Page 49 - Inaugural Lecture Prof Dr Ahmad Sobri Muda

Ahmad Sobri Muda

Neurointervention in Acute Stroke

For a long time, stroke has been part of diagnostic neurology without
much involvement with image-guided procedures, neurointervention.
Recent studies show a significantly good outcome if the clot can
be removed within time to restore the perfusion affected by large
vessel occlusions, bringing neurointerventional procedures as one
of the important treatment options in selected cases with large
vessel occlusion. In early years of endovascular treatment of brain
aneurysms, the majority of morbidity and mortality resulting from
intraprocedural complications are related to stroke. When a patient
developed large vessel occlusion (LVO) during an endovascular
procedure, the neurointerventionalists were subjected to a bail-out
thrombectomy using an aneurysm stent to retrieve the clot. This
gives experience with the stent retriever to reperfuse and remove
the clot causing LVO. Early advocates pushing for thrombectomy
using stent to retrieve the clot in large vessel occlusion as early
concept of aspiration not successful (Cognard et. al 2012).

Figure 15 Coiling procedure showing coil mass and stent in a
stent-assisted technique.

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