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aspiration thrombectomy

Gregory M Weiner, Rafey Feroze, David M Panczykowski, Amin Aghaebrahim, William Ares, Nitin Agarwal, John Enis, Xiao Zhu, Andrew F Ducruet
INTRODUCTION: Tandem occlusion resulting in acute ischemic stroke (AIS) is associated with high morbidity and mortality and a poor response to thrombolytic therapy. The use of endovascular strategies for tandem stroke cases results in an improved outcome for this subgroup of patients. We present two cases with a pattern of tandem occlusion consisting of proximal obstruction at the origin of the common carotid artery (CCA) with concomitant intracranial occlusion treated by endovascular techniques...
October 14, 2016: World Neurosurgery
Eric R Powers
No abstract text is available yet for this article.
October 10, 2016: JACC. Cardiovascular Interventions
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Kei Izumiyama, Fumie Nishizaki, Yoshiyasu Minami, Lei Xing, Erika Yamamoto, Hang Lee, Ken Okumura, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. METHODS: A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included...
October 10, 2016: JACC. Cardiovascular Interventions
Y Pan, J Zhao, J Mei, M Shao, J Zhang, H Wu
OBJECTIVE: The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS: The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram...
September 27, 2016: European Journal of Vascular and Endovascular Surgery
Maxim Mokin, Kyle M Fargen, Christopher T Primiani, Zeguang Ren, Travis M Dumont, Leonardo B C Brasiliense, Guilherme Dabus, Italo Linfante, Peter Kan, Visish M Srinivasan, Mandy J Binning, Rishi Gupta, Aquilla S Turk, Lucas Elijovich, Adam Arthur, Hussain Shallwani, Elad I Levy, Adnan H Siddiqui
BACKGROUND: Vessel perforation during stent retriever thrombectomy is a rare complication; typically only single instances have been reported. OBJECTIVE: To report on a series of patients whose stent retriever thrombectomy was complicated by intraprocedural vessel perforation and discuss its potential mechanisms, rescue treatment strategies, and clinical significance. METHODS: Cases with intraprocedural vessel perforation, where a stent retriever was used either as a primary treatment approach or as a part of a direct aspiration first pass technique (ADAPT), were included in the final analysis...
September 29, 2016: Journal of Neurointerventional Surgery
Diogo C Haussen, Mehdi Bouslama, Jonathan A Grossberg, Raul G Nogueira
The use of balloon guide catheters in acute ischemic stroke intervention has been associated with improved reperfusion rates and clinical outcomes. This technique acts by promoting flow arrest and subsequent reversal to capture the thrombus debris that may be generated during the clot retrieval process. However, to the best of our knowledge, the use of BGC to remotely aspirate and remove intracranial thrombus has not been previously described. We report a three case series of patients with acute ischemic stroke from supraclinoidal internal carotid artery occlusions treated with remote aspiration thrombectomy through a BGC placed at the cervical internal carotid artery, leading to complete reperfusion without the need for intracranial catheterization...
September 28, 2016: Journal of Neurointerventional Surgery
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
September 24, 2016: Advances in Experimental Medicine and Biology
Sorin Giusca, Tom Eisele, Dorothea Raupp, Christoph Eisenbach, Grigorios Korosoglou
Currently, the treatment of thromboembolic ischemia of the lower extremities includes percutaneous rotational thrombectomy and aspiration devices. However, the standard approach for endovascular treatment requires the administration of iodine contrast agents, which is problematic in patients with pre-existing renal disease and diabetes. Herein, we describe a case of a CO2 angiography guided endovascular thrombectomy of the superficial femoral artery (SFA) in a young patient with critical limb ischemia. Mechanical thrombectomy using the Rotarex system, catheter aided aspiration and subsequent stent placement in the SFA was entirely guided using CO2 angiography...
September 23, 2016: Heart and Vessels
Regina El Dib, Frederick Alan Spencer, Erica Aranha Suzumura, Huda Gomaa, Joey Kwong, Gordon Henry Guyatt, Per Olav Vandvik
No abstract text is available yet for this article.
2016: BMC Cardiovascular Disorders
P Bhogal, M AlMatter, M Aguilar, I Nakagawa, O Ganslandt, H Bäzner, H Henkes
No abstract text is available yet for this article.
September 12, 2016: Clinical Neuroradiology
David S Wald, Jonathan P Bestwick
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
Gaurav Jindal, Yafell Serulle, Timothy Miller, Elizabeth Le, Marcella Wozniak, Michael Phipps, Moronke Iyoha, Vikash Gupta, Ravi Shivashankar, Dheeraj Gandhi
BACKGROUND: New device technology has changed the techniques used for revascularization of emergent large vessel occlusion in acute stroke. We report technical results using stent retrievers (SRs) for thrombectomy alone versus SRs used in conjunction with a new group of devices, intracranial aspiration catheters (IACs). Our aim is to demonstrate differences in procedural time and thrombectomy attempts between these two groups. METHODS: A retrospective evaluation was performed of a prospectively maintained database of 97 patients treated at a single institution for anterior circulation stroke with SRs...
September 1, 2016: Journal of Neurointerventional Surgery
Haibo Jia, Jiannan Dai, Jingbo Hou, Lei Xing, Lijia Ma, Huimin Liu, Maoen Xu, Yuan Yao, Sining Hu, Erika Yamamoto, Hang Lee, Shaosong Zhang, Bo Yu, Ik-Kyung Jang
AIMS: Plaque erosion, compared with plaque rupture, has distinctly different underlying pathology and therefore may merit tailored therapy. In this study, we aimed to assess whether patients with acute coronary syndrome (ACS) caused by plaque erosion might be stabilized by anti-thrombotic therapy without stent implantation. METHODS AND RESULTS: This was a single-centre, uncontrolled, prospective, proof-of concept study. Patients with ACS including ST-segment elevation myocardial infarction were prospectively enrolled...
August 30, 2016: European Heart Journal
Giustino Gennaro, Sorin J Brener, Björn Redfors, Ajay J Kirtane, Philippe Généreux, Akiko Maehara, Thomas Neunteufl, D Christopher Metzger, Roxana Mehran, C Michael Gibson, Gregg W Stone
We sought to investigate the effect of smoking on infarct size (IS) and major adverse cardiac events (MACE) in patients with large anterior ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Participants from the Intracoronary Abciximab and Aspiration Thrombectomy in Patients with Large Anterior Myocardial Infarction study were categorized according to smoking status (current or previous smoking vs no history of smoking). The primary imaging outcome was cardiac magnetic resonance imaging-assessed IS of left ventricular mass (%) at 30 days...
October 15, 2016: American Journal of Cardiology
John P Hungerford, Madison Hyer, Aquilla S Turk, Raymond D Turner, M Imran Chaudry, Kyle M Fargen, Alejandro M Spiotta
OBJECTIVE: To investigate the associations between Alberta Stroke Program Early CT Score (ASPECTS) or distribution and sidedness of acute infarction and clinical outcomes following intervention with a direct aspiration first pass technique (ADAPT). METHODS: A review was performed of patients who had undergone thrombectomy with ADAPT for emergent large vessel occlusions of the middle cerebral artery (MCA) between December 2012 and May 2015. Preintervention CT scans were reviewed by a blinded radiologist to calculate ASPECTS and determine the distribution of infarction...
August 22, 2016: Journal of Neurointerventional Surgery
Francesco Biraschi, Francesco Diana, Francesco Alesini, Giulio Guidetti, Simone Peschillo
A 75-year-old man with hypertension and atrial fibrillation was admitted to our emergency room with right-sided hemiplegia and complete aphasia (National Institutes of Health Stroke Scale [NIHSS] score = 18). A noncontrast computed tomography scan showed a slight hypodensity in the left insular region and a bright hyperdense sign in the M1 tract of the left middle cerebral artery (MCA). Angio-CT confirmed an occlusion of the M1 tract of the MCA. Magnetic resonance diffusion-weighted imaging/perfusion-weighted imaging was obtained and revealed a mismatch in the left parietal cortical region...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Rahman Shah, Abdul Rashid
No abstract text is available yet for this article.
November 1, 2016: International Journal of Cardiology
J Mocco, Osama O Zaidat, Rüdiger von Kummer, Albert J Yoo, Rishi Gupta, Demetrius Lopes, Don Frei, Harish Shownkeen, Ron Budzik, Zahra A Ajani, Aaron Grossman, Dorethea Altschul, Cameron McDougall, Lindsey Blake, Brian-Fred Fitzsimmons, Dileep Yavagal, John Terry, Jeffrey Farkas, Seon Kyu Lee, Blaise Baxter, Martin Wiesmann, Michael Knauth, Donald Heck, Syed Hussain, David Chiu, Michael J Alexander, Timothy Malisch, Jawad Kirmani, Laszlo Miskolczi, Pooja Khatri
BACKGROUND AND PURPOSE: Thrombectomy, primarily with stent retrievers with or without adjunctive aspiration, provided clinical benefit across multiple prospective randomized trials. Whether this benefit is exclusive to stent retrievers is unclear. METHODS: THERAPY (The Randomized, Concurrent Controlled Trial to Assess the Penumbra System's Safety and Effectiveness in the Treatment of Acute Stroke; NCT01429350) was an international, multicenter, prospective, randomized (1:1), open label, blinded end point evaluation, concurrent controlled clinical trial of aspiration thrombectomy after intravenous alteplase (IAT) administration compared with intravenous-alteplase alone in patients with large vessel ischemic stroke because of a thrombus length of ≥8 mm...
September 2016: Stroke; a Journal of Cerebral Circulation
Michael P Thomas, Eric R Bates
Primary PCI is the dominant reperfusion strategy for patients with ST-elevation myocardial infarction and continues to evolve. The purpose of this review is to summarize recent reports that focused on the relationship of door-to-balloon time with mortality, radial versus femoral artery access, aspiration thrombectomy, culprit versus multivessel primary PCI, drug-eluting stents, and anticoagulation and antiplatelet therapies.
June 27, 2016: Trends in Cardiovascular Medicine
Yong-Won Kim, Dong-Hun Kang, Yang-Ha Hwang, Jaechan Park, Yong-Sun Kim
OBJECTIVE: Mechanical thrombectomy (MT) for acute intracranial internal carotid artery (ICA) occlusion is often complicated by difficult revascularization and non-involved territory embolization possibly related with larger clot-burden. This study aims to evaluate the efficacy of proximal aspiration thrombectomy (PAT) using a balloon-tipped guide catheter for clot-burden reduction in such cases with period-to-period analysis (period 1 : standard MT without PAT; period 2 : PAT first, then standard MT for the remaining occlusion)...
July 2016: Journal of Korean Neurosurgical Society
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