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aspiration thrombectomy

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https://www.readbyqxmd.com/read/29127196/mechanical-thrombectomy-for-acute-ischemic-stroke-with-occlusion-of-the-m2-segment-of-the-middle-cerebral-artery-a-meta-analysis
#1
Hamidreza Saber, Sandra Narayanan, Mohan Palla, Jeffrey L Saver, Raul G Nogueira, Albert J Yoo, Sunil A Sheth
BACKGROUND: Endovascular thrombectomy has demonstrated benefit for patients with acute ischemic stroke from proximal large vessel occlusion. However, limited evidence is available from recent randomized trials on the role of thrombectomy for M2 segment occlusions of the middle cerebral artery (MCA). METHODS: We conducted a systematic review and meta-analysis to investigate clinical and radiographic outcomes, rates of hemorrhagic complications, and mortality after M2 occlusion thrombectomy using modern devices, and compared these outcomes against patients with M1 occlusions...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29127194/dump-the-pump-manual-aspiration-thrombectomy-mat-with-a-syringe-is-technically-effective-expeditious-and-cost-efficient
#2
Bradley A Gross, Ashutosh P Jadhav, Tudor G Jovin, Brian Thomas Jankowitz
INTRODUCTION: Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. OBJECTIVE: To present in vitro and clinical results of MAT with a syringe. METHODS: An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29118797/comparison-of-vacuum-pressures-and-forces-generated-by-different-catheters-and-pumps-for-aspiration-thrombectomy-in-acute-ischemic-stroke
#3
Michael T Froehler
Background: Direct aspiration thrombectomy is an increasingly utilized technique in endovascular stroke treatment that relies on vacuum and suction force to remove the clot. This report assesses the pressures and forces generated by different catheters and pumps. Methods: Vacuum pressures were measured using a vacuum gauge for several catheters (Stryker Catalyst6, Penumbra Ace 064, Medtronic Arc 061, and Penumbra 041) and pumps (Penumbra pump, 60-mL syringe, and the ASPIRE device)...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29113867/clinical-significance-of-intracoronary-thrombus-aspirated-during-primary-percutaneous-intervention-an-immunohistopathological-study
#4
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/29102272/aspiration-thrombectomy-for-treatment-of-acute-massive-and-submassive-pulmonary-embolism-initial-single-center-prospective-experience
#5
Juan José Ciampi-Dopazo, Juan María Romeu-Prieto, Marcelino Sánchez-Casado, Beatriz Romerosa, Alfonso Canabal, María Luisa Rodríguez-Blanco, Carlos Lanciego
PURPOSE: To evaluate the feasibility of aspiration thrombectomy in patients with acute massive or submassive pulmonary embolism (PE). MATERIALS AND METHODS: This prospective study analyzed patient demographic data, procedural details, and outcomes in 18 consecutive patients (8 men and 10 women; mean age, 60.1 y; range, 36-80 y), 10 with acute submassive PE and 8 with massive PE, treated with an Indigo Continuous Aspiration Mechanical Thrombectomy Catheter between January 2016 and February 2017...
October 25, 2017: Journal of Vascular and Interventional Radiology: JVIR
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
#6
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/29077175/the-important-role-of-manual-aspiration-through-the-guiding-catheter-during-repeated-solitaire-mechanical-thrombectomy-in-acute-ischemic-stroke
#7
R Xu, X-K Zhao, M-L Wang, X Liu, D Xi
OBJECTIVE: Acute ischemic stroke (AIS) is an important global health problem. Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the standard treatment. However, only a small number of patients benefit from it because of strict application restrictions. Increasing evidence has demonstrated that mechanical thrombectomy is an effective and safe therapy for AIS. PATIENTS AND METHODS: We present 14 cases of successful recanalization with Solitaire devices for AIS patients after stroke onset...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29053904/a-direct-aspiration-first-pass-technique-adapt-for-acute-stroke-therapy-a-systematic-review-and-meta-analysis
#8
Benjamin Gory, Xavier Armoiry, Rotem Sivan-Hoffman, Michel Piotin, Mikael Mazighi, Bertrand Lapergue, Raphaël Blanc, Francis Turjman
BACKGROUND AND PURPOSE: ADAPT (A Direct Aspiration First Pass Technique), involving the first-line use of large-bore distal aspiration catheter, is a new strategy in the mechanical thrombectomy of acute ischemic stroke caused by large vessel occlusion. However, its impact on reperfusion rates, clinical outcomes, and complication rates is not fully examined. METHOD: We conducted a systematic review of the literature searching multiple databases for reports on thrombectomy of acute stroke with the ADAPT technique and performed meta-analyses of clinical and radiographic outcomes...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29045981/renal-ewing-s-sarcoma-primitive-neuroectodermal-tumor-a-case-report-and-literature-review
#9
C Liu, L G Cui, H L Wang
Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET) in the kidney is a rare but high-grade malignant tumor that affects predominantly elder children and adolescents. Patients mostly present with nonspecific symptoms such as abdominal pain and gross hematuria. Since EWS/PNET has a rapid clinical progression with early metastasis and death, it is essential to make an accurate and early diagnosis. Once diagnosed, multimodality treatment, including radical surgery combined with adjuvant chemotherapy, and radiotherapy if necessary, is recommended...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29042400/thrombus-aspiration-for-st-segment-elevation-myocardial-infarction-in-modern-era-still-an-issue-of-debate
#10
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/29038080/a-stent-retrieving-into-an-aspiration-catheter-with-proximal-balloon-asap-technique-a-technique-of-mechanical-thrombectomy
#11
Shunsaku Goto, Tomotaka Ohshima, Kojiro Ishikawa, Taiki Yamamoto, Shinji Shimato, Toshihisa Nishizawa, Kyozo Kato
OBJECTIVE: The best technique for the first attempt at mechanical thrombectomy for acute ischemic stroke is a still matter of debate. In this study, we evaluate the efficacy of a stent-retrieving into an aspiration catheter with proximal balloon (ASAP) technique that uses a series of thrombus extraction by withdrawing the stent retriever into the aspiration catheter and continuous aspiration from the aspiration catheter at the first attempt. METHODS: We performed a retrospective analysis of 42 consecutive patients with acute ischemic stroke caused by occlusions in the anterior circulation who were treated with the ASAP technique at our institution...
October 13, 2017: World Neurosurgery
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
#12
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/29025728/necessary-catheter-diameters-for-mechanical-thrombectomy-with-adapt
#13
O Nikoubashman, A Nikoubashman, M Büsen, M Wiesmann
BACKGROUND AND PURPOSE: Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT. MATERIALS AND METHODS: We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model...
October 12, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#14
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29017198/aggressive-treatment-of-cerebral-venous-sinus-thrombosis-cvt-with-stent-retrievers-and-local-thrombolysis-why-we-need-a-registry
#15
Christina Maria Kowoll, Hannah Lockau, Franziska Dorn, Christian Dohmen
Purpose Anticoagulation is the first-line therapy for cerebral venous sinus thrombosis (CVT). Endovascular treatment is increasingly applied in patients deteriorating despite anticoagulation with extensive thrombosis or contraindications for anticoagulation. Experience with stent retrievers in CVT is limited. Results We present three cases of severe CVT treated with stent-retrievers, thrombus aspiration and local thrombolysis. In two patients with extensive thrombosis, a partial recanalization was achieved, but only one of them showed significant improvement...
October 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28987854/contact-aspiration-with-the-new-arc%C3%A2-catheter-for-thrombectomy-of-acute-ischemic-stroke-a-single-center-results
#16
Benjamin Gory, Francis Turjman
BACKGROUND/OBJECTIVE: Contact aspiration has gained growing acceptance in the endovascular stroke therapy. The safety and efficacy data of the novel ARC™ catheter (Medtronic, Irvine, CA) used for intracranial thrombectomy was poorly evaluated. We reported our preliminary results with the ARC™ with regard to angiographic reperfusion, duration of thrombectomy, safety, and clinical outcome at 90 days. METHODS: In a single center series including 20 large-vessel occlusion stroke patients prospectively collected, we retrospectively evaluated the safety and efficacy profiles of the ARC™ intracranial catheter for first-line contact aspiration...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28974665/embolization-of-a-large-intracoronary-thrombus-during-st-segment-elevation-myocardial-infarction
#17
Nathaniel R Smilowitz, Claudia Serrano-Gomez
Aspiration thrombectomy was performed to retrieve intact thrombus in a 69-year-old woman. Bradycardia and hypotension rapidly resolved. Balloon angioplasty was performed at the site of proximal RCA in-stent restenosis with improved angiographic appearance and TIMI 3 flow in the major branches.
October 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28973527/a-direct-aspiration-first-pass-technique-vs-standard-endovascular-therapy-for-acute-stroke-a-systematic-review-and-meta-analysis
#18
Kevin Phan, Adam A Dmytriw, Ian Teng, Justin M Moore, Christoph Griessenauer, Christopher Ogilvy, Ajith Thomas
BACKGROUND: The direct aspiration first pass technique (ADAPT) is a recent endovascular treatment for ischemic stroke due to large vessel occlusion that has been gaining popularity due to the rapidity of the technique and the potential for cost savings in comparison to standard thrombectomy methods such as stent retrievers. However, few studies have directly compared these 2. OBJECTIVE: To compare ADAPT with stent retrievers for thrombectomy via systematic review and meta-analysis...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28963362/comparing-different-thrombectomy-techniques-in-five-large-volume-centers-a-real-world-observational-study
#19
Amélie Carolina Hesse, Daniel Behme, André Kemmling, Antonia Zapf, Nils Große Hokamp, Isabelle Frischmuth, Ilko Maier, Jan Liman, Ioannis Tsogkas, Jan-Hendrik Buhk, Julia Tran, Jens Fiehler, Anastasios Mpotsaris, Peter Schramm, Ansgar Berlis, Michael Knauth, Marios-Nikos Psychogios
BACKGROUND AND PURPOSE: Thrombectomy has become the standard of care for acute ischaemic stroke due to large vessel occlusion. Aim of this study was to compare the radiological outcomes and time metrics of the various thrombectomy techniques. METHODS: In this retrospective, multicent study we analysed the data of 450 patients with occlusion of the anterior circulation, treated in five high-volume cents from 2013 to 2016. The treatment techniques were divided in three categories: first-pass use of a large-bore aspiration-catheter; first-pass use of a stent-retriever; and primary combined approach (PCA) of an aspiration-catheter and stent-retriever...
September 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28948399/interventional-magnetic-resonance-imaging-guided-carotid-embolectomy-using-a-novel-resonant-marker-catheter-demonstration-of-preclinical-feasibility
#20
Jeffrey K Yang, Andre M Cote, Caroline D Jordan, Sravani Kondapavulur, Aaron D Losey, David McCoy, Andrew Chu, Jay F Yu, Teri Moore, Carol Stillson, Fabio Settecase, Matthew D Alexander, Andrew Nicholson, Daniel L Cooke, Maythem Saeed, Dave Barry, Alastair J Martin, Mark W Wilson, Steven W Hetts
To assess the visualization and efficacy of a wireless resonant circuit (wRC) catheter system for carotid artery occlusion and embolectomy under real-time MRI guidance in vivo, and to compare MR imaging modality with x-ray for analysis of qualitative physiological measures of blood flow at baseline and after embolectomy. The wRC catheter system was constructed using a MR compatible PEEK fiber braided catheter (Penumbra, Inc, Alameda, CA) with a single insulated longitudinal copper loop soldered to a printed circuit board embedded within the catheter wall...
September 25, 2017: Biomedical Microdevices
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