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aspiration thrombectomy

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https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#1
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/28864410/aspiration-thrombectomy-with-off-label-distal-access-catheters-in-the-distal-intracranial-vasculature
#2
Alexander G Chartrain, Christopher P Kellner, Jacob R Morey, Thomas J Oxley, Hazem Shoirah, J Mocco, Johanna Fifi, Reade A De Leacy
BACKGROUND: As neurointerventionalists aim to treat occlusions in the ever more distal vasculature, off-label catheters (OLCs) have been adapted for aspiration thrombectomy. This may not be without its attendant risks. Recently issued, a letter from the FDA cautioned providers against using OLCs as substitutes for FDA-cleared aspiration thrombectomy catheters, especially in the distal vasculature. In light of this, we evaluated the efficacy and safety of OLCs used for aspiration thrombectomy in the distal vasculature at our institution...
August 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28845108/the-role-of-endovascular-therapy-in-acute-mesenteric-ischemia
#3
Anna Maria Ierardi, Dimitrios Tsetis, Sara Sbaraini, Salvatore Alessio Angileri, Nikolaos Galanakis, Mario Petrillo, Francesca Patella, Silvia Panella, Federica Balestra, Natalie Lucchina, Gianpaolo Carrafiello
BACKGROUND: Endovascular therapy, including aspiration thrombectomy and local thrombolytic therapy, often associated with angioplasty and stent placement, has been described in the literature. The purpose of this study was to review case series of patients with acute mesenteric ischemia treated with endovascular therapy and evaluate their outcomes. METHODS: An online review using PubMed was carried out to identify all English articles about this topic in the time interval from 2005 to 2016...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28844911/endovascular-mechanical-thrombectomy-for-acute-middle-cerebral-artery-m2-segment-occlusion-a-systematic-review
#4
REVIEW
Ching-Jen Chen, Connor Wang, Thomas J Buell, Dale Ding, Daniel M Raper, Natasha Ironside, Gabriella M Paisan, Robert M Starke, Andrew M Southerland, Kenneth Liu, Bradford B Worrall
INTRODUCTION: The benefit of endovascular mechanical thrombectomy (EMT) for acute distal occlusions of the middle cerebral artery M2 segment is incompletely defined. The aim of this systematic review is to analyze the recent literature regarding EMT for acute M2 occlusions. METHODS: We reviewed the literature to identify all studies of patients with acute M2 occlusions who underwent EMT which were published after January 1, 2015. Excellent and good outcomes were defined as modified Rankin Scale of 0-1 and 0-2 at 3 months, respectively...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28821628/frontline-adapt-therapy-to-treat-patients-with-symptomatic-m2-and-m3-occlusions-in-acute-ischemic-stroke-initial-experience-with-the-penumbra-ace-and-3max-reperfusion-system
#5
Jens Altenbernd, Oliver Kuhnt, Svenja Hennigs, Ruediger Hilker, Christian Loehr
BACKGROUND: After a series of positive studies for mechanical thrombectomy in large vessel occlusion acute ischemic stroke, the question remains, can symptomatic patients with distal vessel occlusion benefit from mechanical thrombectomy? PURPOSE: To assess the safety and efficacy of the 3MAX reperfusion system as frontline therapy for M2 and M3 occlusions. METHODS: This study retrospectively collected data on 58 patients treated for M2 and M3 occlusions between January and September 2016...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28815091/-spice-synthetic-marijuana-induced-acute-myocardial-infarction-a-case-series
#6
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
https://www.readbyqxmd.com/read/28797607/trends-and-clinical-outcomes-in-patients-undergoing-primary-percutaneous-revascularisation-for-st-elevation-myocardial-infarction-a-single-centre-experience
#7
Luke P Dawson, Josephine Warren, Juan Mundisugih, Viveka Nainani, William Chan, Dion Stub, Archer Broughton, Andrew J Taylor, Antony Walton, Stephen J Duffy, James A Shaw
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. METHODS: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28763550/effect-of-endovascular-contact-aspiration-vs-stent-retriever-on-revascularization-in-patients-with-acute-ischemic-stroke-and-large-vessel-occlusion-the-aster-randomized-clinical-trial
#8
RANDOMIZED CONTROLLED TRIAL
Bertrand Lapergue, Raphael Blanc, Benjamin Gory, Julien Labreuche, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
Importance: The benefits of endovascular revascularization using the contact aspiration technique vs the stent retriever technique in patients with acute ischemic stroke remain uncertain because of lack of evidence from randomized trials. Objective: To compare efficacy and adverse events using the contact aspiration technique vs the standard stent retriever technique as a first-line endovascular treatment for successful revascularization among patients with acute ischemic stroke and large vessel occlusion...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28751516/the-use-and-utility-of-aspiration-thrombectomy-in-acute-ischemic-stroke-a-systematic-review-and-meta-analysis
#9
D Wei, J R Mascitelli, D A Nistal, C P Kellner, J T Fifi, J D Mocco, R A De Leacy
BACKGROUND: Thrombectomy trials are often specifically interpreted as evidence for the effectiveness of stent retrievers. The effectiveness of other thrombectomy techniques such as aspiration thrombectomy should be validated through further investigation and review. PURPOSE: To evaluate published treatment times and clinical outcomes in patients treated with aspiration thrombectomy or ADAPT (A Direct Aspiration, First Pass Technique) for acute ischemic stroke. DATA SOURCES: A systematic literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28732458/use-of-a-complete-autologous-blood-recovery-system-the-sorin-xtra%C3%A2-autotransfusion-system-during-mechanical-thrombectomy-of-extensive-cerebral-venous-sinus-thrombosis
#10
C Castaño, C Cubells, S Remollo, M R García-Sort, M Terceño
Background The endovascular therapy for cerebral venous sinus thrombosis (CVST) is currently accepted as a second-line treatment for patients who have failed or those in whom systemic anticoagulation is contraindicated or in a subgroup of patients presenting with rapid neurologic deterioration. A number of different mechanical and pharmacologic endovascular strategies have been reported, either as separate or combined approaches. These new catheters and aspiration systems have a high power and vacuum capacity, which carries a risk of anemization of the patient and hypovolemic shock, being necessitating the transfusion of the patient...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28712720/manual-aspiration-thrombectomy-in-patients-with-acute-stroke-related-calcified-cerebral-emboli
#11
Esther Koh, Hyo Sung Kwak, Gyung-Ho Chung
OBJECTIVE: The aim of this study was to evaluate the effectiveness of mechanical aspiration thrombectomy (MAT) in patients with acute ischemic stroke from calcified cerebral emboli. METHODS: Procedural results were reviewed for acute stroke patients with clinically neurological deficits who underwent recanalization from October 2012 through September 2015. Initial imaging studies and cerebral angiography were analyzed. RESULTS: Of the total number of patients with acute stroke, 5 patients were confirmed to have acute ischemic stroke by calcified cerebral emboli...
July 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28691137/effective-use-of-balloon-guide-catheters-in-reducing-incidence-of-mechanical-thrombectomy-related-distal-embolization
#12
Dong Hoon Lee, Jae Hoon Sung, Sang Uk Kim, Ho Jun Yi, Jae Taek Hong, Sang Won Lee
BACKGROUND AND PURPOSE: The clinical benefit of endovascular stroke therapy has been demonstrated in several prospective randomized trials. However, in a relevant percentage of patients, mechanical thrombectomy bears the risk of causing new infarction in initially unaffected vascular territories through thrombus fragmentation and migration of clot debris. The goal of this study was to evaluate the use of the balloon guide catheter (BGC) to effectively achieve flow arrest and thrombus aspiration during the intervention to avoid distal embolization...
July 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28685015/hybrid-approach-to-the-management-of-infective-endocarditis-complicated-by-coronary-artery-embolism-a-case-report
#13
Amy G Fiedler, Robert C Schutt, David Greenhouse, James Stone, Thoralf M Sundt, Rahul Sakhuja
Septic coronary embolization in a patient with endocarditis is a rare and can be a devastating complication. The management of this clinical problem in the current era may be best served with a multi-modality approach. We present an interesting case of a patient with septic coronary embolization managed with the combined use of aspiration thrombectomy followed by surgical management of the infected valve.
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28669652/severe-vasospasm-of-the-middle-cerebral-artery-after-mechanical-thrombectomy-due-to-infective-endocarditis-an-autopsy-case
#14
Wataru Nishino, Yosuke Tajima, Toru Inoue, Michihiro Hayasaka, Bi Katsu, Koichi Ebihara, Daisuke Kawauchi, Masaaki Kubota, Sumio Suda
Untreated infective endocarditis (IE) often produces infective emboli in major cerebral arteries. We describe a case of middle cerebral artery occlusion due to IE, which caused severe vasospasm and reocclusion after mechanical thrombectomy (MT). We present the pathologic findings of the occluded middle cerebral artery and investigate the precautions to be taken while performing MT due to IE. A 72-year-old man with atrial fibrillation treated with dabigatran presented with right hemiparesis and aphasia. A diffusion-weighted image showed a high-intensity area in the left temporoparietal junction, and magnetic resonance angiography revealed a left M2 occlusion...
September 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28660560/jetstream-atherectomy-and-balloon-angioplasty-with-distal-embolic-protection-for-angio-seal%C3%A2-related-vascular-access-complications
#15
Mihir Barvalia, Mohammad Thawabi, Yassir Nawaz, Nishant Sethi, John Shao, Michael Amponsah, Gautam Visveswaran, Marc Cohen, Najam Wasty
Arteriotomy closure devices (ACDs) are routinely used for vascular closure during invasive cardiovascular procedures. They decrease time to hemostasis as well as length of stay. Major complications such as arterial ischemia and occlusion can be encountered in a minority of patients. We are describing a series of 3 patients with access site closure using Angio-Seal after coronary angiography who developed intermittent claudication within 2-3 weeks of follow-up. Access site thrombosis/stenosis in the CFA was found in all the three cases...
June 28, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28611829/stent-retriever-mediated-manual-aspiration-thrombectomy-for-acute-ischemic-stroke
#16
Ashutosh P Jadhav, Amin Aghaebrahim, Anat Horev, Dan-Victor Giurgiutiu, Andrew F Ducruet, Brian Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: Stent retriever thrombectomy and manual aspiration thrombectomy (MAT) have each been shown to lead to high rates of recanalization as single-modality endovascular stroke therapy. We sought to describe the safety and efficacy of a multimodal approach combining these two techniques termed 'stent retriever-mediated manual aspiration thrombectomy' (SMAT) and compared them to MAT alone. METHODS: Retrospective review of a prospectively acquired acute endovascular stroke database...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28605743/incomplete-large-vessel-occlusions-in-mechanical-thrombectomy-an-independent-predictor-of-favorable-outcome-in-ischemic-stroke
#17
Volker Maus, Seunghwa You, Alev Kalkan, Jan Borggrefe, Christoph Kabbasch, Utako Birgit Barnikol, Henning Stetefeld, Christian Dohmen, Thomas Liebig, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND AND PURPOSE: Cerebral large vessel occlusion (LVO) in acute ischemic stroke (AIS) may be complete (CLVO) or incomplete (ILVO). The influence of ILVO on clinical outcome after mechanical thrombectomy (MT) remains unclear. We investigated primarily the clinical outcome in patients with AIS due to ILVO or CLVO. METHODS: Five hundred three consecutive AIS patients with LVO treated with stent-retriever or direct aspiration-based MT between 2010 and 2016 were analyzed...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28596447/impact-of-thrombus-length-on-outcomes-after-intra-arterial-aspiration-thrombectomy-in-the-therapy-trial
#18
RANDOMIZED CONTROLLED TRIAL
Albert J Yoo, Pooja Khatri, J Mocco, Osama O Zaidat, Rishi Gupta, Donald Frei, Demetrius Lopes, Harish Shownkeen, Olvert A Berkhemer, Denise Meyer, Susana S Hak, Sophia S Kuo, Hope Buell, Arani Bose, Siu Po Sit, Rüdiger von Kummer
BACKGROUND AND PURPOSE: Increasing thrombus length (TL) impedes recanalization after intravenous (IV) thrombolysis. We sought to determine whether the clinical benefit of aspiration thrombectomy relative to IV r-tPA (recombinant tissue-type plasminogen activator) may be greater at longer TL. METHODS: THERAPY was a randomized trial of aspiration thrombectomy plus IV r-tPA versus IV r-tPA alone in large-vessel stroke patients with prospective TL measurement ≥8 mm...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28592218/first-line-use-of-contact-aspiration-for-thrombectomy-versus-a-stent-retriever-for-recanalization-in-acute-cerebral-infarction-the-randomized-aster-study-protocol
#19
Bertrand Lapergue, Julien Labreuche, Raphael Blanc, Xavier Barreau, Jérome Berge, Arturo Consoli, Georges Rodesch, Susanna Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Alain Duhamel, Sandrine Baffert, Mikael Mazighi, Benjamin Gory, Francis Turjman, Michel Piotin
Rationale Mechanical thrombectomy with a stent retriever is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion. New techniques for mechanical thrombectomy, such as contact aspiration, appear promising to increase reperfusion status and improve clinical outcome. Aim We aim at ascertaining whether contact aspiration is more efficient than the stent retriever as a first-line endovascular procedure. Sample size estimates With a two-sided test (alpha = 5%, power = 90%) and an anticipated rate of spontaneous recanalization and catheterization failures of 15%, we estimate that a sample size of 380 patients will be necessary to detect an absolute difference of 15% in primary outcome (superiority design)...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28555191/percutaneous-mechanical-thrombectomy-using-rotarex%C3%A2-s-device-in-acute-limb-ischemia-in-infrainguinal-occlusions
#20
Samuel Heller, Jean-Claude Lubanda, Petr Varejka, Miroslav Chochola, Pavel Prochazka, David Rucka, Sylvie Kuchynkova, Johana Horakova, Ales Linhart
PURPOSE: To evaluate the effectiveness of percutaneous mechanical thrombectomy using Rotarex S in the treatment of acute limb ischemia (ALI) in infrainguinal occlusions in a retrospective study of patients treated in our institution. METHODS: In this study, we identified a total of 147 ALI patients that underwent mechanical thrombectomy using Rotarex S at our institution. In 82% of the cases, percutaneous thrombectomy was used as first-line treatment, and for the remainder of the cases, it was used as bailout after ineffective aspiration or thrombolysis...
2017: BioMed Research International
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