Skip to main content Accessibility help
Hostname: page-component-888d5979f-bkf9v Total loading time: 1.6 Render date: 2021-10-28T06:16:03.922Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

8 - Dilemmas in endovascular stroke therapy

Published online by Cambridge University Press:  05 August 2015

José Biller
Loyola University Stricht School of Medicine
José M. Ferro
Universidade de Lisboa
Get access
Common Pitfalls in Cerebrovascular Disease
Case-Based Learning
, pp. 90 - 112
Publisher: Cambridge University Press
Print publication year: 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1.Furlan, A, Higashida, R, Wechsler, L, Gent, M, Rowley, H, Kase, C, et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA 1999;282(21):2003–11.CrossRefGoogle ScholarPubMed
2.Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med 1995;333(24):1581–7.
3.Del Zoppo, GJ, Saver, JL, Jauch, EC, Adams, HP, Jr. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: a science advisory from the American Heart Association/American Stroke Association. Stroke 2009;40(8):2945–8.CrossRefGoogle ScholarPubMed
4.Akins, PT, Amar, AP, Pakbaz, RS, Fields, JD. Complications of endovascular treatment for acute stroke in the SWIFT trial with solitaire and Merci devices. AJNR Am J Neuroradiol 2014;35(3):524–8.CrossRefGoogle ScholarPubMed
5.Mokin, M, Snyder, KV, Siddiqui, AH, Hopkins, LN, Levy, EI. Endovascular management and treatment of acute ischemic stroke. Neurosurg Clin N Am 2014;25(3):583–92.CrossRefGoogle ScholarPubMed
6.Hassan, AE, Chaudhry, SA, Grigoryan, M, Tekle, WG, Qureshi, AI. National trends in utilization and outcomes of endovascular treatment of acute ischemic stroke patients in the mechanical thrombectomy era. Stroke 2012;43(11):3012–17.CrossRefGoogle ScholarPubMed
7.Broderick, JP, Palesch, YY, Demchuk, AM, Yeatts, SD, Khatri, P, Hill, MD, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med 2013;368(10):893903.CrossRefGoogle ScholarPubMed
8.Ciccone, A, Valvassori, L, Nichelatti, M, Sgoifo, A, Ponzio, M, Sterzi, R, et al. Endovascular treatment for acute ischemic stroke. N Engl J Med 2013;368(10):904–13.CrossRefGoogle ScholarPubMed
9.Demchuk, AM, Goyal, M, Yeatts, SD, Carrozzella, J, Foster, LD, Qazi, E, et al. Recanalization and clinical outcome of occlusion sites at baseline CT angiography in the Interventional Management of Stroke III Trial. Radiology 2014;273(1):202–10.CrossRefGoogle ScholarPubMed
10.Pereira, VM, Gralla, J, Davalos, A, Bonafe, A, Castano, C, Chapot, R, et al. Prospective, multicenter, single-arm study of mechanical thrombectomy using Solitaire Flow Restoration in acute ischemic stroke. Stroke 2013;44(10):2802–7.CrossRefGoogle ScholarPubMed
11.Saver, JL, Jahan, R, Levy, EI, Jovin, TG, Baxter, B, Nogueira, RG, et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet 2012;380(9849):1241–9.CrossRefGoogle ScholarPubMed
12.Janjua, N, Katzan, I, Badruddin, A, Nguyen, TN, Abou-Chebl, A, Zaidat, OO. Endovascular comprehensive stroke center designation parameters. Neurology 2012;79(13 Suppl 1):S239–42.CrossRefGoogle ScholarPubMed
13.Gorelick, PB. Primary and comprehensive stroke centers: history, value and certification criteria. J Stroke 2013;15(2):7889.CrossRefGoogle ScholarPubMed
14.Darkhabani, Z, Nguyen, T, Lazzaro, MA, Zaidat, OO, Lynch, JR, Fitzsimmons, BF, et al. Complications of endovascular therapy for acute ischemic stroke and proposed management approach. Neurology 2012;79(13 Suppl 1):S192–8.CrossRefGoogle ScholarPubMed
15.Larrue, V, von Kummer, R, Muller, A, Bluhmki, E. Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European-Australasian Acute Stroke Study (ECASS II). Stroke 2001;32(2):438–41.CrossRefGoogle Scholar
16.Tijssen, MP, Hofman, PA, Stadler, AA, van Zwam, W, de Graaf, R, van Oostenbrugge, RJ, et al. The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke. Eur Radiol 2014;24(4):834–40.CrossRefGoogle ScholarPubMed
17.Cloft, HJ, Jensen, ME, Kallmes, DF, Dion, JE. Arterial dissections complicating cerebral angiography and cerebrovascular interventions. AJNR Am J Neuroradiol 2000;21(3):541–5.Google ScholarPubMed
18.Turk, AS, Spiotta, A, Frei, D, Mocco, J, Baxter, B, Fiorella, D, et al. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg 2014;6(3):231–7.Google ScholarPubMed
19.Nguyen, TN, Malisch, T, Castonguay, AC, Gupta, R, Sun, CH, Martin, CO, et al. Balloon guide catheter improves revascularization and clinical outcomes with the Solitaire device: analysis of the North American Solitaire Acute Stroke Registry. Stroke 2014;45(1):141–5.CrossRefGoogle ScholarPubMed
20.Gupta, R, Vora, N, Thomas, A, Crammond, D, Roth, R, Jovin, T, et al. Symptomatic cerebral air embolism during neuro-angiographic procedures: incidence and problem avoidance. Neurocrit Care 2007;7(3):241–6.CrossRefGoogle ScholarPubMed
21.Schonewille, WJ, Algra, A, Serena, J, Molina, CA, Kappelle, LJ. Outcome in patients with basilar artery occlusion treated conventionally. J Neurol Neurosurg Psychiatry 2005;76(9):1238–41.CrossRefGoogle ScholarPubMed
22.Ferbert, A, Bruckmann, H, Drummen, R. Clinical features of proven basilar artery occlusion. Stroke 1990;21(8):1135–42.CrossRefGoogle ScholarPubMed
23.Schonewille, WJ, Wijman, CA, Michel, P, Rueckert, CM, Weimar, C, Mattle, HP, et al. Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol 2009;8(8):724–30.CrossRefGoogle ScholarPubMed
24.Arnold, M, Steinlin, M, Baumann, A, Nedeltchev, K, Remonda, L, Moser, SJ, et al. Thrombolysis in childhood stroke: report of 2 cases and review of the literature. Stroke 2009;40(3):801–7.CrossRefGoogle ScholarPubMed
25.Ellis, MJ, Amlie-Lefond, C, Orbach, DB. Endovascular therapy in children with acute ischemic stroke: review and recommendations. Neurology 2012;79(13 Suppl 1):S158–64.CrossRefGoogle ScholarPubMed
26.Di Carlo, A. Human and economic burden of stroke. Age Ageing 2009;38(1):45.CrossRefGoogle ScholarPubMed
27.Srinivasan, J, Miller, SP, Phan, TG, Mackay, MT. Delayed recognition of initial stroke in children: need for increased awareness. Pediatrics 2009;124(2):e227–34.CrossRefGoogle ScholarPubMed
28.Hu, YC, Chugh, C, Jeevan, D, Gillick, JL, Marks, S, Stiefel, MF. Modern endovascular treatments of occlusive pediatric acute ischemic strokes: case series and review of the literature. Childs Nerv Syst 2014;30(5):937–43.CrossRefGoogle ScholarPubMed
29.Monagle, P, Chalmers, E, Chan, A, DeVeber, G, Kirkham, F, Massicotte, P, et al. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):887S968S.CrossRefGoogle Scholar
30.Roach, ES, Golomb, MR, Adams, R, Biller, J, Daniels, S, Deveber, G, et al. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 2008;39(9):2644–91.CrossRefGoogle Scholar
31.Dubedout, S, Cognard, C, Cances, C, Albucher, JF, Cheuret, E. Successful clinical treatment of child stroke using mechanical embolectomy. Pediatr Neurol 2013;49(5):379–82.CrossRefGoogle ScholarPubMed
32.Kuhle, S, Male, C, Mitchell, L. Developmental hemostasis: pro- and anticoagulant systems during childhood. Semin Thromb Hemost 2003;29(4):329–38.Google ScholarPubMed
33.Glower, DD, Clements, FM, Debruijn, NP, Stafford-Smith, M, Davis, RD, Landolfo, KP, Smith, PK. Comparison of direct aortic and femoral cannulation for port-access cardiac operations. Ann Thorac Surg 1999;68:1529–31.CrossRefGoogle Scholar
34Bendock, BR, Przybylo, JH, Parkinson, R, Hu, Y, Awad, IA, Batjer, HH. Neuroendovascular interventions for intracranial posterior circulation disease via the transradial approach: technical case report. Neurosurgery 2005;56(3):E626.Google Scholar
35.Eskioglu, E, Burry, MV, Mericle, RA. Transradial approach for neuroendovascular surgery of intracranial vascular lesions. J Neurosurg 2004;101:767–9.CrossRefGoogle Scholar
36.Gritter, KJ, Laidlaw, WW, Peterson, NT. Complications of outpatient transbrachial intraarterial digital subtraction angiography: work in progress. Radiology 1987;162:125–7.CrossRefGoogle ScholarPubMed
37.Yip, KM, Yurianto, H, Lin, J. False aneurysm with median nerve palsy after iatrogenic brachial artery puncture. Postgrad Med J 1997;73:43–4.CrossRefGoogle Scholar
38.Zaldat, OO, Szeder, V, Alexander, MJ. Transbrachial stent-assisted coil embolization of right posterior inferior cerebellar artery aneurysm: technical case report. J Neuroimaging 2007;17(4):344–7.Google Scholar
39.Berkmen, T, Troffkin, N, Wakhloo, AK. Direct percutaneous puncture of a cervical internal carotid artery aneurysm for coil placement after previous incomplete stent-assisted endovascular treatment. AJNR Am J Neuroradiol 2003;24:1230–3.Google ScholarPubMed
40.Mandel, M, Dauchet, P. Radial artery cannulation in 1,000 patients: precautions and complications. J Hand Surg 1977;6:482–5.Google Scholar
41.Slogoff, S, Keats, AS, Arlund, C. On the safety of radial artery cannulation. Anesthesiology 1983;59:42–7.CrossRefGoogle ScholarPubMed
42.Saito, S, Miyake, S, Hosokawa, G, Tanaka, S, Kawamitsu, K, Kaneda, H, Ikei, H, Shiono, T. Transradial coronary intervention in Japanese patients. Catheter Cardiovasc Interv 1999;46:3742.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
43.Kiemeneij, F, Laarman, GJ, de Melker, E. Transradial artery coronary angioplasty. Am Heart J 1995;129:17.CrossRefGoogle ScholarPubMed
44.Lotan, C, Hasin, Y, Mosseri, M, Rozenman, Y, Admon, D, Nassar, H, Gotsman, MS. Transradial approach for coronary angiography and angioplasty. Am J Cardiol 1995;76:164–7.CrossRefGoogle ScholarPubMed
45.Mann, JT III, Cubeddu, G, Bowen, J, Schneider, JE, Arrowood, M, Newman, WN, Zellinger, MJ, Rose, GC. Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites. J Am Coll Cardiol 1998;32:572–6.CrossRefGoogle ScholarPubMed
46.Otaki, M. Percutaneous transradial approach for coronary angiography. Cardiology 1992;81:330–3.CrossRefGoogle ScholarPubMed
47.Scheinert, D, Brèaunlich, S, Nonnast-Daniel, B, Schroeder, M, Schmidt, A, Biamino, G, Daniel, WG, Ludwig, J. Transradial approach for renal artery stenting. Catheter Cardiovasc Interv 2001;54:442–7.CrossRefGoogle ScholarPubMed
48.Shuck, J, Khan, A, Cavros, N, Galanakis, S, Patel, V. Transradial renal angioplasty: initial experience. Catheter Cardiovasc Interv 2001;54:346–9.CrossRefGoogle ScholarPubMed
49.Benit, E, Missault, L, Eeman, T, Carlier, M, Muyldermans, L, Materne, P, Lafontaine, P, De Keyser, J, Decoster, O, Pourbaix, S, Castadot, M, Boland, J. Brachial, radial, or femoral approach for elective Palmaz-Schatz stent implantation: a randomized comparison. Cathet Cardiovasc Diagn 1997;41:124–30.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
50.Kiemeneij, F, Laarman, GJ, Odekerken, D, et al. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol 1997;29:1269–75.CrossRefGoogle ScholarPubMed
51.Levy, EI, Boulos, AS, Fessler, RD, Bendok, BR, Ringer, AJ, Kim, SH, Qureshi, AI, Guterman, LR, Hopkins, LN. Transradial cerebral angiography: an alternative route. Neurosurgery 2002;51:335–40.CrossRefGoogle Scholar
52.Iwasaki, S, Yokoyama, K, Takayama, K, et al. The transradial approach for selective carotid and vertebral angiography. Acta Radiol 2002;43:549–55.CrossRefGoogle ScholarPubMed
53.Nohara, AM, Kallmes, DF. Transradial cerebral angiography: technique and outcomes. AJNR Am J Neuroradiol 2003;24:1247–50.Google ScholarPubMed
54.Fessler, RD, Wakhloo, AK, Lanzino, G, Guterman, LR, Hopkins, LN. Transradial approach for vertebral artery stenting: technical case report. Neurosurgery 2000;46:1524–7.CrossRefGoogle ScholarPubMed
55.Yoo, BS, Lee, SH, Kim, JY, Lee, HH, Ko, JY, Lee, BK, Hwang, SO, Choe, KH, Yoon, J. A case of transradial carotid stenting in a patient with total occlusion of distal abdominal aorta. Catheter Cardiovasc Interv 2002;56:243–5.CrossRefGoogle Scholar
56.Levy, EI, Kim, SH, Bendok, BR, et al. Transradial stenting of the cervical internal carotid artery: technical case report. Neurosurgery 2003;53:448–52.CrossRefGoogle ScholarPubMed
57.Goldberg, SL, Renslo, R, Sinow, R, French, WJ. Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 1998;44:147–52.3.0.CO;2-6>CrossRefGoogle Scholar
58.Hildick-Smith, DJ, Lowe, MD, Walsh, JT, Ludman, PF, Stephens, NG, Schofield, PM, Stone, DL, Shapiro, LM, Petch, MC. Coronary angiography from the radial artery: experience, complications and limitations. Int J Cardiol 1998;64:231–9.CrossRefGoogle ScholarPubMed
59.Yokoyama, N, Takeshita, S, Ochiai, M, Koyama, Y, Hoshino, S, Isshiki, T, Sato, T. Anatomic variations of the radial artery in patients undergoing transradial coronary intervention. Catheter Cardiovasc Interv 2000;49:357–62.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
60.Yadav, JS, Wholey, MH, Kuntz, RE, et al. Protected carotid artery stenting versus endarterectomy in high-risk patients. N Engl J Med 2004;351(15):1493–501.CrossRefGoogle ScholarPubMed
61.Tong, FC, Cloft, HJ, Joseph, GJ, et al. Abciximab rescue in acute carotid stent thrombosis. AJNR Am J Neuroradiol 2000;21(9):1750–2.Google ScholarPubMed
62.Angelini, A, Reimers, B, Della Barbera, M, et al. Cerebral protection during carotid artery stenting: collection and histopathologic analysis of embolized debris. Stroke 2002;33(2):456–61.CrossRefGoogle ScholarPubMed
63.Bonaldi, G, Aiazzi, L, Baruzzi, F, et al. Angioplasty and stenting of the cervical carotid bifurcation under filter protection: a prospective study in a series of 53 patients. J Neuroradiol 2005;32(2):109–17.CrossRefGoogle Scholar
64.Kwon, OK, Kim, SH, Jacobsen, EA, et al. Clinical implications of internal carotid artery flow impairment caused by filter occlusion during carotid artery stenting. AJNR Am J Neuroradiol 2012;33(3):494–9.CrossRefGoogle ScholarPubMed
65.Castellan, L, Causin, F, Danieli, D, et al. Carotid stenting with filter protection. Correlation of ACT values with angiographic and histopathologic findings. J Neuroradiol 2003;30(2):103–8.Google ScholarPubMed
66.Iancu, A, Grosz, C, Lazar, A. Acute carotid stent thrombosis: review of the literature and long-term follow-up. Cardiovasc Revasc Med 2010;11(2):110–13.CrossRefGoogle ScholarPubMed
67.Jeong, MH, Owen, WG, Staab, ME, et al. Porcine model of stent thrombosis: platelets are the primary component of acute stent closure. Cathet Cardiovasc Diagn 1996;38(1):3843.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
68.Steiner-Boker, S, Cejna, M, Nasel, C, et al. Successful revascularization of acute carotid stent thrombosis by facilitated thrombolysis. AJNR Am J Neuroradiol 2004;25(8):1411–13.Google ScholarPubMed
69.Markatis, F, Petrosyan, A, Abdulamit, T, et al. Acute carotid stent thrombosis: a case of surgical revascularization and review of treatment options. Vascular 2012;20(4):217–20.CrossRefGoogle ScholarPubMed
70.Owens, EL, Kumins, NH, Bergan, JJ, et al. Surgical management of acute complications and critical restenosis following carotid artery stenting. Ann Vasc Surg. 2002;16(2):16875.CrossRefGoogle ScholarPubMed

Send book to Kindle

To send this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats