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Expanding the role of NCCT in acute stroke imaging: thrombus length measurement and its potential impact on current practice
- Source :
- Journal of NeuroInterventional Surgery. 6:5-6
- Publication Year :
- 2013
- Publisher :
- BMJ, 2013.
-
Abstract
- The current standard of care for acute ischemic stroke is intravenous recombinant tissue type plasminogen activator (rt-PA) for eligible patients who present within 3–4.5 h from stroke onset.1 ,2 There is firm evidence supporting its efficacy when administered to patients suspected of having acute ischemic stroke and without imaging evidence of intracranial hemorrhage.3 ,4 For patients with major artery occlusions the use of intra-arterial therapy has grown significantly,5 but remains controversial as clear outcome benefits have not been prospectively demonstrated despite higher rates of recanalization compared with intravenous rt-PA.6 ,7 Proper patient selection is paramount in all interventions. An integral component in this effort is identifying clinically proven imaging biomarkers.8 The foundational principle of reperfusion therapy is that timely vessel recanalization will stop the progression of cell apoptosis in the ischemic penumbra and limit final infarct size. For this reason, the focus of ischemic stroke imaging has been the physiologic characterization of the affected brain parenchyma. The ideal patient possesses a major artery occlusion, a small infarct (core), as well as a significant volume of threatened but still viable tissue (penumbra). Indeed, advanced parenchymal imaging techniques have been shown to identify patients for whom …
- Subjects :
- medicine.medical_specialty
Potential impact
business.industry
Penumbra
Thrombosis
General Medicine
medicine.disease
Surgery
Stroke
Reperfusion therapy
Current practice
Tissue Plasminogen Activator
Internal medicine
Occlusion
medicine
Cardiology
Animals
Humans
Neurology (clinical)
Thrombus
Tomography, X-Ray Computed
business
Acute stroke
Subjects
Details
- ISSN :
- 17598486 and 17598478
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of NeuroInterventional Surgery
- Accession number :
- edsair.doi.dedup.....714da277e784bf7c63ad83c21465b6fb