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<meta name="DC.Title" content="Imaging, Intervention, and Workflow in Acute Ischemic Stroke: The Calgary Approach" />
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<meta name="DC.Description" content="SUMMARY: Five recently published clinical trials showed dramatically higher rates of favorable functional outcome and a satisfying safety profile of endovascular treatment compared with the previous standard of care in acute ischemic stroke with proximal anterior circulation artery occlusion. Eligibility criteria within these trials varied by age, stroke severity, imaging, treatment-time window, and endovascular treatment devices. This focused review provides an overview of the trial results and explores the heterogeneity in imaging techniques, workflow, and endovascular techniques used in these trials and the consequent impact on practice. Using evidence from these trials and following a case from start to finish, this review recommends strategies that will help the appropriate patient undergo a fast, focused clinical evaluation, imaging, and intervention.

MR CLEAN
:   Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands
EMS
:   Emergency Medical Services
ESCAPE
:   Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke
EXTEND-IA
:   Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial
REVASCAT
:   Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours
SWIFT-PRIME
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&lt;p&gt;Five recently published clinical trials showed dramatically higher rates of favorable functional outcome and a satisfying safety profile of endovascular treatment compared with the previous standard of care in acute ischemic stroke with proximal anterior circulation artery occlusion. Eligibility criteria within these trials varied by age, stroke severity, imaging, treatment-time window, and endovascular treatment devices. This focused review provides an overview of the trial results and explores the heterogeneity in imaging techniques, workflow, and endovascular techniques used in these trials and the consequent impact on practice. Using evidence from these trials and following a case from start to finish, this review recommends strategies that will help the appropriate patient undergo a fast, focused clinical evaluation, imaging, and intervention.&lt;/p&gt;" />
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MR CLEAN
:   Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands
EMS
:   Emergency Medical Services
ESCAPE
:   Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke
EXTEND-IA
:   Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial
REVASCAT
:   Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours
SWIFT-PRIME
:   Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment" />
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MR CLEAN
:   Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands
EMS
:   Emergency Medical Services
ESCAPE
:   Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke
EXTEND-IA
:   Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial
REVASCAT
:   Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours
SWIFT-PRIME
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">C. Zerna</span>, <span class="highwire-citation-author" data-delta="1">Z. Assis</span>, <span class="highwire-citation-author" data-delta="2">C.D. d'Esterre</span>, <span class="highwire-citation-author" data-delta="3">B.K. Menon</span> and <span class="highwire-citation-author" data-delta="4">M. Goyal</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">978-984; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4610 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14383--6879728693" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">C. Zerna </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BZerna%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zerna%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BZerna%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5969-8990" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Zerna</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Z. Assis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.%2BAssis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Assis%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AZ.%2BAssis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9907-4840" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Z. Assis</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.D. d'Esterre </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.D.%2Bd%27Esterre%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=d%27Esterre%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.D.%2Bd%2527Esterre%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5568-9325" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.D. d'Esterre</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">B.K. Menon </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.K.%2BMenon%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Menon%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.K.%2BMenon%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3466-496X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B.K. 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Goyal </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Calgary Stroke Program, Clinical Neurosciences, and Department of Radiology, University of Calgary, Calgary, Alberta, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BGoyal%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Goyal%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BGoyal%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9060-2109" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. 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      <div class="highwire-cite-title">Imaging, Intervention, and Workflow in Acute Ischemic Stroke: The Calgary Approach</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">978-984; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4610 </span></div>
  
  
  
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      <div class="highwire-cite-title">Imaging, Intervention, and Workflow in Acute Ischemic Stroke: The Calgary Approach</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Zerna</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Assis</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.D.</span> <span class="nlm-surname">d'Esterre</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">B.K.</span> <span class="nlm-surname">Menon</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Goyal</span></span></span></div>
  
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