Endovascular Treatment of Stroke

As the evidence supporting intra-arterial treatment for acute ischemic stroke continues to build, more patients are becoming candidates for mechanical thrombectomy of large cerebral vessel occlusions. Time is the key principle defining stroke care, and expediting reperfusion is associated with improved outcomes. Successful endovascular intervention for large vessel occlusions requires an intimate understanding of the various techniques as well as the cache of thrombectomy devices in the interventionalist's armamentarium. In this chapter, we review the evidence supporting thrombectomy for acute ischemic stroke, present the workup of the acute stroke patient, and explain the specific procedural details for thrombectomy with either aspiration or stent-retriever.