Intra-arterial Thrombolysis in Acute Ischemic Stroke

Acute stroke treatment has evolved rapidly in the last two decades with systemic thrombolysis and endovascular interventions for intracranial large artery occlusions. Neurointerventional techniques to achieve reperfusion in ischemic stroke initially involved local intra-arterial infusion of thrombolytic agents. The subsequent development of mechanical thrombectomy devices has resulted in better and faster arterial recanalization while maintaining patient safety. This approach has recently taken a large step forward with the introduction of “stent retriever” technology. In this chapter we discuss various endovascular recanalization techniques in acute ischemic stroke with illustrative cases.