ARRS 2022 Abstracts

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E1131. Brain Attack: Interventionalist's Guide to Thrombectomy for Acute Ischemic Stroke
Authors
  1. Alexandra So; Massachusetts Institute of Technology
  2. Hwayoung Lee; Torrance Memorial Medical Center
  3. Jimmy Huang; West Los Angeles VA Medical Center
  4. Jonathan Park; Torrance Memorial Medical Center
Background
Previously the treatment for acute ischemic stroke focused on IV thrombolytics, but endovascular mechanical thrombectomy has emerged as an important therapy. The development and refinement of stent retriever and aspiration catheter technology has been a critical development. Mechanical thrombectomy has also become an important part of many interventional radiology practices with the increasing numbers of comprehensive stroke centers.

Educational Goals / Teaching Points
This exhibit aims to provide a brief overview of the indications for mechanical thrombectomy in acute ischemic stroke, including the use of CT perfusion for patient selection; review the interventional techniques, setup, and major devices for acute ischemic stroke treatment; and provide a case-based format to illustrate the above.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit includes an overview of indications for thrombectomy in acute ischemic stroke (brief review of evidence for mechanical thrombectomy and patient selection, including use of CT perfusion to guide decision making) and a review of interventional mechanical stroke thrombectomy (current techniques, with a focus on stent retrievers and aspiration, as well as their synergy; review of major devices currently available for mechanical thrombectomy; and review of potential complications).

Conclusion
Endovascular therapy for acute ischemic stroke has been revolutionized by the development of novel devices such as stent retrievers and aspiration catheters. Furthermore, mechanical thrombectomy has been proven to improve outcomes in the setting of large vessel occlusions. Stroke therapy is increasingly becoming a part of many interventional radiology practices and as such is a useful skill for interventional radiologists.