Article ID: 10776
We reviewed literatures and guidelines for acute cerebrovascular imaging to perform acute reperfusion therapy in patients with Acute ischemic stroke (AIS). AIS is treatable with acute reperfusion therapy. Imaging evaluation by CT or MRI is essential for the diagnosis of AIS. We need to promptly determine whether AIS patients are candidates for acute reperfusion therapy with the minimum imaging evaluation. The American Heart Association/American Stroke Association (AHA/ASA) guideline 2018 recommended that brain imaging studies can be performed within 20 minutes of hospital arrival, but Japanese guideline do not recommend the time to brain imaging. MRI is available in most Japanese stroke centers. Immediate evaluation of large vessel occlusion is required to decide indications for mechanical thrombectomy. In selected AIS patients within 6 to 24 hours of last known normal, volumetric evaluation of ischemic core and/or perfusion imaging with CT or MRI is recommended to aid in patient selection for mechanical thrombectomy (the AHA/ASA guideline 2018). In Japan, perfusion imaging and automated imaging analysis are not commonly used so far. Development of diagnostic imaging guidelines for AIS to perform appropriate reperfusion therapy is expected in Japan.
