Question 1295
{"accessible":false,"alternatives":[{"id":6469,"text":"\u003e 6 hours since onset"},{"id":6470,"text":"intracerebral hemorrhage"},{"id":6471,"text":"ipsilateral cervical carotid stenosis or dissection"},{"id":6472,"text":"large ischemic core volume"},{"id":6473,"text":"prior intravenous thrombolysis (tPA)"}],"archived":false,"correctAlternativeId":6470,"explanation":"\u003cp\u003eIntracerebral hemorrhage is a contraindication to clot retrieval.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAlthough ideally all patients should be treated as early as possible, there are multiple trials (e.g. DAWN and DEFUSE3) showing that time since stroke alone is not an absolute contraindication to endovascular clot retrieval and that in some patients benefits can be obtained even at 24 hours.\u0026nbsp;\u003c/p\u003e\u003cp\u003eIpsilateral access stenosis can prove technically challenging but can be treated at the same time as clot retrieval.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAlthough large ischemic core volumes are likely to result in greater disability, there is evidence that patients with large volumes still benefit from clot retrieval.\u0026nbsp;\u003cbr\u003e\u003cbr\u003ePatients are often treated with intravenous tPA prior to clot retrieval, especially if they are being transferred from a center that does not offer clot retrieval.\u0026nbsp;\u003c/p\u003e","id":1295,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2096","nextQuestionPath":null,"relatedArticles":[{"id":13437,"title":"Ischemic stroke","link":"/articles/ischaemic-stroke?lang=us"}],"alsoUsedIn":[{"id":1182,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1182","link":"https://radiopaedia.org/courses/adult-neuroradiology-review-course/pages/1182"},{"id":1182,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1182","link":"https://radiopaedia.org/courses/adult-brain-mri-review-course-2015-online-video/pages/1182"}],"stem":"\u003cp\u003eWhich of the following is\u0026nbsp;the strongest contraindication to endovascular clot retrieval for the treatment of cerebral thromboembolic stroke?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1295"}],"attemptsPercentages":[{"alternativeId":"6473","percentage":3},{"alternativeId":"6471","percentage":10},{"alternativeId":"6469","percentage":5},{"alternativeId":"6472","percentage":28},{"alternativeId":"6470","percentage":54}],"promptToLogin":false,"questionManager":false,"articleId":"endovascular-clot-retrieval-ecr"}