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Triage of Stroke Patients for Urgent Intervention

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Neurointervention in the Medical Specialties

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Presently, urgent interventional treatment of patients with acute ischemic stroke (AIS) is feasible not only for those with large artery occlusion (LAO) but also for others with more distal branch occlusions, encompassing various techniques for thrombectomy (i.e., direct clot removal), as well as additional techniques for flow restoration in cases with concurrent steno-occlusive pathology (e.g., angioplasty, stenting). However, the reasonableness of this type of treatment requires proper identification of patients considered High Value Targets (HVT) for urgent intervention. Ideally, a HVT patient is one with a clearly identified LAO that is manageable using available endovascular techniques, has a measurable and disabling neurologic deficit, and whose CT perfusion (CTP) map displays an ischemic core that is as small as possible accompanied by mismatch volume sufficiently large to warrant salvaging efforts.

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Authors and Affiliations

  1. University of Missouri Columbia School of Medicine, Columbia, MO, USA

    Camilo R. Gomez, Brandi R. French, Farhan Siddiq & Adnan I. Qureshi

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Correspondence to Camilo R. Gomez .

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  1. Neurology and Psychiatry, Saint Louis University, Saint Louis, MO, USA

    Randall C. Edgell

  2. Department of Neurology, Saint Louis University, St. Louis, MO, USA

    Kara M. Christopher

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Gomez, C.R., French, B.R., Siddiq, F., Qureshi, A.I. (2022). Triage of Stroke Patients for Urgent Intervention. In: Edgell, R.C., M. Christopher, K. (eds) Neurointervention in the Medical Specialties. Current Clinical Neurology. Humana, Cham. https://doi.org/10.1007/978-3-030-87428-5_6

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