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https://www.readbyqxmd.com/read/28912883/tirofiban-facilitates-the-reperfusion-process-during-endovascular-thrombectomy-in-icas
#1
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
https://www.readbyqxmd.com/read/28906352/clinical-and-angiographic-outcomes-following-endovascular-treatment-of-very-small-3%C3%A2-mm-or-smaller-intracranial-aneurysm-a-single-center-experience
#2
Yongsheng Liu, Feng Wang, Xiaochen Fu, Yongjian Liu, Guodong Zhang, Ke Xu
Treatments for very small (3 mm or smaller) intracranial aneurysms (VSAs) remain controversial. The aim of this study was to evaluate the efficacy of endovascular treatment for VSAs and to evaluate clinical risk factors associated with complications.This retrospective study enrolled 82 VSA patients who underwent coil embolization in our institution. Angiographic outcomes were assessed according to the Meyers classification. The clinical results were evaluated using the modified Rankin scale (mRS) immediately after coiling, at discharge, and during follow-up...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905110/-indications-and-technique-for-transconjunctival-optic-nerve-sheath-fenestration-video-article
#3
REVIEW
W A Lagrèze, N Gross, J Biermann, L Joachimsen
BACKGROUND: Placement of a ventricular shunt is the primary surgical procedure for lowering intracranial pressure in pseudotumor cerebri syndrome; however, if ophthalmological symptoms prevail over neurological symptoms or if there are no neurological symptoms at all, optic nerve sheath fenestration may be a valuable option for relief of pressure on the retrobulbar optic nerve when papilledema caused by pseudotumor cerebri syndrome threatens vision despite previous conservative measures...
September 13, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28904465/spectrum-of-visual-impairment-in-cerebral-venous-thrombosis-importance-of-tailoring-therapies-based-on-pathophysiology
#4
Sanjith Aaron, Anupriya Arthur, A T Prabakhar, Pavitra Mannam, N K Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904450/acute-ischemic-stroke-treatment-using-mechanical-thrombectomy-a-study-of-137-patients
#5
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#6
Waleed Brinjikji, Jeffrey Pasternak, Mohammad H Murad, Harry J Cloft, Tasha L Welch, David F Kallmes, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28895453/extracranial-internal-carotid-artery-vasospasm-during-thrombectomy
#7
Isamu Miura, Akitsugu Kawashima, Masataka Hayashi, Akane Tanda, Tomomi Ishikawa, Takakazu Kawamata
The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient's National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28887238/emergent-carotid-stent-removal-after-carotid-stent-thrombosis-surgical-technique
#8
Konstantinos G Moulakakis, Andreas Lazaris
OBJECTIVE: To present the technique for emergent removal of the thrombosed stent in acute carotid stent thrombosis in patients undergoing carotid artery angioplasty-stenting (CAS) BACKGROUND: Acute carotid stent thrombosis in patients undergoing CAS is a relatively rare and potentially devastating complication influencing significantly the quality of life. With the increasing use of stenting in clinical practice, it is expected to represent a more often encountered complication for physicians performing CAS...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28884026/idiopathic-intracranial-hypertension-prognostic-factors-and-multidisciplinary-management
#9
Claire Chagot, Marie Blonski, Jean-Loup Machu, Serge Bracard, Jean-Christophe Lacour, Sébastien Richard
BACKGROUND: Idiopathic intracranial hypertension (IIH) mostly affects young obese women and can lead to permanent visual impairment. However, prognostic factors and therapeutic strategy remain unclear. METHODS: We retrospectively collected data from all patients diagnosed and managed for IIH in our university center from January 2001 to December 2016. RESULTS: Seventy-nine patients were diagnosed with IIH. Bilateral transverse sinus stenosis (TSS) was found in 74% of the population...
2017: Journal of Obesity
https://www.readbyqxmd.com/read/28882859/flow-diversion-with-low-profile-braided-stents-for-the-treatment-of-very-small-or-uncoilable-intracranial-aneurysms-at-or-distal-to-the-circle-of-willis
#10
K Aydin, M Barburoglu, S Sencer, M Berdikhojayev, B Coskun, S Akpek
BACKGROUND AND PURPOSE: The endovascular treatment of aneurysms located at or distal to the circle of Willis and not amenable to coiling remains a challenge. We report our experience with flow-diversion treatment using low-profile braided stents as a stent monotherapy procedure for treating distally located very small or uncoilable aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our data bases to identify patients with aneurysms located at or distal to the circle of Willis who were treated with stent monotherapy using low-profile braided stents...
September 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28882858/web-treatment-of-ruptured-intracranial-aneurysms-a-single-center-cohort-of-100-patients
#11
S B T van Rooij, W J van Rooij, J P Peluso, M Sluzewski, R S Bechan, H G Kortman, G N Beute, B van der Pol, C B Majoie
BACKGROUND AND PURPOSE: The Woven EndoBridge device was recently introduced for the intrasaccular treatment of wide-neck aneurysms without the need for adjunctive devices. We present our results of the primary treatment of ruptured aneurysms with the Woven EndoBridge regardless of location or neck size. MATERIALS AND METHODS: Between February 2015 and April 2017, 100 ruptured aneurysms were selectively treated with the Woven EndoBridge. No supporting stents or balloons were used...
September 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28878444/experimental-evaluation-and-training-of-stent-clot-retrieval-the-confront-clot-scrambling-method
#12
Tomotaka Ohshima, Shunsaku Goto, Taiki Yamamoto, Kojiro Ishikawa
The introduction of stent retrievers has changed the methods used for acute intracranial thrombectomy, but the training approach has not been discussed enough. We, therefore, aimed to establish a simple skill up method which can be used to train anytime and anywhere with low costs. Also, we introduce our experimental confront clot scrambling method (CCSM) which makes a profitable visualization in how the stent retriever works. The CCSM involved a sham clot set in the middle of a polyvinyl chloride tube, after which two stent retrievers were navigated from each side before being simultaneously withdrawn with the same force...
August 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28877643/a-case-series-of-18-patients-receiving-ticagrelor-after-carotid-stenting
#13
Elizabeth M Olafson, Jodi R DeGrote, Alexander Drofa, Evgueni Kouznetsov, Michael Manchak, Nathan D Leedahl, David D Leedahl
PURPOSE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor antagonist is often used to prevent thrombotic complications after endovascular stent placement. Most of the published experience surrounding DAPT after carotid stenting is with clopidogrel. Ticagrelor may be a promising alternative, especially in patients who may be considered nonresponders to clopidogrel. However, clinical outcomes utilizing DAPT with ticagrelor in a cohort with carotid stenting is lacking. In this case series, we describe our experience with systematic prescribing of ticagrelor after carotid stent placement in 18 patients...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28864867/safety-of-the-solitaire-4%C3%A2-%C3%A3-%C3%A2-40%C3%A2-mm-stent-retriever-in-the-treatment-of-ischemic-stroke
#14
Felix Zibold, Pasquale Mordasini, Pascal Mosimann, Eike Piechowiak, Tomas Dobrocky, Urs Fischer, Marcel Arnold, Sebastian Bellwald, Jan Gralla
PURPOSE: Stent retrievers apply mechanical force to the intracranial vasculature. Our aim was to evaluate the safety and efficacy of the long Solitaire 4 × 40 mm stent retriever for large vessel occlusion in stroke patients. METHODS: We conducted a retrospective analysis of all patients treated for acute ischemic large vessel occlusion stroke with the Solitaire 2 FR 4 × 40 device between May and October 2016 at our institution. Patient-specific data at baseline and at discharge were documented...
September 1, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28864601/predictive-value-of-computed-tomography-angiography-determined-occlusion-type-in-stent-retriever-thrombectomy
#15
Jang-Hyun Baek, Byung Moon Kim, Joonsang Yoo, Hyo Suk Nam, Young Dae Kim, Dong Joon Kim, Ji Hoe Heo, Oh Young Bang
BACKGROUND AND PURPOSE: We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. METHODS: Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment...
September 1, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28863285/endovascular-treatment-of-acute-ischemic-stroke-in-octogenarians-a-meta-analysis-of-observational-studies
#16
Jin Pyeong Jeon, Sung-Eun Kim, Chul Ho Kim
OBJECTIVES: The aim of this study is to compare procedural outcomes after endovascular treatment (EVT) according to age (≥80 years vs. <80 years) and to examine treatment outcomes after mechanical thrombectomy using a stent retriever between the different age groups. PATIENTS AND METHODS: A systemic literature review of an online database of articles published from January 2004 to February 2017 was conducted. The primary outcome was successful recanalization in the final angiogram and symptomatic intracranial hemorrhage (S-ICH) after EVT...
August 29, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28855886/advanced-imaging-of-intracranial-atherosclerosis-lessons-from-interventional-cardiology
#17
Davor Pavlin-Premrl, Rahul Sharma, Bruce C V Campbell, J Mocco, Nicholas L Opie, Thomas J Oxley
Intracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving periprocedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR), intravascular ultrasound (IVUS), and optical coherence tomography (OCT) are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28841117/transient-resolution-of-venous-sinus-stenosis-after-high-volume-lumbar-puncture-in-a-patient-with-idiopathic-intracranial-hypertension
#18
Thomas J Buell, Daniel M S Raper, I Jonathan Pomeraniec, Dale Ding, Ching-Jen Chen, Davis G Taylor, Kenneth C Liu
Stenosis of the transverse sinus (TS) and sigmoid sinus (SS), with a trans-stenosis pressure gradient, has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH). MRI has shown improvement in TS and SS stenosis after high-volume lumbar puncture (HVLP) in a subset of patients with IIH. The authors present the first report of an IIH patient with immediate post-HVLP TS and SS trans-stenosis pressure gradient reduction and an attendant increase in TS and SS cross-sectional area confirmed using intravascular ultrasonography (IVUS)...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28839527/a-new-imaging-tool-for-realtime-measurement-of-flow-velocity-in-intracranial-aneurysms
#19
Athanasios K Petridis, Marius Kaschner, Jan F Cornelius, Marcel A Kamp, Angelo Tortora, Hans-Jakob Steiger, Bernd Turowski
With modern imaging modalities of the brain a significant number of unruptured aneurysms are detected. However, not every aneurysm is prone to rupture. Because treatment morbidity is about 10% it is crucial to identify unstable aneurysms for which treatment should be discussed. Recently, new imaging tools allow analysis of flow dynamics and wall stability have become available. It seems that they might provide additional data for better risk profiling. In this study we present a new imaging tool for analysis of flow dynamics, which calculates fluid velocity in an aneurysm (Phillips Electronics, N...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28835400/stenting-for-symptomatic-vertebral-artery-stenosis-the-vertebral-artery-ischaemia-stenting-trial
#20
Hugh S Markus, Susanna C Larsson, Wilhelm Kuker, Ursula G Schulz, Ian Ford, Peter M Rothwell, Andrew Clifton
OBJECTIVE: To compare in the Vertebral Artery Ischaemia Stenting Trial (VIST) the risks and benefits of vertebral angioplasty and stenting with best medical treatment (BMT) alone for symptomatic vertebral artery stenosis. METHODS: VIST was a prospective, randomized, open-blinded endpoint clinical trial performed in 14 hospitals in the United Kingdom. Participants with symptomatic vertebral stenosis ≥50% were randomly assigned (1:1) to vertebral angioplasty/stenting plus BMT or to BMT alone with randomization stratified by site of stenosis (extracranial vs intracranial)...
August 23, 2017: Neurology
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