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    Module

    Interventional Radiology - The Stroke Patient

    The role of interventional radiologists in the management of stroke patients.

    Interventional Radiology - The Stroke Patient
    Radiology Expert
    Table of contents
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    CT Angiography

    With the help of a CT angiography (CTA) examination, the arterial vascular supply of the neck/brain region can be well visualized.

    Key reasons:

    1. Detection of intracranial occlusions (also called 'Large Vessel Occlusion'), where the patient may be eligible for endovascular treatment (Fig. 17).
    2. Assessment of collateral circulation (further explained below).
    3. Evaluation for the presence of (additional) vascular pathologies, such as atherosclerosis (including significant stenosis at the carotid bifurcation), dissection, aneurysm, and vascular malformation.
    4. Planning endovascular treatment; detailed information about the clot (location, size) and other vasculature (anatomy, accessibility, estimation of potential risks).

     

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    Literature: sources and author

    Text & Illustrations

    drs.A. van der Plas, MSK radiologist Maastricht UMC+

    For content review, special thanks to:

    Prof. dr. W.H. van Zwam, interventional radiologist Maastricht UMC+
    Dr. S.W. de Boer, interventional radiologist Maastricht UMC+

    Sources:

    • M. Abdalkadera, J. E. Sieglerb et al.;Neuroimaging of Acute Ischemic Stroke: Multimodal Imaging Approach for Acute Endovascular Therapy. J. Stroke 2023

    • Dr. J.B.M. Kuks, Dr. J. W. Snoek; Klinische Neurologie (2007)

    • B.K. Menon et al; Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology 2015;275:510-520

    • C.A. Potter; CT for Treatment Selection in Acute Ischemic Stroke: A Code Stroke Primer. Radiographics 2019

    • H.P. Adams Jr., P.H. Davis et al.;. Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology 1999

    • D. Runde; Calculated Decisions: NIH stroke scale/score (NIHSS). Emerg Med Pract. 2020

    • V. Puetz et al.; The Alberta Stroke Program Early CT Score in Clinical Practice: What have We Learned? Int J Stroke 2009

    • U.Jensen-Kondering, C. Riedel, O. Jansen; Hyperdense artery sign on computed tomography in acute ischemic stroke. World J Radiol. 2010

    • A.Y. Poppe et al.; Tandem Carotid Lesions in Acute Ischemic Stroke: Mechanisms, Therapeutic Challenges, and Future Directions. American Journal of Neuroradiology (2020)

    • S.H. Baik; A Review of Endovascular Treatment for Posterior Circulation Strokes. Neurointervention (2023)

    • S.M Pilgram-Pastor et al.; Stroke thrombectomy complication management. J Neurointerv Surg. (2021)

    • M.U.Farooq; Pathophysiology and management of reperfusion injury and hyperperfusion syndrome after carotid endarterectomy and carotid artery stenting. Experimental & Translational Stroke Medicine (2016)

    26/02/2024

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