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            <title xml:lang="en">Imaging Findings Following Mechanical Thrombectomy in Acute Ischemic Stroke</title>
            <title xml:lang="fr">L’Imagerie Post Thrombectomie Mécanique dans l’Accident Vasculaire Cérébral Ischémique</title>
            <author role="aut">
              <persName>
                <forename type="first">Julien</forename>
                <surname>Puntonet</surname>
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                <forename>MEDECINE</forename>
                <surname>UPC</surname>
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              <date type="whenSubmitted">2021-04-01 11:48:24</date>
              <date type="whenModified">2023-06-20 22:06:47</date>
              <date type="whenReleased">2021-09-02 12:44:35</date>
              <date type="whenProduced">2019-10-02</date>
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            <idno type="halRefHtml">Médecine humaine et pathologie. 2019</idno>
            <idno type="halRef">Médecine humaine et pathologie. 2019</idno>
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            <idno type="stamp" n="UNIV-PARIS5" corresp="UNIV-PARIS">Université Paris Descartes (Paris 5)</idno>
            <idno type="stamp" n="USPC">Université Sorbonne Paris Cité</idno>
            <idno type="stamp" n="DUMAS">DUMAS</idno>
            <idno type="stamp" n="UNIV-PARIS">Université Paris Cité</idno>
            <idno type="stamp" n="MEM-UNIV-UPCITE">Université Paris Cité</idno>
            <idno type="stamp" n="MEM-SANTE">LA SANTÉ DANS DUMAS</idno>
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                <title xml:lang="en">Imaging Findings Following Mechanical Thrombectomy in Acute Ischemic Stroke</title>
                <title xml:lang="fr">L’Imagerie Post Thrombectomie Mécanique dans l’Accident Vasculaire Cérébral Ischémique</title>
                <author role="aut">
                  <persName>
                    <forename type="first">Julien</forename>
                    <surname>Puntonet</surname>
                  </persName>
                  <idno type="halauthorid">2181562-0</idno>
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                  <biblScope unit="pp">56</biblScope>
                  <date type="dateDefended">2019-10-02</date>
                </imprint>
                <authority type="supervisor">Catherine Oppenheim</authority>
                <authority type="jury">Jean-François Meder</authority>
                <authority type="jury">Olivier Naggara</authority>
                <authority type="jury">Grégoire Boulouis</authority>
                <authority type="jury">Myriam Edjlali-Goujon</authority>
                <authority type="jury">Catherine Oppenheim</authority>
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              <language ident="fr">French</language>
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              <keywords scheme="author">
                <term xml:lang="en">CT</term>
                <term xml:lang="en">MRI</term>
                <term xml:lang="en">Imaging</term>
                <term xml:lang="en">Mechanical Thrombectomy</term>
                <term xml:lang="fr">AVC ischémique</term>
                <term xml:lang="fr">TDM</term>
                <term xml:lang="fr">IRM</term>
                <term xml:lang="fr">Imagerie</term>
                <term xml:lang="fr">Thrombectomie mécanique</term>
              </keywords>
              <classCode scheme="mesh">Mechanical Thrombolysis</classCode>
              <classCode scheme="mesh">Diagnostic Imaging</classCode>
              <classCode scheme="mesh">Magnetic Resonance Imaging</classCode>
              <classCode scheme="mesh">Depressive Disorder</classCode>
              <classCode scheme="mesh">Major</classCode>
              <classCode scheme="mesh">Stroke</classCode>
              <classCode scheme="halDomain" n="sdv.mhep">Life Sciences [q-bio]/Human health and pathology</classCode>
              <classCode scheme="halTypology" n="MEM">Master Thesis</classCode>
              <classCode scheme="halOldTypology" n="MEM">Master Thesis</classCode>
              <classCode scheme="halTreeTypology" n="MEM">Master Thesis</classCode>
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              <p>Mechanical thrombectomy (MT) therapy has become the standard of care for selected patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion. After MT, the scheme for follow-up brain imaging is currently similar to that for patients treated with intravenous thrombolysis (IVT) or medical treatment: it is performed emergently in cases of neurological worsening, and/or within 24 hours to detect hemorrhagic transformation, guide anti-thrombotic treatment regimen, and evaluate arterial patency and final infarct volume. Follow-up brain imaging findings nonetheless differ in patients who received MT from those who only received IVT, due to the arterial injection of iodine contrast in the target vessel, direct clot manipulations, and intracranial/cervical catheterization, as well as specific MT-related complications. Physicians managing AIS patients require an appropriate understanding of the varying imaging patterns after MT and their clinical relevance so as to optimize patient management and care-related decisions. Since MT has been the standard of care for less than 3 years, reports on imaging data following MT are scarce and guidelines on optimal post procedure imaging timing and modalities are lacking. Here, we provide a comprehensive, illustrated, overview of key early follow-up imaging findings after MT in AIS patients, discuss their clinical relevance and conclude with a discussion on advanced imaging techniques and research priorities in this field.</p>
            </abstract>
            <abstract xml:lang="fr">
              <p>Depuis 2015, la thrombectomie mécanique (TM) est le traitement de première ligne en cas d’infarctus cérébral sur occlusion proximale intracrânienne, en complément d’une thrombolyse intraveineuse lorsqu’indiquée. Les spécificités de la TM (manipulations intravasculaires, perforation, injection intra-artérielle de produit de contraste iodé) sont associées à des particularités d’imagerie lors du suivi des patients. La TM permet en outre dater précisément la revascularisation cérébrale, et ainsi de mieux comprendre les mécanismes ischémiques, de pénombre et de reperfusion. Ce travail reprend les principaux aspects, pathologiques ou non, retrouvés en scanner et en IRM dans les suites d'une TM en trois chapitres : imagerie vasculaire, parenchymateuse/sous arachnoïdienne et imagerie avancée. Les médecins impliqués dans la prise en charge de l’infarctus cérébral doivent connaître ces spécificités pour une meilleure optimisation de la prise en charge. Ils doivent ainsi reconnaître les complications (perforation vasculaire, dissection, …), les facteurs pronostiques (croissance de l’infarctus, reperméabilisation vasculaire), les situations complexes (hémorragie versus extravasation de produit de contraste, progression de l’ischémie malgré une recanalisation), et être au courant des possibilités de l’imagerie avancée (imagerie de paroi, perfusion) après TM.</p>
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