Intravenous Thrombolytic and Endovascular Treatment of Acute Ischemic Stroke

  • Ameer Al-Wafai
  • William Humphries
  • Lucas ElijovichEmail author
Reference work entry


Acute ischemic stroke is a disease with an immense global impact. The past 30 years has seen an explosion in diagnostic and therapeutic options that has changed the way stroke is treated. We will review the scientific evidence for acute ischemic stroke therapy, discuss new treatment algorithms and systems of care, and also review the available imaging modalities utilized for patient selection as well as endovascular devices/techniques that are employed to treat acute large vessel intracranial occlusions, one of the most difficult subtypes of acute ischemic stroke.


Acute Ischemic Stroke Tissue Plasminogen Activator Acute Ischemic Stroke Patient Stent Retriever Large Vessel Occlusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Glossary of Terms

Tissue Plasminogen Activator (TPA)

A fibrinolyic medication that can be administered both intravenously and intraarterially.

Large Vessel Occlusion

Intracranial occlusion of one of the major arteries of the circle of willis including the internal carotid artery, anterior cerebral artery, middle cerebral artery, vertebral artery, basilar artery, and posterior cerebral arteries

Mechanical Embolectomy

A catheter based technique used to perform acute ischemic stroke surgery that utilizes fluoroscopically visualized devices that remove emboli with suction/aspiration or retrievable stents.

Multi-Modal Stroke Imaging

CT or MRI based techniques employing a combination of image sequences that evaluate brain tissue integrity, the cervico-cerebral vasculature, and brain perfusion in order to best select patients for thrombolysis with IV TPA and/or mechanical embolectomy


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Further Reading

  1. Moll R, Dinkel HP (2001) Value of the CT angiography in the diagnosis of common carotid artery bifurcation disease: CT angiography versus digital subtraction angiography and color flow Doppler. Eur J Radiol 39:155–162CrossRefPubMedGoogle Scholar
  2. Solitaire™ FR as primary treatment for acute ischemic stroke (SWIFT PRIME). NCT01657461Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ameer Al-Wafai
    • 1
  • William Humphries
    • 2
  • Lucas Elijovich
    • 2
    • 1
    Email author
  1. 1.Department of NeurologyUniversity of Tennessee Health Sciences CenterMemphisUSA
  2. 2.Department of Neurosurgery, Semmes-Murphey Neurologic InstituteUniversity of Tennessee Health Sciences CenterMemphisUSA

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