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Intra-arterial Treatment: Who and When

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Controversies in Vascular Neurosurgery

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Abstract

Stroke causes 9 % of all deaths around the world and is the second most common cause of death after ischemic heart disease [1]. In the United States of America, stroke is the fourth most common cause of death with approximately 795,000 strokes occurring per year at an estimated annual cost of $36.5 billion [2]. Up to 87 % of strokes are ischemic in nature and secondary to embolic or thrombotic etiologies [2] where large vessel occlusions (LVO) fare poorly, with basilar artery, internal carotid artery (ICA), and middle cerebral artery (MCA) occlusions having mortality rates of 50 %, 35 %, and 24 %, respectively [3]. Furthermore, the natural history of acute ischemic stroke (AIS) for patients with a National Institute of Health Stroke Scale (NIHSS) >10 is especially poor, and fewer than 25 % of patients will have a good clinical outcome (modified Rankin score (mRS) ≤2) [4]. As the incidence of stroke continues to increase in combination with greater awareness of the disease in the general population, new treatment options and expanding pathophysiological knowledge have allowed the medical community to delineate which patients benefit most from various treatment options currently available though many questions still remain.

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Author information

Authors and Affiliations

  1. Department of Neurological Surgery, Wake Forest University Baptist Medical Center, Winston Salem, NC, USA

    Hirad S. Hedayat MD (Chief Resident)

  2. Novant Healthcare Forsyth Medical Center, Winston Salem, NC, USA

    Rashid M. Janjua MD, MBA (Director of (Endo)Vascular and Skull Base Surgery)

Authors
  1. Hirad S. Hedayat MD
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  2. Rashid M. Janjua MD, MBA
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Corresponding author

Correspondence to Rashid M. Janjua MD, MBA .

Editor information

Editors and Affiliations

  1. Neuroscience Inst. Dept. of Neurosurgery, Drexel Univ. College of Medicine, Drexel, Philadelphia, Pennsylvania, USA

    Erol Veznedaroglu

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Hedayat, H.S., Janjua, R.M. (2016). Intra-arterial Treatment: Who and When. In: Veznedaroglu, E. (eds) Controversies in Vascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27315-0_16

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  • DOI: https://doi.org/10.1007/978-3-319-27315-0_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27313-6

  • Online ISBN: 978-3-319-27315-0

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