RESUMO
Endovascular intraarterial (IA) strategies have emerged as important treatment options for patients with acute ischemic stroke who are ineligible for intravenous (IV) tissue plasminogen activator (tPA) or in whom such therapy has failed. The goal of this article is to provide a comprehensive review of percutaneous IA endovascular techniques aimed at revascularization in the setting of acute ischemic stroke from IA thrombolysis, mechanical thrombectomy, and primary intracranial stenting to retrievable-stent technology. For each modality, we focus on the existing clinical data, including our institutional experience and techniques.
Assuntos
Angioplastia/métodos , Isquemia Encefálica/cirurgia , Stents , Acidente Vascular Cerebral/cirurgia , Trombectomia/métodos , Terapia Trombolítica/métodos , Doença Aguda , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/terapia , Humanos , Infusões Intra-Arteriais , Radiografia , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/terapiaRESUMO
The authors describe a low-cost CT scanner integrated with a radiotherapy simulator and designed for treatment planning. The standard rotational gantry and x-ray tube of the simulator are used with a multiwire xenon lonization chamber and simple current-proportional readout system to measure patient attenuation, avoiding problems associated with diagnostic CT scanners in treatment planning. Although design constraints limit performance, software compensation techniques have reduced artifacts and given satisfactory images.
