title: Imaging, Intervention, and Workflow in Acute Ischemic Stroke: The Calgary Approach.
abstract: Five recently published clinical trials showed dramatically higher rates of favorable functional outcome and a satisfying safety profile of endovascular treatment compared with the previous standard of care in acute ischemic stroke with proximal anterior circulation artery occlusion. Eligibility criteria within these trials varied by age, stroke severity, imaging, treatment-time window, and endovascular treatment devices. This focused review provides an overview of the trial results and explores the heterogeneity in imaging techniques, workflow, and endovascular techniques used in these trials and the consequent impact on practice. Using evidence from these trials and following a case from start to finish, this review recommends strategies that will help the appropriate patient undergo a fast, focused clinical evaluation, imaging, and intervention.
authors.affiliation: From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: C
authors.identifier: 0000-0001-5969-8990
authors.initials: C
authors.lastname: Zerna
authors.affiliation: From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Z
authors.identifier: 0000-0001-9907-4840
authors.initials: Z
authors.lastname: Assis
authors.affiliation: From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: C D
authors.identifier: 0000-0001-5568-9325
authors.initials: CD
authors.lastname: d'Esterre
authors.affiliation: From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: B K
authors.identifier: 0000-0002-3466-496X
authors.initials: BK
authors.lastname: Menon
authors.affiliation: From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada. mgoyal@ucalgary.ca.
authors.forename: M
authors.identifier: 0000-0001-9060-2109
authors.initials: M
authors.lastname: Goyal
mesh_terms: D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D009462:Neurology / Q000379:methods; D020521:Stroke / Q000000981:diagnostic imaging* / Q000628:therapy*; D057188:Workflow