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What Should We Know Before Doing Mechanical Thrombectomy in Stroke Patients

AUTHORS

Ramin Pourghorban 1 , *

1 Department of Radiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

How to Cite: Pourghorban R. What Should We Know Before Doing Mechanical Thrombectomy in Stroke Patients, Iran J Radiol. Online ahead of Print ; 14(Special Issue):e48401. doi: 10.5812/iranjradiol.48401.

ARTICLE INFORMATION

Iranian Journal of Radiology: 14 (Special Issue); e48401
Published Online: April 12, 2017
Article Type: Abstract
Received: December 20, 2016
Accepted: February 7, 2017
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Abstract

Mechanical thrombectomy has shown promising results in large vessel ischemic stroke, with recent large trials changing to guidelines worldwide. In this presentation, results from the five recent randomized trials will be discussed. There is an ongoing debate on the inclusion and exclusion criteria of mechanical thrombectomy. It can be done in large vessel occlusions, including up to M2 middle cerebral artery (MCA), anterior cerebral artery (ACA), basilar artery, and posterior cerebral artery (PCA). The effect of time window, age, prior intravenous thromblysis on patients selection will be discussed. An elaboration on the effect of national institutes of health stroke scale (NIHSS) score in the clinical setting, Alberta stroke program early computed tomography score (ASPECTS) on non-contrast CT, presence of collaterals on CT angiography (CTA), and presence of penumbra on CT perfusion or post contrast MRI will be given as well. The pros and cons of general anesthesia versus conscious sedation during mechanical thrombectomy and aspiration technique versus stent-retriever will be reviewed. The usual devices used in mechanical thrombectomy and practical tips of endovascular treatment will be discussed. Finally, modified treatment in cerebral ischemia (mTICI) score after thrombectomy will be shown.

Keywords

© 2017, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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