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Intra stent thrombosis

Wataro Tsuruta, Tetsuya Yamamoto, Go Ikeda, Masayuki Sato, Yoshiro Ito, Tomoji Takigawa, Aiki Marushima, Yasunobu Nakai, Yuji Matsumaru, Akira Matsumura
BACKGROUND: Endovascular surgery for vertebral artery dissections (VADs) carries the risk of spinal cord infarction (SCI). Although SCI in the region of the anterior spinal artery (ASA) has been reported, SCI in the region of the posterior spinal artery (PSA) is rare. OBJECTIVE: To investigate PSA infarction after endovascular surgery for VAD. METHODS: Infarction in the region of the PSA after endovascular surgery for VADs carried out in consecutive 21 cases was investigated...
March 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
Koji Kuroda, Toshiro Shinke, Hiromasa Otake, Hiroto Kinutani, Raisuke Iijima, Junya Ako, Hisayuki Okada, Yoshiaki Ito, Kenji Ando, Hitoshi Anzai, Hiroyuki Tanaka, Yasunori Ueda, Shin Takiuchi, Yasunori Nishida, Hiroshi Ohira, Katsuhiro Kawaguchi, Makoto Kadotani, Hiroyuki Niinuma, Kazuto Omiya, Takashi Morita, Kan Zen, Yoshinori Yasaka, Kenji Inoue, Sugao Ishiwata, Masahiko Ochiai, Toshimitsu Hamasaki, Kazushi Urasawa, Toru Kataoka, Minoru Yoshiyama, Kenshi Fujii, Takumi Inoue, Masahito Kawata, Hiroyoshi Yokoi, Masato Nakamura
Dual antiplatelet therapy (DAPT) with thienopyridine and aspirin is the standard care for the prevention of stent thrombosis. However, the optimal duration and effect of the duration of DAPT on intra-stent thrombus (IS-Th) formation are unknown. The NIPPON study (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was an open label, randomized multicenter, assessor-blinded, trial designed to demonstrate the non-inferiority of shorter (6-month) DAPT to prolonged (18-month) DAPT, after biolimus A9 eluting stent implantation in 3773 patients at 130 sites in Japan...
February 20, 2018: Heart and Vessels
Alejandro Santillan, Srikanth Boddu, Justin Schwarz, Ning Lin, Y Pierre Gobin, Jared Knopman, Athos Patsalides
Background and purpose This retrospective study evaluates the safety, effectiveness, and long-term clinical and angiographic follow-up of intracranial aneurysms treated with the Low-Profile Visualized Intraluminal Support Junior (LVIS Jr.) stent and parent vessels of diameter equal to or less than 2.5 mm. Materials and methods We included all patients treated with the LVIS Jr. stent in aneurysms with small parent vessel diameter between March 2015 and July 2017. Periprocedural adverse events, immediate aneurysm occlusion rates, and clinical and angiographic follow-up are reported...
January 1, 2018: Interventional Neuroradiology
H G Woo, L Sunwoo, C Jung, B J Kim, M-K Han, H-J Bae, Y J Bae, B S Choi, J H Kim
BACKGROUND AND PURPOSE: The Solitaire FR can be used not only as a tool for mechanical thrombectomy but also as a detachable permanent stent. Our aim was to assess the feasibility and safety of permanent stent placement with the Solitaire FR compared with other self-expanding stents for intracranial artery recanalization for acute ischemic stroke. MATERIALS AND METHODS: From January 2011 through January 2016, we retrospectively selected 2979 patients with acute ischemic stroke...
December 14, 2017: AJNR. American Journal of Neuroradiology
Philip Lindsey, Angela Echeverria, Mun J Poi, Jesus Matos, Carlos F Bechara, Mathew Cheung, Peter H Lin
BACKGROUND: This study evaluated the risk of thromboembolism during endovascular interventions in patients with symptomatic lower extremity deep vein thrombosis (DVT) METHODS: Clinical records of all patients who underwent endovascular interventions for symptomatic lower extremity DVT from 2001 to 2017 were retrospectively analyzed using a prospectively maintained database. Only patients who received an inferior vena cava (IVC) filter were included in the analysis. Trapped intrafilter thrombus was assessed for procedure-related thromboembolism...
November 29, 2017: Annals of Vascular Surgery
P Jiang, Y Song, J J Xu, Y L Ma, X F Tang, Y Yao, L Jiang, H H Wang, X Zhang, X L Diao, Y J Yang, R L Gao, S B Qiao, B Xu, J Q Yuan
Objective: To evaluate the relationship between platelet distribution width(PDW) and the extent of coronary artery disease and 2-year outcome in patients received percutaneous coronary artery intervention(PCI) because of stable coronary artery disease(SCAD). Methods: We consecutively enrolled 4 293 patients who received PCI because of SCAD in Fuwai Hospital from Jan 2013 to Dec 2013, patients were followed up for 2 years. Patients were divided into three groups according to tertiles values of PDW as follows: PDW≤11...
October 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
Surinder S Rana, Ravi Sharma, Sobur Uddin Ahmed, Rajesh Gupta
BACKGROUND: Acute necrotizing pancreatitis (ANP) is complicated with segmental portal hypertension (PHT) and formation of venous collaterals. Presence of collaterals in vicinity of endoscopic transmural tract can lead to potentially catastrophic situation. Here, we report safety and outcome of EUS-guided transmural drainage of walled-off pancreatic necrosis (WOPN) in patients with PHT and intra-abdominal collaterals. METHODS: Retrospective analysis of collected database of patients (n=18; age 40...
September 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Hongchen Zhao, Jinhua Zhang, Danyan Gu, Zongjie Shi, Jie Pan, Yu Geng, Tianming Shi
The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Tirofiban was injected intra-arterially via a temporarily deployed Solitaire stent with continuous intravenous infusion for the subsequent 24 h; half of the conventionally recommended dose was employed...
October 2017: Experimental and Therapeutic Medicine
Torin Karsonovich, Ajeet Gordhan
BACKGROUND: Pre-aneurysmal internal carotid steno-occlusive disease resulting in cerebral intra-aneurysmal thrombosis and subsequent embolic infarction has not been previously described. CONCLUSION: Antithrombotic treatment for dissolution of the thrombus and pre-aneurysmal stent angioplasty followed by Pipeline embolization flow diverter placement through the aneurysm is a safe and feasible management option.
2017: SAGE Open Medical Case Reports
Siang Lin Yeow, Hwa Liang Leo
A computational fluid dynamic model to assess the impact of flow-diverter device on intra-aneurysmal flow in complex aortic aneurysm from the viewpoint of hemodynamics is presented. The aim of this study is to investigate the hemodynamic effects of an endovascular flow-diverter technique using multiple overlapping uncovered stents (MOUS) in the treatment of complex aortic aneurysm involving side branch. The placement of porous barrier such as MOUS across the aneurysm alters the blood flow pattern in the aneurysm sac...
September 11, 2017: Artificial Organs
Hidde Jongsma, Patricia van Mierlo-van den Broek, Farshad Imani, Daniel van den Heuvel, Jean-Paul P M de Vries, Bram Fioole
The optimal endovascular treatment for femoropopliteal arterial occlusive disease has yet to be assessed. Patency rates after uncoated balloon angioplasty are disappointing. Although stents have better outcomes, they also have limitations. Intra-arterial stenting may lead to stent thrombosis and flow pattern disruption, which may result in stent fracture or in-stent restenosis. In the past decade, drug-eluting balloons (DEBs) and drug-eluting stents (DESs) have been introduced, and both have been proven to possess antirestenotic features compared with conventional techniques...
October 2017: Journal of Vascular Surgery
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
October 2017: European Journal of Vascular and Endovascular Surgery
J J Xu, Z Gao, Y Song, Y L Ma, X F Tang, Y Yao, C He, H H Wang, Y J Yang, R L Gao, S B Qiao, B Xu, J Q Yuan
Objective: To observe the impact and clinical outcome of intra-aortic balloon pump(IABP) use in patients underwent percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were enrolled.After 2 years' follow-up, the incidence of major adverse cardiovascular and cerebrovascular events such as death, myocardial infarction, stent thrombosis, revascularization, recurrent stroke were recorded, propensity score was used to match baseline data, and the clinical outcomes in patients with IABP and non-IABP were compared...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
José M Amorim, Santiago Rosati, Ronit Agid, Vítor Mendes Pereira, Timo Krings
Background Double lumen balloon catheters (DLBCs) are currently used in the treatment of intracranial aneurysms, especially when involving balloon or stent-assisted coiling. The existing DLBCs allow the delivery of self-expandable stents but do not offer the possibility to deploy flow-diverters. Despite the increasing use and success of flow-diverters, there have been numerous reports of procedural complications such as early in-stent thrombosis or delayed distal embolization. It seems that these complications can be avoided by correct stent positioning and adequate wall apposition, achieved either by manoeuvres with the microguidewire and/or microcatheter or by performing balloon angioplasty following an exchange guidewire manoeuvre...
June 2017: Interventional Neuroradiology
David Dornbos, Ciarán J Powers
The introduction of flow diverting stents, particularly for treatment of petrous to supraclinoid internal carotid artery aneurysms, has greatly impacted endovascular treatment of intracranial aneurysms. Despite their high efficacy, complications, such as ischemic events, distal hemorrhage, or problems with stent deployment, remain a significant concern. We present the first reported case of acute distal migration of a Pipeline Embolization Device (PED). A 24-year old female underwent elective placement of a PED for treatment of a left paraclinoid internal carotid artery aneurysm...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Harshavardhan B Rao, Hasim Ahamed, Suprabha Panicker, Surendran Sudhindran, Rama P Venu
AIM: To identify factors predicting outcome of endoscopic therapy in bile duct strictures (BDS) post living donor liver transplantation (LDLT). METHODS: Patients referred with BDS post LDLT, were retrospectively studied. Patient demographics, symptoms (Pruritus, Jaundice, cholangitis), intra-op variables (cold ischemia time, blood transfusions, number of ducts used, etc.), peri-op complications [hepatic artery thrombosis (HAT), bile leak, infections], stricture morphology (length, donor and recipient duct diameters) and relevant laboratory data both pre- and post-endotherapy were studied...
May 15, 2017: World Journal of Gastrointestinal Pathophysiology
Konstantinos G Moulakakis, John Kakisis, Georgios Tsivgoulis, Vasilis Zymvragoudakis, Stavros Spiliopoulos, Andreas Lazaris, Giorgos S Sfyroeras, Spyridon N Mylonas, Spyridon N Vasdekis, George Geroulakos, Elias N Brountzos
BACKGROUND: Acute early carotid stent thrombosis (AcuteCST) is a rare complication after carotid artery stenting (CAS). The purpose of this retrospective study was to investigate the incidence, causes, and optimal management of AcuteCST. METHODS: Medical records of all patients undergoing CAS between 2008 and 2016 were retrospectively reviewed. The time of thrombosis, grade of stenosis, lesion side, preprocedural and postprocedural anticoagulants, causes, symptoms, treatment, recanalization, and outcome were reviewed...
November 2017: Annals of Vascular Surgery
Aaron Fargion, Fabrizio Masciello, Giovanni Pratesi, Elena Giacomelli, Walter Dorigo, Carlo Pratesi
BACKGROUND: Only anecdotal cases concerning primary stenting of thrombosed popliteal artery aneurysm (PAA) without a preoperative intra-arterial thrombolysis are reported. We report our series of 6 patients treated with this technique. METHODS: Six male patients, aged between 63 and 88, came to our attention in the last 10 years for acute limb ischemia due to thrombosis of a PAA. In all the cases, immediate digital subtraction angiography was performed, the occlusion was crossed with an angiographic guidewire, and once an adequate distal landing zone was identified in the distal popliteal artery, a primary stenting was performed...
October 2017: Annals of Vascular Surgery
Ali Sultan-Qurraie, Gregory Rozansky, John Andrew Cox, Marc Lazzaro
Introduction The efficacy of the endovascular treatment of acute ischemic stroke has been substantiated by several recent randomized clinical trials. While intra-arterial therapy has significantly evolved in recent years, anatomic cerebrovascular variants and disease burden can present challenges to timely recanalization. We present the first reported case of anterior-to-posterior mechanical clot retrieval with use of a stent retriever. Case description A 53-year-old man presented with basilar artery thrombosis...
August 2017: Interventional Neuroradiology
Takao Sato, Ralph Tölg, Mohamed El-Mawardy, Dmitriy S Sulimov, Gert Richardt, Mohamed Abdel-Wahab
BACKGROUND: Incomplete stent apposition (ISA) can be divided into acute and late forms. Late ISA may be due to persistent ISA or late-acquired ISA (LAISA). This study evaluated the natural course of ISA after bioresorbable vascular scaffold (BRS) implantation using optical coherence tomography (OCT). METHODS: Thirty-two patients (45 BRS) were assessed immediately after BRS implantation and 1 year thereafter using OCT. Acute ISA identified after BRS implantation but absent at follow-up was defined as resolved; otherwise, it was considered persistent...
November 2017: Journal of Cardiology
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