Neuroimaging in Patient Selection for Thrombectomy, From the AJR Special Series on Emergency Radiology

AJR Am J Roentgenol. 2023 May;220(5):630-640. doi: 10.2214/AJR.22.28608. Epub 2022 Nov 30.

Abstract

Endovascular thrombectomy has become the standard-of-care treatment for carefully selected patients with acute ischemic stroke due to a large-vessel occlusion of the anterior circulation. Neuroimaging plays a vital role in determining patient eligibility for thrombectomy, both in the early (0-6 hours from symptom onset) and late (> 6 to 24 hours from symptom onset) time windows. Various neuroimaging algorithms are used to determine thrombectomy eligibility, and each algorithm must be optimized for institutional workflow. In this review, we describe common imaging modalities and recommended algorithms for the evaluation of patients for endovascular thrombectomy. We also discuss emerging patient populations who might qualify for thrombectomy in the coming years.

Keywords: core; penumbra; perfusion; stroke; thrombectomy.

Publication types

  • Review

MeSH terms

  • Brain Ischemia* / therapy
  • Endovascular Procedures* / methods
  • Humans
  • Ischemic Stroke*
  • Neuroimaging
  • Patient Selection
  • Radiology*
  • Stroke* / diagnostic imaging
  • Stroke* / surgery
  • Thrombectomy / methods
  • Treatment Outcome