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Intra stent thrombosis

Giancarlo Nicosia, Domenico Cicala, Giuseppe Mirone, Pietro Spennato, Vincenzo Trischitta, Claudio Ruggiero, Gianluigi Guarneri, Mario Muto, Giuseppe Cinalli
INTRODUCTION: Acute basilar artery occlusion (ABAO) is an infrequent but potentially fatal cause of strokes in both adults and children, and it is usually due to vertebral artery dissection (VAD). VAD has been found to be usually a consequence of traumatic vertebral artery injury. ABAO usually presents with symptoms of acute ischemic stroke (AIS) of the posterior circulation or transient ischemic attack (TIA). It may lead to death or long-term disability if not promptly recanalized. Basilar artery recanalization in children can be achieved safely and with excellent clinical outcome using endovascular thrombectomy with the new generation self-expanding and retrievable stents...
October 4, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Pierre Maitrias, Gwendoline Deltombe, Valérie Molin, Thierry Reix
OBJECTIVE: Iliofemoral endarterectomy with external iliac artery (EIA) stent grafting can be an alternative to traditional open surgery in patients with severe iliac occlusive disease extending to the common femoral artery. We report the midterm outcomes of this approach. METHODS: Between 2009 and 2015, 108 patients (76% male; median age, 63 years) underwent a total of 127 iliofemoral endarterectomies combined with EIA stent grafting. Indications were claudication in 60%, rest pain in 20%, ulceration in 15%, and acute ischemia in 5%...
September 29, 2016: Journal of Vascular Surgery
Shan Zhong, Xiquan Zhang, Zhong Chen, Peng Dong, Yequan Sun, Wei Zhu, Xiaolin Pan, Deming Qi
OBJECTIVE: To evaluate the feasibility and effectiveness of endovascular repair for blunt popliteal arterial injuries. MATERIALS AND METHODS: A retrospective analysis of seven patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2009 to July 2014. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, instrument utilized, and follow-up...
September 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Paul-Emile Labeyrie, Benjamin Gory, Udi Sadeh-Gonike, Nazyed Huguet, Rotem Sivan-Hoffmann, Roberto Riva, Patrick Courthéoux, Francis Turjman
BACKGROUND AND PURPOSE: Flow-diverter stents (FDS) are new devices for the endovascular treatment of intracranial aneurysms (IAs) promoting progressive aneurysmal thrombosis. To date, the delay of aneurysmal exclusion remains unclear. We evaluated the correlation between angiographic changes in the first 24 hours and 12-month occlusion in aneurysms treated with FDS. METHODS: We retrospectively analyzed the intra-aneurysmal flow by evaluating the in-flow and out-flow delays on preoperative, immediate postoperative, 24-hour and 12-month follow-up angiography...
August 10, 2016: Interventional Neuroradiology
Qing-Hui Yang, Wen Zhang, Qing-Xin Liu, Ling-Xiao Liu, Lin-Lin Wu, Jian-Hua Wang, Zhi-Ping Yan, Jian-Jun Luo
PURPOSE: This study was designed to evaluate the safety and efficacy of transarterial chemoembolization (TACE) combined with intra-IVC implantation of an irradiation stent for the treatment of hepatocellular carcinoma (HCC) complicated by inferior vena cava tumor thrombosis (IVCTT). METHODS: Sixty-one consecutive patients with HCC complicated by IVCTT treated by TACE combined with IVC stenting were retrospectively analysed. IVC stenting was performed using a stent loaded with (125)I seeds strands (the irradiation stent) in 33 patients (Group A) and 28 patients with a bare stent (Group B)...
September 2016: Cardiovascular and Interventional Radiology
Guilherme Cabral de Andrade, Helvercio P Alves, Valter Clímaco, Eduardo Pereira, Alexandre Lesczynsky, Michel E Frudit
Intracranial circumferential fusiform aneurysms of the posterior circulation involving arterial branches or perforating vessels are difficult to treat. This article shows an endovascular reconstruction technique not yet described, using a telescoping self-expandable stent (LEO+) and flow-diverter device (SILK) at different surgical times. Two patients with circumferential fusiform aneurysm, one being an aneurysm of the segments P2 and P3 of the posterior cerebral artery, diagnosed after a headache, and the other a partially thrombosed aneurysm of the lower basilar artery, diagnosed following ischemia of the brain stem...
October 2016: Interventional Neuroradiology
Marc Laine, Corinne Frere, Thomas Cuisset, Franck Paganelli, Pierre-Emmanuel Morange, Francoise Dignat-George, Julie Berbis, Laurence Camoin-Jau, Laurent Bonello
BACKGROUND: Clinical trials have demonstrated an excess of acute stent thrombosis (AST) in acute coronary syndromes patients (ACS) undergoing percutaneous coronary intervention (PCI) with bivalirudin compared to heparin. We aimed to investigate the potential mechanisms responsible for thrombus formation under bivalirudin. METHODS: We compared heparin and bivalirudin during PCI for ACS in a prospective monocentre randomized study. Twenty patients were included after coronary angiography and received a loading dose (LD) of 180mg of ticagrelor at the time of PCI...
October 1, 2016: International Journal of Cardiology
Erhan Tenekecioglu, Christos V Bourantas, Mohammad Abdelghani, Yohei Sotomi, Pannipa Suwannasom, Hiroki Tateishi, Yoshinobu Onuma, Mustafa Yılmaz, Patrick W Serruys
INTRODUCTION: With new developments in percutaneous coronary intervention (PCI), such as the introduction of bioresorbable scaffolds (BRS), percutaneous treatment of coronary artery diseases has entered a new era. Without metallic remnants, BRSs appear able to overcome several limitations of the existing metallic stents and provide a physiologic treatment of coronary artery pathology. AREAS COVERED: BRS have different mechanical properties compared to the traditional metallic stents that should be taken into account during their implantation...
September 2016: Expert Review of Cardiovascular Therapy
Fernando Alfonso, María José Pérez-Vizcayno, Bruno García Del Blanco, Imanol Otaegui, Mónica Masotti, Javier Zueco, Maite Veláquez, Juan Sanchís, Arturo García-Touchard, Rosa Lázaro-García, José Moreu, Armando Bethencourt, Javier Cuesta, Fernando Rivero, Alberto Cárdenas, Nieves Gonzalo, Pilar Jiménez-Quevedo, Cristina Fernández
OBJECTIVES: The aim of this study was to compare the long-term efficacy of everolimus-eluting stents (EES) and drug-eluting balloons (DEB) in patients with bare-metal stent in-stent restenosis (ISR). BACKGROUND: The relative long-term clinical efficacy of current therapeutic modalities in patients with ISR remains unknown. METHODS: The 3-year clinical follow-up (pre-specified endpoint) of patients included in the RIBS V (Restenosis Intra-Stent of Bare-Metal Stents: Drug-Eluting Balloon vs Everolimus-Eluting Stent Implantation) randomized clinical trial was analyzed...
June 27, 2016: JACC. Cardiovascular Interventions
G Galasso, M Mirra, G De Luca, F Piscione
Acute coronary syndrome (ACS) represents the most common cause of death worldwide. Percutaneous coronary intervention (PCI) is the management of choice in patients with ACS and occurrence of intra-procedural thrombotic complications are an independent predictor of mortality and other major adverse cardiovascular events in patients undergoing PCI. According to current guideline, anticoagulation therapy is indicated during PCI in order to reduce the risk of thrombotic complications such as stent thrombosis. Among currently available anticoagulant drugs, bivalirudin demonstrates a lower incidence of bleeding risk, despite it is associated with an increased risk of stent thrombosis...
May 2016: Translational Medicine @ UniSa
Y Murata, S Mizuno, H Kato, A Tanemura, N Kuriyama, Y Azumi, M Kishiwada, M Usui, H Sakurai, M Fujimori, T Yamanaka, A Nakatsuka, K Yamakado, S Isaji
OBJECTIVES: Hepatic artery thrombosis (HAT) is a serious complication after living-donor liver transplantation (LDLT) leading to patient death in the absence of revascularization. With the recent advances in interventional radiology, interventional endovascular techniques have been used as alternative therapeutic options for HAT. This study evaluates the feasibility and clinical outcomes of endovascular treatment for HAT after LDLT. METHODS: The medical records of 120 patients who underwent adult-to-adult LDLT between February 2002 and February 2015 in our hospital were retrospectively reviewed to evaluate the frequency of HAT and outcomes of endovascular treatment...
May 2016: Transplantation Proceedings
Sayal Parag, Zafar Arif, Rajaraman Chittoor
BACKGROUND: Radiotherapy-related intracranial aneurysms are a recognized but rare phenomenon and often present following rupture leading to subarachnoid hemorrhage. Treatment poses a particular dilemma and both endovascular, and surgical approaches have been used with varied success. We present the case of a radiotherapy-related aneurysm treated conservatively with a favorable outcome. CASE DESCRIPTION: A 37-year-old man was diagnosed with a left temporal lobe mass for which he underwent an uneventful craniotomy and debulking...
2016: Surgical Neurology International
Anna Mara Scandroglio, Friedrich Kaufmann, Marina Pieri, Alexandra Kretzschmar, Marcus Müller, Panagiotis Pergantis, Stephan Dreysse, Volkmar Falk, Thomas Krabatsch, Evgenij V Potapov
BACKGROUND: Thrombosis is an uncommon, but severe complication of left ventricular assist devices (LVADs). OBJECTIVES: This study analyzed experience with obstruction of blood flow through the LVAD with the purpose of developing optimal diagnosis and treatment of LVAD-related thrombosis. METHODS: Between October 2009 and July 2015, a total of 652 LVAD were implanted in 557 patients. Blood flow abnormalities in patients with LVAD (n = 524) were identified and classified as "high-power" and "low-flow" events...
June 14, 2016: Journal of the American College of Cardiology
Hidenori Oishi, Kosuke Teranishi, Senshu Nonaka, Munetaka Yamamoto, Hajime Arai
Flow diversion stents (FDSs) are constructed from high-density braided mesh, which alters intra-aneurysmal hemodynamics and leads to aneurysm occlusion by inducing thrombus formation. Although there are potential complications associated with FDS embolization, one of the serious complications is the parent artery occlusion due to the in-stent thrombosis. A 72-year-old woman with a symptomatic giant fusiform aneurysm in the cavernous segment of ICA underwent single-layer pipeline embolization device (PED) embolization...
June 15, 2016: Neurologia Medico-chirurgica
Fawaz Al-Mufti, Krishna Amuluru, Chirag D Gandhi, Charles J Prestigiacomo
Endovascular treatment of intracranial aneurysms with complex morphologies such as giant, wide-necked, or fusiform aneurysms is challenging. Stent-assisted coiling and balloon-assisted coiling are alternative techniques to treat such complex aneurysms, but studies have shown less-than-expected efficacy, as suggested by their high rate of recanalization. The management of complex aneurysms via microsurgery or conventional neuroendovascular strategies has traditionally been poor. However, over the last few years, flow-diverting stents (FDS) have revolutionized the treatment of such aneurysms...
July 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Ju-Hua Gao, Xiao-Ping Gao, Su-Yue Pan
OBJECTIVE: To investigate whether intensive statin therapy during the perioperative period improves outcomes in patients undergoing middle cerebral artery (MCA) stent implantation for ischemic stroke. METHODS: Forty patients with ischemic stroke undergoing delayed stent implantation in our department from January, 2010 to November, 2014 were randomized to intensive statin group (atorvastatin, 80 mg/day, 3 days before till 3 days after intervention; n=20) and standard therapy group (atorvastatin, 20 mg/day, n=20)...
March 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Khalid Bin Thani, Fajer Al-Moosa, Eman Murad, Aisha Al-Moosa, Mohamed E Alalawi, Hind Al-Sindi
MAIN PROBLEM: To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI). METHODS: An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years...
2015: Open Cardiovascular Medicine Journal
Won Yu Kang, Umberto Campia, Nelson Lim Bernardo, Romain J Didier, Smita I Negi, Sarkis Kiramijyan, Edward Koifman, Nevin C Baker, Michael J Lipinski, Ricardo O Escarcega, Rebecca Torguson, Ron Waksman
PURPOSE: To report a case of a thrombosed GORE® VIABAHN® endoprosthesis stent-graft in the femoral artery (SFA) and popliteal artery managed using the pulse-spray technique and complicated by compartment syndrome of the lower leg of the affected limb. CASE REPORT: A 61-year-old woman with three Viabahn stent grafts relining seven bare-metal stents in her right SFA and popliteal artery visited our hospital with complaint of recurrent lifestyle-limiting claudication of right leg...
March 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Mathieu Lempereur, Nigussie Bogale, Peter Fahmy, Imran Shiekh, Andrew Starovoytov, Eve Aymong, Robert Boone, Simon Robinson, Jahangir Charania, Richard Townley, Christopher Thompson, Andrew Kmetic, Lillian Ding, Anthony Fung
BACKGROUND: Stent thrombosis (ST) is rare, but is associated with significant morbidity and mortality. METHODS: We analyzed data from the British Columbia (BC) Registry from April 2011-January 2012. RESULTS: 101 ST cases were reported and verified. Based on timing, ST was considered early (≤30days) in 35.6%, late (>30days-1year) in 17.8% and very late (>1year) in 46.5%. The majority (68.5%) presented with STEMI, and the remaining with non-STEMI (31...
March 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Rafik Ouared, Ignacio Larrabide, Olivier Brina, Pierre Bouillot, Gorislav Erceg, Hasan Yilmaz, Karl-Olof Lovblad, Vitor Mendes Pereira
BACKGROUND AND PURPOSE: Flow-diverter stents (FDSs) have been used effectively to treat large neck and complex saccular aneurysms on the anterior carotid circulation. Intra-aneurysmal flow reduction induces progressive aneurysm thrombosis in most patients. Understanding the degree of flow modification necessary to induce complete aneurysm occlusion among patients with considerable hemodynamics variability may be important for treatment planning. MATERIALS AND METHODS: Patients with incidental intracranial saccular aneurysms who underwent FDS endovascular procedures were included and studied for a 12 months' follow-up period...
February 15, 2016: Journal of Neurointerventional Surgery
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