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Acute ischemic stroke AND mechanical thrombectomy

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https://www.readbyqxmd.com/read/28097310/combined-intravenous-thrombolysis-and-thrombectomy-vs-thrombectomy-alone-for-acute-ischemic-stroke-a-pooled-analysis-of-the-swift-and-star-studies
#1
Jonathan M Coutinho, David S Liebeskind, Lee-Anne Slater, Raul G Nogueira, Wayne Clark, Antoni Dávalos, Alain Bonafé, Reza Jahan, Urs Fischer, Jan Gralla, Jeffrey L Saver, Vitor M Pereira
Importance: Mechanical thrombectomy (MT) improves clinical outcomes in patients with acute ischemic stroke (AIS) caused by a large vessel occlusion. However, it is not known whether intravenous thrombolysis (IVT) is of added benefit in patients undergoing MT. Objective: To examine whether treatment with IVT before MT with a stent retriever is beneficial in patients undergoing MT. Design, Setting, and Participants: This post hoc analysis used data from 291 patients treated with MT included in 2 large, multicenter, prospective clinical trials that evaluated MT for AIS (Solitaire With the Intention for Thrombectomy performed from January 1, 2010, through December 31, 2011, and Solitaire Flow Restoration Thrombectomy for Acute Revascularization from January 1, 2010, through December 31, 2012)...
January 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28097308/mechanical-thrombectomy-for-acute-ischemic-stroke-are-we-done
#2
Gursant S Atwal, Adnan H Siddiqui
No abstract text is available yet for this article.
January 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28070000/anesthesia-technique-and-outcomes-of-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke
#3
Kimon Bekelis, Symeon Missios, Todd A MacKenzie, Stavropoula Tjoumakaris, Pascal Jabbour
BACKGROUND AND PURPOSE: The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS: We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
January 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28068049/medical-devices-neurological-devices-classification-of-the-neurovascular-mechanical-thrombectomy-device-for-acute-ischemic-stroke-treatment-final-order
#4
(no author information available yet)
The Food and Drug Administration (FDA) is classifying the neurovascular mechanical thrombectomy device for acute ischemic stroke treatment into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the neurovascular mechanical thrombectomy device for acute ischemic stroke treatment's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device...
23, 2016: Federal Register
https://www.readbyqxmd.com/read/28065616/experience-on-mechanical-thrombectomy-for-acute-stroke-treatment-in-a-brazilian-university-hospital
#5
Guilherme S Nakiri, Luis H Castro-Afonso, Lucas M Monsignore, Francisco A Dias, Frederico F Alessio-Alves, Soraia Ramos C Fabio, Millene R Camilo, Pedro T Cougo-Pinto, Octavio M Pontes-Neto, João Pereira Leite, Daniel G Abud
BACKGROUND: Brazil is a developing country struggling to reduce its extreme social inequality, which is reflected on shortage of health-care infrastructure, mainly to the low-income class, which depends exclusively on the public health system. In Brazil, less than 1% of stroke patients have access to intravenous thrombolysis in a stroke unit, and constraints to the development of mechanical thrombectomy in the public health system increase the social burden of stroke. OBJECTIVE: Report the feasibility of mechanical thrombectomy as part of routine stroke care in a Brazilian public university hospital...
January 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28059802/recent-progress-in-translational-research-on-neurovascular-and-neurodegenerative-disorders
#6
Hans-Ulrich Demuth, Rick M Dijkhuizen, Tracy D Farr, Mathias Gelderblom, Karen Horsburgh, Costantino Iadecola, Damian D Mcleod, Dominik Michalski, Tim H Murphy, Josune Orbe, Willem M Otte, Gabor C Petzold, Nikolaus Plesnila, Georg Reiser, Klaus G Reymann, Maria A Rueger, Dorothee Saur, Sean I Savitz, Stephan Schilling, Neil J Spratt, Renée J Turner, Raghu Vemuganti, Denis Vivien, Manuel Yepes, Marietta Zille, Johannes Boltze
The already established and widely used intravenous application of recombinant tissue plasminogen activator as a re-opening strategy for acute vessel occlusion in ischemic stroke was recently added by mechanical thrombectomy, representing a fundamental progress in evidence-based medicine to improve the patient's outcome. This has been paralleled by a swift increase in our understanding of pathomechanisms underlying many neurovascular diseases and most prevalent forms of dementia. Taken together, these current advances offer the potential to overcome almost two decades of marginally successful translational research on stroke and dementia, thereby spurring the entire field of translational neuroscience...
January 3, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28048545/we-de-207a-04-advances-in-radiological-neuro-endovascular-interventional-imaging
#7
S Rudin
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048454/we-de-207a-00-advances-in-image-guided-neurointerventions-clinical-pull-and-technology-push
#8
Jeffrey Siewerdsen, Rebecca Fahrig
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047800/we-de-207a-01-parallels-in-the-evolution-of-x-ray-angiographic-systems-and-devices-used-for-minimally-invasive-endovascular-therapy
#9
C Strother
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047144/we-de-207a-02-advances-in-cone-beam-ct-anatomical-and-functional-imaging-in-angio-suite-to-enable-one-stop-shop-stroke-imaging-workflow
#10
G Chen
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046482/we-de-207a-03-recent-advances-in-devices-used-in-neuro-interventions
#11
M Gounis
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28038899/mechanical-thrombectomy-in-acute-ischemic-stroke-initial-single-center-experience-and-comparison-with-randomized-controlled-trials
#12
Andreia Carvalho, André Cunha, Marta Rodrigues, Sofia Figueiredo, Ludovina Paredes, Tiago Gregório, Hugo Morais, Joaquim Pinheiro, Vítor Tedim Cruz, José Mário Roriz, João Pinho, Carla Ferreira, Edgar Torre, Joana Nunes, Sérgio Castro, Manuel Ribeiro, Miguel Veloso, Pedro Barros
BACKGROUND: Until recently, intravenous thrombolysis was the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. However, this treatment option has low recanalization rates in large-vessel occlusions. The search for additional treatments continued until 5 randomized trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) revealed the superiority of mechanical thrombectomy for anterior circulation large-vessel occlusion. After 1 year of performing thrombectomy with stent retrievers in our tertiary hospital, we intended to answer the question: is it possible to achieve similar results in a "real-world" setting? METHODS: We analyzed data from our prospective observational registry, compared it with the trials aforementioned, and concluded that the answer is affirmative...
December 27, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28025467/mechanical-thrombectomy-using-the-trevo-provue-in-50-consecutive-patients-with-anterior-circulation-stroke-a-single-center-experience-after-approval-of-the-stent-retriever-in-japan
#13
Taichiro Imahori, Kazuhiro Tanaka, Junji Koyama, Atsushi Arai, Ryoji Shiomi, Hirofumi Iwahashi, Akiyoshi Yokote, Kazushi Matsushima, Daisaku Matsui, Makoto Kobayashi, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
Mechanical thrombectomy using the stent retriever has been proven to be effective for select patients with acute ischemic stroke. We evaluated our early experience using the device after its approval in 2014 in Japan, with a special emphasis on the occlusion site. Fifty consecutive endovascular revascularization procedures for treating anterior acute large vessel occlusion were performed using the Trevo ProVue as the first-line device at our institute between April 2015 and March 2016. Focusing on the involvement of the M1-M2 bifurcation with deployment or retrieval of the stent retriever, we regarded the middle cerebral artery M1 mid-portion as the boundary and divided the cases into proximal (n = 26) and distal (n = 24) groups...
December 27, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28017749/general-anesthesia-during-endovascular-stroke-therapy-does-not-negatively-impact-outcome
#14
Arthur Wang, Madison Stellfox, Fred Moy, Apolonia E Abramowicz, Rachel Lehrer, Rivkah Epstein, Nicole Eiden, Amy Aquilina, Noorie Pednekar, Glenn Brady, Matthew Wecksell, John Cooley, Justin Santarelli, Michael F Stiefel
OBJECTIVE: Recent randomized trials, have demonstrated that endovascular therapy improves outcomes in patients with an acute ischemic stroke from a large vessel occlusion (LVO). Sub-group analysis of the MR CLEAN study found that patients undergoing general anesthesia (GA) for the procedure did worse than those with non-general anesthesia (non-GA). Current guidelines now suggest that we consider non-GA over GA, without large, randomized trials specifically designed to address this issue...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28004198/leukoaraiosis-is-a-predictor-of-futile-recanalization-in-acute-ischemic-stroke
#15
Nicola Gilberti, Massimo Gamba, Enrico Premi, Angelo Costa, Veronica Vergani, Ilenia Delrio, Raffaella Spezi, Mardighian Dikran, Michele Frigerio, Roberto Gasparotti, Alessandro Pezzini, Alessandro Padovani, Mauro Magoni
Futile recanalization occurs when successful recanalization fails to improve clinical outcome in acute ischemic stroke patients. Predictors of futile recanalization are still debated and may help in selecting patients for reperfusion strategies. We aim to determine whether leukoaraiosis may be useful in predicting futile recanalization in acute ischemic stroke patients treated by endovascular mechanical thrombectomy. We included in the analysis patients with acute ischemic stroke due to anterior circulation large vessel occlusion undergoing endovascular mechanical thrombectomy obtaining complete vessel recanalization...
December 21, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/28000971/safety-and-tolerability-of-sonovue%C3%A2-in-patients-with-large-artery-anterior-circulation-acute-stroke
#16
Claudio Baracchini, Federica Viaro, Silvia Favaretto, Anna Palmieri, Caterina Kulyk, Francesco Causin, Filippo Farina, Enzo Ballotta
BACKGROUND AND PURPOSE: Ultrasound contrast agents (UCAs) are routinely used to improve the visualization of intracranial arteries. Since a higher rate of intracranial hemorrhage (ICH) has been observed in patients undergoing sonothrombolysis in combination with UCAs, we conducted this study with the aim of assessing safety and tolerability of SonoVue® in patients with acute ischemic stroke due to anterior circulation large artery occlusion (LAO) and eligible to intravenous thrombolysis and/or mechanical thrombectomy...
December 21, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27999507/the-penumbra-5max-ace-catheter-is-safe-efficient-and-cost-saving-as-a-primary-mechanical-thrombectomy-device-for-large-vessel-occlusions-in-acute-ischemic-stroke
#17
Gabriel A Vidal, James M Milburn
BACKGROUND: Reperfusion of large vessel occlusions in acute stroke can improve patient outcomes. The purposes of this study were to assess the safety and efficacy of the Penumbra 5MAX ACE catheter for revascularization of large vessels and to compare its cost to the cost of stent retrievers. METHODS: In this retrospective, single-center case review study, data were captured on consecutive patients treated with the Penumbra 5MAX ACE as first-line therapy during an 11-month period...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27974375/catch-plus-thrombectomy-device-in-acute-stroke-initial-evaluation
#18
Ahmet Peker, Ethem Murat Arsava, Mehmet Akif Topçuoğlu, Anıl Arat
OBJECTIVE: To report our initial experience with the Catch Plus thrombectomy device (CPD) in patients with acute ischemic stroke (AIS). MATERIALS AND METHODS: We retrospectively evaluated the procedural variables as well as the clinical and angiographic outcomes of patients with acute occlusion of a major intracranial artery in the anterior circulation who were treated with CPD at our center. Baseline characteristics (gender, age, comorbidities, cardiovascular risk factors, National Institutes of Health Stroke Scale (NIHSS) score, and vessel occlusion sites) of these patients were recorded...
December 14, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27972322/cost-effectiveness-of-mechanical-thrombectomy-using-stent-retriever-after-intravenous-t-pa-compared-with-intravenous-t-pa-alone-in-the-treatment-of-acute-ischemic-stroke-due-to-large-vessel-occlusion-in-spain
#19
F de Andrés-Nogales, M Álvarez, M Á de Miquel, T Segura, A Gil, P Cardona, M Á Casado, R G Nogueira, A Dávalos
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27920715/intra-arterial-mechanical-thrombectomy-an-effective-treatment-for-ischemic-stroke-caused-by-endocarditis
#20
Olafur Sveinsson, Lars Herrman, Staffan Holmin
Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis...
September 2016: Case Reports in Neurology
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