TY - JOUR T1 - Imaging, Intervention, and Workflow in Acute Ischemic Stroke: The Calgary Approach JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A4610 AU - C. Zerna AU - Z. Assis AU - C.D. d'Esterre AU - B.K. Menon AU - M. Goyal Y1 - 2015/12/10 UR - http://www.ajnr.org/content/early/2015/12/10/ajnr.A4610.abstract N2 - 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.AbbreviationsMR CLEANMulticenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the NetherlandsEMSEmergency Medical ServicesESCAPEEndovascular Treatment for Small Core and Proximal Occlusion Ischemic StrokeEXTEND-IAExtending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-ArterialREVASCATEndovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 HoursSWIFT-PRIMESolitaire With the Intention for Thrombectomy as Primary Endovascular Treatment ER -