Video Atlas of Acute Ischemic Stroke Intervention

Description:

The go-to resource for managing a full spectrum of clinical scenarios in acute ischemic stroke

Ever-evolving technological advances have created a daunting number of emergent neurointerventional protocols and therapies for treating acute ischemic stroke. This has created an urgent need for reader-friendly, hands-on resources. Video Atlas of Acute Ischemic Stroke Intervention edited by renowned neuroinventional stroke experts Maxim Mokin, Elad I. Levy, Adnan H. Siddiqui, and esteemed contributors fills a void in education and knowledge with interactive, case-based guidance on mastering challenging stroke interventions. The atlas leverages current knowledge and decades of experience in acute stroke treatment and device innovations to familiarize clinicians at various career stages with a wide repertoire of techniques available in the neurointerventional suite.

The book focuses on technical aspects of interventional stroke procedures including pitfalls and complications, an overview of the most useful tools of the trade, and discussion of pre- and post-procedural care. Eighteen chapters provide comprehensive coverage on the most common endovascular treatment approaches for acute stroke—aspiration and stent-retriever thrombectomy of proximal, distal, and tandem occlusions. Several cases focus on recognition and management of complications that clinicians may encounter during emergent procedures. Topics include the importance of arterial access, unmet need in current devices, and methods for overcoming these challenges.

Key Highlights

Thirty-eight individually narrated, high-definition videos describe angiographic and procedural cases, step by step

High-quality illustrations emphasize and delineate key aspects of complex procedures

Firsthand tips and tricks enhance the ability to manage highly challenging and less common pathologies, including arterial dissection, atherosclerosis, and venous strokes

This must-have resource will benefit all practitioners involved in the interventional care of patients with acute ischemic stroke.

Table of Contents:

1 Clinical and Imaging Evaluation

1.1 Clinical Evaluation

1.2 Imaging Evaluation

1.3 Pearls and Pitfalls

2 Arterial Access

2.1 Anatomical and Imaging Aspects

2.2 Technique and Key Steps—FA Access

2.3 Technique and Key Steps—RA Access

2.4 Technique and Key Steps—Alternative Access

2.5 Pearls and Pitfalls

2.6 Cases with Videos and Images

2.6.1 Case 2.1 RA Loop

3 Challenging Access

3.1 Anatomical and Imaging Aspects

3.2 Technique and Key Steps

3.3 Pearls and Pitfalls

3.4 Cases with Videos and Images

3.4.1 Case 3.1 Balloon Guide Catheter Anchoring Technique

3.4.2 Case 3.2 ICA Loop and “Soft” Long Guide Sheath

4 Common Carotid Artery Occlusion

4.1 Anatomical and Imaging Aspects

4.2 Carotid Stent Selection

4.3 Pearls and Pitfalls

4.4 Cases with Videos and Images

4.4.1 Case 4.1 Covered Stents in CCA Origin Occlusion

4.4.2 Case 4.2 Common Carotid Artery Occlusion with a Long Lesion: A Two-Stent Construct

4.4.3 Case 4.3 Covered Stent Placement Through Brachial Access for Brachiocephalic Artery Occlusion

5 Internal Carotid Artery Occlusion

5.1 Anatomical and Imaging Aspects

5.2 Carotid Stent Selection

5.3 Technique and Key Steps

5.4 Pearls and Pitfalls

5.5 Cases with Videos and Images

5.5.1 Case 5.1 Balloon Guide Catheter and Distal Filter for Cervical ICA Occlusion

5.5.2 Case 5.2 Mo.Ma Device for ICA Occlusion

5.5.3 Case 5.3 Unprotected Stenting and Distal Embolization

6 Internal Carotid Artery Dissection

6.1 Anatomical and Imaging Aspects

6.2 Carotid Stent Selection

6.3 Technique and Key Steps

6.4 Pearls and Pitfalls

6.5 Cases with Videos and Images

6.5.1 Case 6.1 Stenting of Cervical Internal Carotid Artery (ICA) Dissection under Flow Arrest

6.5.2 Case 6.2 Repair of a Long Dissection with Two Stents

7 Internal Carotid Artery Terminus Occlusion

7.1 Anatomical and Imaging Aspects

7.2 Technique and Key Steps

7.3 Pearls and Pitfalls

7.4 Cases with Videos and Images

7.4.1 Case 7.1 Balloon Guide Catheter and Stent Retriever

7.4.2 Case 7.2 Intracranial Stenting

8 Tandem Occlusion

8.1 Anatomical and Imaging Aspects

8.2 Technique and Key Steps

8.3 Pearls and Pitfalls

8.4 Cases with Videos and Images

8.4.1 Case 8.1 Tandem CCA and MCA Lesion and Aspiration Thrombectomy

8.4.2 Case 8.2 Tandem ICA Occlusion and Stent Retriever Thrombectomy

9 Proximal Middle Cerebral Artery Occlusion—Stent-Retriever Thrombectomy

9.1 Anatomical and Imaging Aspects

9.2 Technique and Key Steps

9.3 Pearls and Pitfalls

9.4 Cases with Videos and Images

9.4.1 Case 9.1 Long Sheath, Intermediate Catheter, and Stent Retriever for M1 Occlusion

9.4.2 Case 9.2 Balloon Guide Catheter, Intermediate Catheter, and Stent Retriever for Ml Occlusion

9.4.3 Case 9.3 Stent Retriever for M2 Occlusion and Vasospasm

9.4.4 Case 9.4 Multiple Passes with Stent Retriever and Failed Recanalization

10 Proximal Middle Cerebral Artery Occlusion—Aspiration

10.1 Anatomical and Imaging Aspects

10.2 Technique and Key Steps

10.3 Pearls and Pitfalls

10.4 Cases with Videos and Images

10.4.1 Case 10.1 Direct Aspiration with First-Pass Effect

10.4.2 Case 10.2 Direct Aspiration of Ml Followed by Stent Retriever for a More Distal Occlusion

10.4.3 Case 10.3 Aborted Stent-Retriever Attempt and Successful Aspiration Instead

10.4.4 Case 10.4 Aspiration Catheter Catches on Ophthalmic Artery; Stent Retriever is Used

10.4.5 Case 10.5 Direct Aspiration with Reocclusion, Underlying Atherosclerosis, and Rescue Intracranial Stenting

11 Proximal Middle Cerebral Artery Occlusion—Angioplasty and Stenting

11.1 Anatomical and Imaging Aspects

11.2 Technique and Key Steps

11.3 Pearls and Pitfalls

11.4 Cases with Videos and Images

11.4.1 Case 11.1 Failed Angioplasty and Successful Stenting of M2 Occlusion

11.4.2 Case 11.2 Fractional Flow Reserve and Primary Stenting of Critical MCA Stenosis

12 Distal Middle Cerebral Artery Occlusion

12.1 Anatomical and Imaging Aspects

12.2 Technique and Key Steps

12.3 Cases with Videos and Images

12.3.1 Case 12.1 Stent Retriever for M3 Occlusion

12.3.2 Case 12.2 Intra-arterial Thrombolysis for M3/4 Occlusion

13 Anterior Cerebral Artery Occlusion

13.1 Anatomical and Imaging Aspects

13.2 Technique and Key Steps

13.3 Cases with Videos and Images

13.3.1 Case 13.1 Direct Aspiration of A2 Occlusion

13.3.2 Case 13.2 Stent-Retriever Thrombectomy of A2 Occlusion

14 Vertebral Artery Occlusion

14.1 Anatomical and Imaging Aspects

14.2 Techniques and Key Steps

14.3 Pearls and Pitfalls

14.4 Cases with Videos and Images

14.4.1 Case 14.1 Vertebral Artery Origin Stenting and Ostial Balloon Angioplasty

15 Basilar Artery Occlusion—Mechanical Thrombectomy

15.1 Anatomical and Imaging Aspects

15.2 Techniques and Key Steps

15.3 Pearls and Pitfalls

15.4 Cases with Videos and Images

15.4.1 Case 15.1 Long Sheath, Intermediate Catheter, and Stent Retriever for BA Occlusion

15.4.2 Case 15.2 Multiple Attempts of Direct Aspiration for BA Occlusion

16 Basilar Artery Occlusion—Angioplasty and Stenting

16.1 Anatomical and Imaging Aspects

16.2 Techniques and Key Steps

16.3 Pearls and Pitfalls

16.4 Cases with Videos and Images

16.4.1 Case 16.1 Angioplasty and Stenting of Flow-Limiting Vertebrobasilar Stenosis

16.4.2 Case 16.2 Basilar Artery Submaximal Angioplasty

17 Cerebral Venous Sinus Thrombosis

17.1 Anatomical and Imaging Aspects

17.2 Techniques and Key Steps

17.3 Pearls and Pitfalls

17.4 Cases with Videos and Images

17.4.1 Case 17.1 Clot Disruption Using Balloon and Mechanical Thrombectomy

18 Management of Complications

18.1 Vessel Perforation

18.2 Dissection

18.3 Access-Site Complications

18.4 Reperfusion Hemorrhage

18.5 Reocclusion

18.6 In-Stent Thrombosis

18.7 Pearls and Pitfalls

18.8 Cases with Videos and Images

18.8.1 Case 18.1 Acute In-Stent Thrombosis

18.8.2 Case 18.2 MCA Perforation during Thrombectomy

Index

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