Acute Stroke Management in the Era of Thrombectomy

This book contains a compilation of the revolution of mechanical thrombectomy (MT) in the treatment of strokes. The initial chapters summarize information about the best medical management of acute ischemic stroke, imaging modalities and patient selection

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Acute Stroke Management in the Era of Thrombectomy

Edgar A. Samaniego  •  David Hasan Editors

Acute Stroke Management in the Era of Thrombectomy

Editors Edgar A. Samaniego Department of Neurology Neurosurgery and Radiology University of Iowa Hospitals and Clinics Iowa City, IA USA

David Hasan Department of Neurosurgery University of Iowa Hospitals and Clinics Iowa City, IA USA

ISBN 978-3-030-17534-4    ISBN 978-3-030-17535-1 (eBook) https://doi.org/10.1007/978-3-030-17535-1 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

This book is dedicated to my parents, Edgar and Jenny, who taught me to love books and the value of hard work. Edgar A. Samaniego

Foreword

The Road Not Taken … Two roads diverged in a wood, and I took the one less traveled by, And that has made all the difference. Robert Lee Frost (San Francisco, March 26, 1874–Boston, January 29, 1963) We are in the dawn of a new era for the treatment of cerebrovascular diseases. The beginning of this new road was the development of endovascular therapy. The endovascular era undoubtedly represents a revolutionary paradigm shift to treat cerebral circulation pathology by the inside of the vessel rather than by an open surgical approach. If the endovascular approach has been extremely successful for the treatment of cerebral aneurysms and vascular malformations, the road appeared more challenging for the treatment of acute ischemic stroke. In 1995, the NINDS IV tPA trial clearly showed that revascularization of the occluded artery was possible and, without a doubt, represented the way forward. Therefore, for large artery occlusions (LVO), endovascular recanalization was the most logical