Does Having Knowledge About Collateral Circulation Affect Patient Selection in Mechanical Thrombectomy?
Fatma Ger Akarsu1
, Özlem Aykaç1, Hayri Demirbaş2, Atilla Özcan Özdemir1
1Eskisehir Osmangazi University Faculty of Medicine, Department of Neurology, Eskisehir, Turkey
2Afyon Kocatepe University Faculty of Medicine, Department of Neurology, Afyon, Turkey
Keywords: Acute stroke, mechanical thrombectomy, collateral circulation, RAPID perfusion
Abstract
Endovascular thrombectomy is a well-known effective treatment in the first six hours of acute ischemic stroke, but endovascular therapy is also efficient in patients admitted six hours after symptom onset. The RAPID software is a powerful tool that processes computed tomography perfusion data and predicts ischemic core size and collateral status for endovascular treatment in these patients. Presented herein is a 66-year-old female patient with acute right middle cerebral artery occlusion with a symptom onset of >6 h. The reason why mechanical thrombectomy was not performed despite volume loss in the patient’s perfusion imaging is also discussed. Brain hemodynamics is undeniably different in every patient, and this should be kept in mind while evaluating imaging methods based on blood flow, such as the RAPID software. Therefore, this report aimed to present a patient that demonstrated the importance of patient-based selection in acute ischemic stroke treatment.
Patient consent was obtained.
Externally peer-reviewed.
Surgical and Medical Practices: F.G.A., Ö.A., H.D., A.Ö.Ö., Concept: F.G.A., Ö.A., H.D., A.Ö.Ö., Design: F.G.A., Ö.A., H.D., A.Ö.Ö., Data Collection or Processing: F.G.A., Ö.A., H.D., A.Ö.Ö., Analysis or Interpretation: F.G.A., Ö.A., H.D., A.Ö.Ö., Literature Search: .G.A., Ö.A., H.D., A.Ö.Ö., Writing: F.G.A., Ö.A., H.D., A.Ö.Ö.
No conflict of interest was declared by the authors.
The authors declared that this study received no financial support.