To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.

 
 

Description

Purpose:

Large vessel occlusion (LVO) stroke is associated with high rates of morbidity and mortality, and patient outcomes are strongly influenced by rapid identification and timely reperfusion. Advances in acute neurovascular imaging have transformed stroke care by enabling precise patient selection, extending treatment windows, and accelerating clinical workflows. The purpose of this project is to evaluate how modern neurovascular imaging strategies influence treatment selection, workflow efficiency, and clinical outcomes in patients with acute LVO stroke.

Methods:

A narrative review of peer-reviewed literature published within the past decade was conducted. The review focused on CT-based imaging (non-contrast CT, CT angiography, CT perfusion), MRI techniques, quantitative imaging biomarkers, and workflow innovations including mobile stroke units and automated imaging analysis using artificial intelligence-based triage platforms. Major randomized trials, meta-analyses, and guideline statements were emphasized to assess outcome-driven applications of acute neurovascular imaging.

Results:

Rapid CT-based imaging remains the cornerstone of acute stroke triage due to widespread availability and speed. CT angiography reliably identifies LVOs, while perfusion imaging enables differentiation of ischemic core from salvageable penumbra, facilitating reperfusion therapy beyond traditional time windows. Advanced imaging selection has been associated with higher rates of functional independence and lower disability in late window thrombectomy populations. Imaging biomarkers, including infarct core volume, collateral status, and perfusion metrics, correlate with reperfusion success, hemorrhagic transformation risk, and long-term functional outcomes. Workflow innovations, including mobile stroke units and AI-based triage software, significantly reduce door-to-needle and door-to-puncture times, increasing access to reperfusion therapies and improving clinical outcomes.

Conclusions:

Modern acute neurovascular imaging directly impacts clinical outcomes by guiding reperfusion decisions and optimizing stroke workflows. Integration of advanced imaging techniques and system-level innovations is essential for improving functional and clinical outcomes in patients with LVO stroke and represents a critical component of precision stroke care.

Disciplines

Emergency Medicine | Interprofessional Education | Neurosciences | Neurosurgery | Radiology

Keywords

Large Vessel Occlusion, Acute Ischemic Stroke, Neurovascular Emergency, Endovascular Thrombectomy, Reperfusion Therapy, AI Triage, Workflow Optimization

Document Type

Poster

Download

Share

COinS
 

Imaging in Acute Neurovascular Emergencies: Optimizing Outcomes in Large Vessel Occlusion Stroke

Purpose:

Large vessel occlusion (LVO) stroke is associated with high rates of morbidity and mortality, and patient outcomes are strongly influenced by rapid identification and timely reperfusion. Advances in acute neurovascular imaging have transformed stroke care by enabling precise patient selection, extending treatment windows, and accelerating clinical workflows. The purpose of this project is to evaluate how modern neurovascular imaging strategies influence treatment selection, workflow efficiency, and clinical outcomes in patients with acute LVO stroke.

Methods:

A narrative review of peer-reviewed literature published within the past decade was conducted. The review focused on CT-based imaging (non-contrast CT, CT angiography, CT perfusion), MRI techniques, quantitative imaging biomarkers, and workflow innovations including mobile stroke units and automated imaging analysis using artificial intelligence-based triage platforms. Major randomized trials, meta-analyses, and guideline statements were emphasized to assess outcome-driven applications of acute neurovascular imaging.

Results:

Rapid CT-based imaging remains the cornerstone of acute stroke triage due to widespread availability and speed. CT angiography reliably identifies LVOs, while perfusion imaging enables differentiation of ischemic core from salvageable penumbra, facilitating reperfusion therapy beyond traditional time windows. Advanced imaging selection has been associated with higher rates of functional independence and lower disability in late window thrombectomy populations. Imaging biomarkers, including infarct core volume, collateral status, and perfusion metrics, correlate with reperfusion success, hemorrhagic transformation risk, and long-term functional outcomes. Workflow innovations, including mobile stroke units and AI-based triage software, significantly reduce door-to-needle and door-to-puncture times, increasing access to reperfusion therapies and improving clinical outcomes.

Conclusions:

Modern acute neurovascular imaging directly impacts clinical outcomes by guiding reperfusion decisions and optimizing stroke workflows. Integration of advanced imaging techniques and system-level innovations is essential for improving functional and clinical outcomes in patients with LVO stroke and represents a critical component of precision stroke care.