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https://www.readbyqxmd.com/read/29303110/-role-of-thrombectomy-in-acute-ischemic-stroke
#1
Albert Pall Sigurdsson
This article discusses endovascular thrombectomy in acute ischemic stroke. This treatment is vascular medicine's most significant leap in years. This treatment is complicated, and various technical aspects are discussed. Close cooperation is required between different specialties since patient selection for treatment is complex. Interventionists need close collaboration with stroke neurologists. Government needs to be involved as this treatment mandates structural changes which will incur more manpower and financial resources...
January 2018: Læknablađiđ
https://www.readbyqxmd.com/read/29298651/is-atherothromboaspiration-a-possible-solution-for-the-prevention-of-no-reflow-phenomenon-in-acute-coronary-syndromes-single-centre-experience-and-review-of-the-literature
#2
Antonis S Manolis
BACKGROUND: Intracoronary thrombus in acute myocardial infarction (MI) confers higher rates of no-reflow with attendant adverse consequences. Earlier randomized-controlled-trials (RCTs) of routine thromboaspiration during percutaneous coronary intervention (PCI) indicated a clinical benefit, but more recent RCTs were negative. However, data of selective use of this adjunctive approach remain scarce. OBJECTIVE: The aim of this single-centre prospective study was to report the results of selective thromboaspiration during PCI in patients with intracoronary thrombi, and also to provide an extensive literature review on current status of thromboaspiration...
January 1, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29279816/when-ablation-is-not-the-answer-acute-left-main-thrombosis-causing-incessant-ventricular-tachycardia-following-left-ventricular-assist-device-implant
#3
Mohammad K Mojadidi, Ahmed N Mahmoud, Akram Y Elgendy, R David Anderson
Ventricular arrhythmia from aortic cusp thrombosis and coronary embolization is a rare complication of left ventricular assist device (LVAD) implantation. In this report, we present a case of acute left main and left anterior descending artery occlusion from embolic aortic cusp thrombi after LVAD implant. The patient presented with chest pain and incessant ventricular tachycardia post-LVAD implant. This was successfully treated by intracoronary thrombolysis, aspiration thrombectomy, and rheolytic thrombectomy...
October 21, 2017: Curēus
https://www.readbyqxmd.com/read/29279529/optical-frequency-domain-imaging-of-very-late-stent-thrombosis-following-bare-metal-stent-implantation-for-acute-myocardial-infarction
#4
Shinichiro Masuda, Takashi Shibui, Ryuki Kawamura, Hitoshi Saiki, Akihiro Hata
A 43-year-old man was admitted to our hospital with ST-segment elevation acute coronary syndrome. He had experienced myocardial infarction 19 months previously, and a bare-metal stent (BMS) had been implanted in the culprit distal right coronary artery at another hospital. Emergency coronary angiography showed thrombotic in-stent occlusion of the BMS. Intravascular ultrasound revealed an undersized stent compared with the size of the vessel and late stent malapposition (LSM) with abundant thrombi. The lesion was successfully recanalized via thrombectomy and plain old balloon angioplasty...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29275878/microcatheter-facilitated-primary-angioplasty-in-st-segment-elevation-myocardial-infarction
#5
Guy Achkouty, Jean-Guillaume Dillinger, Georgios Sideris, Stephane Manzo-Silberman, Sebastian Voicu, Benoit Merat, Damien Logeart, Patrick Henry
BACKGROUND: Direct stenting is the best method for achieving reperfusion in primary percutaneous coronary intervention (PPCI). We hypothesized that the use of a microcatheter (MC) during PPCI when Thrombolysis in Myocardial Infarction (TIMI) flow ≤ 1 after wire crossing would allow visualization of the downstream artery with an optimal TIMI 3 flow at the end of the procedure. METHODS: In this pilot study, PPCI patients with TIMI flow ≤ 1 after wire crossing formed the MC group (n = 60); the MC was positioned in the distal part of the culprit artery and a small amount of contrast was injected through it to determine stent size and length to treat the culprit lesion...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29249300/incidence-and-etiological-mechanism-of-stroke-in-cardiac-surgery
#6
J M Arribas, E Garcia, R Jara, F Gutierrez, L Albert, D Bixquert, J García-Puente, C Albacete, S Canovas, A Morales
OBJECTIVE: We studied patients who had experienced a stroke in the postoperative period of cardiac surgery, aiming to analyse their progression and determine the factors that may influence prognosis and treatment. METHODS: We established a protocol for early detection of stroke after cardiac surgery and collected data on stroke onset and a number of clinical, surgical, and prognostic variables in order to perform a descriptive analysis. RESULTS: Over the 15-month study period we recorded 16 strokes, which represent 2...
December 14, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29247157/a-case-of-subacute-bioresorbable-vascular-scaffold-thrombosis-what-was-wrong
#7
Seraj A Abualnaja, Hanan M Alrammah, Bayan A Alsaif, Malak O Almulla, Bayan A Alzahrani
BACKGROUND The introduction of bioresorbable vascular scaffolds (BVS) into the field of percutaneous coronary intervention (PCI) was thought to be a promising step in solving the issues raised with the use of early bare metal stents (BMS) and drug eluting stents (DES); however, studies have raised concerns regarding thrombosis risk associated with the use of these stents. CASE REPORT A 42-year-old male presented with acute coronary syndrome (ACS), on diagnostic coronary angiography he had 75% and 70% stenosis in mid and distal left anterior descending artery (LAD) respectively, PCI with BVS implantation was done...
December 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29238362/combined-thrombectomy-and-intracoronary-administration-of-glycoprotein-iib-iiia-inhibitors-improves-myocardial-reperfusion-in-patients-undergoing-primary-percutaneous-coronary-intervention-a-meta-analysis
#8
Xiao-Wei Niu, Jing-Jing Zhang, Ming Bai, Yu Peng, Zheng Zhang
Background: Suboptimal myocardial reperfusion is common in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Furthermore, it results in increased infarct size and mortality rates. We performed a meta-analysis to evaluate the role of aspiration thrombectomy (AT) combined with intracoronary administration of glycoprotein IIb/IIIa inhibitors (GPI) in the improvement of myocardial reperfusion and clinical outcomes...
October 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29153812/surgical-management-of-extensive-perinatal-myocardial-infarction
#9
Stephanie Perrier, Alice Parker, Christian P Brizard, Bennett Sheridan, Igor E Konstantinov, Yves d'Udekem, Johann Brink
Extensive perinatal myocardial infarction caused by coronary artery thrombosis is extremely rare and has a dismal prognosis. We report a 3.5-kg neonate who presented at birth with an extensive myocardial infarction caused by aortic root and left main coronary artery thrombus after an emergency cesarean section. We performed emergency surgical thrombectomy and insertion of extracorporeal membrane oxygenation support. After subsequent conversion to long-term left ventricular assist device with an EXCOR device (Berlin Heart, Berlin, Germany), the patient had no ventricular recovery after 163 days of support...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29114095/direct-mechanical-intervention-versus-bridging-therapy-in-stroke-patients-eligible-for-intravenous-thrombolysis-a-pooled-analysis-of-2-registries
#10
COMPARATIVE STUDY
Sebastian Bellwald, Ralph Weber, Tomas Dobrocky, Hannes Nordmeyer, Simon Jung, Jeffrie Hadisurya, Pasquale Mordasini, Marie-Luise Mono, Christian P Stracke, Hakan Sarikaya, Corrado Bernasconi, Klaus Berger, Marcel Arnold, René Chapot, Jan Gralla, Urs Fischer
BACKGROUND AND PURPOSE: Randomized controlled trials have shown that mechanical thrombectomy (MT) plus best medical treatment improves outcome in stroke patients with large-vessel occlusion in the anterior circulation. Whether direct MT is equally effective as bridging thrombolysis (intravenous thrombolysis plus MT) in intravenous thrombolysis eligible patients remains unclear. METHODS: We compared clinical and radiological outcomes at 3 months in 249 bridging patients with 111 patients receiving direct MT for large-vessel occlusion anterior circulation stroke from 2 prospective registries (study period Essen: June 2012 to August 2013, Bern February 2009 to August 2014)...
December 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29113867/clinical-significance-of-intracoronary-thrombus-aspirated-during-primary-percutaneous-intervention-an-immunohistopathological-study
#11
Neeraj Parakh, Basavaraj Utagi, Sudhir Arava, Sunil Verma, Ganesan Karthikeyan, Sandeep Singh, Balram Bhargava, Ruma Ray, Chetan D Patel, Vinay K Bahl
BACKGROUND: Manual thrombus aspiration during primary percutaneous intervention provides us with aspirated thrombus sample, that may contain material from the disrupted plaque. Immunohistopathological analysis of thrombus can yield valuable information about the clinical and cardiovascular outcomes and possible mechanisms of myocardial infarction. MATERIAL AND METHODS: We studied and analysed the immunohistopathological features of coronary thrombus aspirated from patients undergoing primary percutaneous coronary angioplasty...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29103567/-difficulty-in-diagnosis-of-a-cardiogenic-shock-with-thrombotic-and-sub-occluded-lad-a-train-can-hide-another-one
#12
R Cheaito, A Tritar, H Benamer, M Saighi Bouaouina, A Masri, M A Bouzid, M Younes, H Mansour, P Jessen
The pheochromocytome is a localized tumor at the level of the medullosurrenale in 85% of the cases. The clinical presentation is very variable. Severe Heart failure presentation can be the mode of revelation in 2% of the cases. We present the case of a patient admitted for refractory cardiogenic shock correlated to pheochromocytome tumor. The difficulty of this rare clinical presentation was to confirm rapidly and in emergency this diagnosis in the same time when the patient presents a persistante and severe cardiogenic chock after finding a sub-occluded and thrombotic LAD coronary artery and which was treated by thrombectomy and coronary revascularization...
November 2, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29084042/a-comparison-of-intracoronary-treatment-strategies-for-thrombus-burden-removal-during-primary-percutaneous-coronary-intervention-a-coctail-ii-substudy
#13
Laura Gatto, Alessio Di Landro, Enrico Romagnoli, Valeria Marco, Chiara Russo, Tomasz Pawlowski, Francesco Versaci, Ugo Limbruno, Fausto Castriota, Luca Di Vito, Antonio Trivisonno, Francesco Prati
BACKGROUND: Manual thrombus aspiration and local drug delivery of abciximab have been proposed as a strategy to reduce thrombus burden during percutaneous coronary intervention in patients with ST elevation myocardial infarction; however, the effectiveness of these approaches, is uncertain. In this COCTAIL II substudy, we compared the effect of these strategies on prestenting and poststenting thrombus burden assessed by optical coherence tomography. PATIENTS AND METHODS: COCTAIL II trial enrolled patients with ST elevation myocardial infarction randomized to intralesion (IL, by the ClearWay catheter) versus intracoronary (IC, by the guide catheter) abciximab bolus with or without aspiration thrombectomy (AT)...
October 27, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29042400/thrombus-aspiration-for-st-segment-elevation-myocardial-infarction-in-modern-era-still-an-issue-of-debate
#14
REVIEW
Junhua Ge, Andreas Schäfer, Georg Ertl, Peter Nordbeck
The role of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for acute ST-segment-elevation myocardial infarction has been a matter of intense research and debate now. Although recent randomized controlled clinical trials (notably TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia] and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) do not supply evidence supporting the routine use of TA in patients with ST-segment-elevation myocardial infarction, manual TA remains a therapeutic option for interventional cardiologists when treating patients with substantial thrombus burden during PPCI...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29026412/the-role-of-manual-thrombectomy-in-cardiovascular-outcome-among-patients-with-total-cutoff-vessel-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#15
Alireza Khosravi, Davoud Rajabi, Masoud Pourmoghaddas, Afzal Roohi, Masoumeh Esmaeili
BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014...
March 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29018137/incidence-and-outcomes-of-myocardial-infarction-in-patients-admitted-with-acute-ischemic-stroke
#16
Fahad Alqahtani, Sami Aljohani, Abdul Tarabishy, Tatiana Busu, Amelia Adcock, Mohamad Alkhouli
BACKGROUND AND PURPOSE: Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database. METHODS: The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28989934/takotsubo-cardiomyopathy-with-a-rapidly-resolved-left-ventricular-thrombus
#17
Abdel Anabtawi, Paola C Roldan, Carlos A Roldan
This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28919314/24-hour-alberta-stroke-program-early-ct-score-assessment-in-post-stroke-spasticity-development-in-patients-with-a-first-documented-anterior-circulation-ischemic-stroke
#18
Ondrej Volny, Maria Justanova, Petra Cimflova, Linda Kasickova, Ivana Svobodova, Jan Muzik, Martin Bares
BACKGROUND: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. METHODS: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry)...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28867126/early-ventricular-tachycardia-or-fibrillation-in-patients-with-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-and-impact-on-mortality-and-stent-thrombosis-from-the-harmonizing-outcomes-with-revascularization-and-stents
#19
RANDOMIZED CONTROLLED TRIAL
Ioanna Kosmidou, Monica Embacher, Thomas McAndrew, José M Dizon, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
The prevalence and impact of early ventricular arrhythmias (ventricular tachycardia [VT]/ventricular fibrillation [VF]) occurring before mechanical revascularization for acute ST segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention are poorly understood. We sought to investigate the association between early VT/VF and long-term clinical outcomes using data from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial. Among 3,602 patients with STEMI, 108 patients (3...
November 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28815091/-spice-synthetic-marijuana-induced-acute-myocardial-infarction-a-case-series
#20
E Ul Haq, A Shafiq, A A Khan, A A Awan, S Ezad, W J Minteer, B Omar
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI...
2017: Case Reports in Cardiology
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