Endovascular Treatment of Acute Ischemic Stroke

The work in this thesis (through two randomized controlled trials (ESCAPE and SWIFT PRIME and a meta-analysis) helped make endovascular thrombectomy (EVT) the standard of care for acute ischemic stroke due to large vessel occlusion. In addition, analyses provided further proof of ‘time is brain’ and delineated factors that could influence workflow. Analysis of the imaging features demonstrated benefit of treatment in all evaluated subgroups including even those with sizeable infarcts at presentation (ASPECTS 3-5). The usefulness of an innovative imaging technique: multiphase CTA is presented and was shown to be as good or maybe even better than CT perfusion at patient selection. With EVT becoming standard of care, there needs to be better organization of stroke care. A mathematical model to help better understand how stroke care should be organized is presented in this thesis. This mathematical model is then further overlaid on actual geography using google maps.

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