Emergency Radiology

, Volume 26, Issue 2, pp 195–203 | Cite as

Imaging in neurointerventional stroke treatment: review of the recent trials and what your neurointerventionalist wants to know from emergency radiologists

  • Bhavya RehaniEmail author
  • Yi Zhang
  • Simon Ammanuel
  • Wade Smith
  • Ramon G. Gonzalez
  • Daniel L. Cooke
  • Steven W. Hetts
  • S. Andrew Josephson
  • Anthony Kim
  • J. Claude HemphillIII
  • William Dillon
Review Article


Stroke is one of the leading causes of death and disability worldwide. Standard treatment for stroke is intravenous (IV) injection of tissue plasminogen activator (t-PA) rapidly after symptom onset. However, there are limitations of IV t-PA treatment, such as a short time window for administration and risk for hemorrhage. Recent trials have demonstrated the benefit of endovascular treatment when added to standard treatment to improve outcomes for patients. Advanced imaging was utilized in some trials to identify patients with proximal intracranial occlusion to target for endovascular reperfusion therapy, and to exclude patients with large infarct cores or poor collateral circulation who would not be expected to benefit from intervention. This article summarizes the use of imaging in recent stroke trials in details, provides a stroke imaging protocol, and provides tips which radiologists should know to help their neurointerventionalists.


Late-onset stroke Stroke imaging Neurointerventional treatment 


Authors’ contributions

BR was involved in design of the work, data collection, analysis, and drafting the paper. YZ was involved in the data collection and drafting the article. SA, WS, RGG, DLC, SWH, SAJ, AK, JCH were involved in drafting the article and revision of the article. WD was involved in drafting and revision of the article, and design of the work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© American Society of Emergency Radiology 2018

Authors and Affiliations

  • Bhavya Rehani
    • 1
    Email author
  • Yi Zhang
    • 1
  • Simon Ammanuel
    • 1
  • Wade Smith
    • 2
  • Ramon G. Gonzalez
    • 3
  • Daniel L. Cooke
    • 1
  • Steven W. Hetts
    • 1
  • S. Andrew Josephson
    • 2
  • Anthony Kim
    • 2
  • J. Claude HemphillIII
    • 2
  • William Dillon
    • 1
  1. 1.Department of Radiology and Biomedical ImagingUniversity of California San Francisco School of MedicineSan FranciscoUSA
  2. 2.Department of NeurologyUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Department of RadiologyMassachusetts General HospitalBostonUSA

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