Use of Perfusion Imaging and Other Imaging Techniques to Assess Risks/Benefits of Acute Stroke Interventions
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The advent of multimodal neuroimaging has provided acute stroke care providers with an armamentarium of sophisticated imaging options to utilize for guidance in clinical decision-making and management of acute ischemic stroke patients. Here, we propose a framework and potential algorithm-based methodology for imaging modality selection and utilization for the purpose of achieving optimal stroke clinical care. We first review imaging options that may best inform decision-making regarding revascularization eligibility, with a focus on the imaging modalities that best identify critical inclusion and exclusion criteria. Next, we review imaging methods that may guide the successful achievement of revascularization once it has been deemed desirable and feasible. Further, we review imaging modalities that may best assist in both the noninterventional care of acute stroke as well as the identification of stroke-mimics. Finally, we review imaging techniques under current investigation that show promise to improve future acute stroke management.
KeywordsImaging Revascularization Perfusion Stroke Collaterals
Sources of Funding
This work has been funded by NIH-National Institute of Neurological Disorders and Stroke Awards NIH/NINDS P50NS044378, K24NS072272, R01NS077706, R13NS082049.
Conflict of interest
Jason Tarpley declares that he has no conflicts of interest.
Dan Franc declares that he has no conflicts of interest.
Aaron P Tansy declares that he has no conflicts of interest.
David S Liebeskind is a scientific consultant regarding trial design and conduct to Stryker (modest) and Covidien (modest).
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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