Fig. 1
From: An historical and contemporary review of endovascular therapy for acute ischemic stroke
Illustrative cases of difficult patients pushing boundaries of conventional therapeutic criteria: Advanced age and baseline function. Ninety-five year old male with known dementia – lives at home with his wife, ambulates independently but needs assistance with activities of daily living; pre-stroke mRS 3. Presents with a left MCA syndrome, NIHSS 22. Very early presentation with very favourable imaging – ASPECTS 9 on NCCT (a). Note the hyperdense right proximal MCA. CTA (b) confirmed a left M1 occlusion with a large clot extending along the M1 trunk into the M2 vessels. Good collaterals were present with a large mismatch on CT perfusion (c). The patient was treated with IVT - door to needle (DTN) time 32 min; onset to tPA treatment (OTT) time 74 min. Successful EVT recanalization at 150 min post stroke onset (d). A small deep infarct was present on DWI (e). Patient was discharged home on day 8 with NIHSS of 5 and was ambulating independently