Neuroimaging in Patient Selection for Thrombectomy, From the AJR Special Series on Emergency Radiology.

Abstract

Endovascular thrombectomy has become the standard-of-care treatment in carefully selected patients with an acute ischemic stroke due to a large-vessel occlusion of the anterior circulation. Neuroimaging plays a vital role in determining patient eligibility for thrombectomy, both in the early (0-6 hours from symptom onset) and late (>6-24 hours from symptom onset) time windows. Various neuroimaging algorithms are used to determine thrombectomy eligibility, and each algorithm must be optimized for institutional workflow. In this review, we describe common imaging modalities and recommended algorithms for the evaluation of patients for endovascular thrombectomy. We also discuss emerging patient populations that might qualify for thrombectomy in the coming years.