Thrombectomy

20 Endovascular Therapy for Patients with an Isolated M2 Occlusion

IV Advanced Techniques

21 Percutaneous Radial Arterial Access for Thrombectomy

22 Percutaneous Transcarotid Endovascular Thrombectomy for Acute Ischemic Stroke

23 Distal Access Catheter Technique without Balloon Assistance

V Complex Cases

24 Tandem Lesions

25 Pseudo-occlusion

26 Underlying Intracranial Stenosis

27 Intracranial Dissection

28 Hyperacute Extracranial Angioplasty and Stenting: When and How

29 Failed Mechanical Thrombectomy: What to Do Next

30 Rescue Permanent Stenting

31 Acute Dissection with Hemodynamic Infarctions

32 The SAVE Technique

33 Aspiration-Retriever Technique for Stroke (ARTS)

VI Complications

34 Clot Migration with Emboli to Distal Territories

35 Endothelial Damage

36 Management of Vessel Perforation during Stroke Intervention

37 Arterial Access Complications

38 Intraprocedural Vasospasm during Thrombectomy

39 Hemorrhagic Transformation after Endovascular Stroke Therapy

40 Endovascular Treatment of Cerebral Venous Thrombosis

41 Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke

VII Stroke Mimics and Rare Causes

42 Hemiplegic Migraine

43 Intra-arterial Contrast Injection during Computed Tomography Angiography

44 Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS)

45 Reversible Cerebral Vasoconstriction Syndrome

46 Acute Ischemic Stroke Secondary to Cardiac Myxoma Embolus

47 Seizure

48 Cerebral Amyloid Angiopathy

49 Contrast Staining Masquerading as Hemorrhage

50 HaNDL

51 Appendix: Essential Terms, Trials, and Tools