Acute Ischemic Stroke Treatments

Aetna covers endovascular mechanical thrombectomy with a retrievable stent (e.g., Solitaire, Trevo) for acute ischemic stroke due to anterior circulation (MCA trunk/branches or ICA) occlusion when imaging shows salvageable tissue and the procedure is performed within 12 hours of onset, and it covers intra‑arterial infusion of spasmolytics or calcium‑channel blockers (e.g., papaverine, nicardipine) only for medically refractory symptomatic delayed cerebral ischemia (vasospasm) after aneurysmal subarachnoid hemorrhage, with CPT codes 37184/37185/61645 and specified ICD‑10 codes allowed if selection criteria are met (all eligible AIS patients should receive IV thrombolysis). Aetna considers intra‑arterial spasmolytic/CCB infusion experimental for other indications and deems acute stenting with tirofiban, Cerebrolysin, defibrinogen therapy (ancrod, batroxobin), and erythropoietin investigational for AIS.

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