Therapeutic Neuroradiology; Intra-Arterial Thrombolysis

Endovascular treatment for patients with acute ischemic stroke is rapidly evolving. Early efforts relied on direct infusion of fibrinolytic agents at the surface of the thrombus. More recently, mechanical devices for suction aspiration or clot retrieval have been introduced with very high technical success rates for recanalization. Randomized trial data proving clinical efficacy is lacking but several trials are underway. The optimal methods for patient selection (imaging and clinical criteria) remain to be determined. Endovascular intervention almost certainly will benefit a subset of patients presenting with acute ischemic stroke.