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JOURNAL ARTICLE
Leyla Ramazanoglu, Kalyoncu Isil Aslan, Yilmaz Onal, Murat Velioglu, Osman Melih Topcuoglu
BACKGROUND: The safety and efficacy of mechanical thrombectomy (MT) for proximal large vessel occlusion after acute ischemic stroke (AIS) have been demonstrated. Clinical investigations of endovascular approaches for treating AIS due to M2 occlusions have been ongoing. PURPOSE: To assess the outcomes of M2 occlusions according to treatment modality and anatomical division. METHODS: A total of 113 consecutive M2 occlusions treated with endovascular treatment (EVT) at our tertiary stroke center between January 2019 and December 2022 were retrospectively analyzed...
April 22, 2024: Acta Radiologica
#2
JOURNAL ARTICLE
K Y Manisha, Rajalakshmi Poyuran, Deepthi Narasimhaiah, Naveen Kumar Paramasivan, Harikrishnan Ramachandran, Sapna Erat Sreedharan, Jayadevan Er, Santhosh Kumar, Jissa Vinoda Thulaseedharan, P N Sylaja
BACKGROUND: There is conflicting data on whether clot retrieved from mechanical thrombectomy can predict stroke etiology or the success of recanalization. We aimed to analyse the relation between thrombus histology and stroke aetiology as well as recanalization. METHODOLOGY: Histopathological analysis of clots retrieved from patients with acute ischemic stroke and large vessel occlusion was done. Quantification of the amount of fibrin, red blood cells(RBC), platelets and white blood cells (WBC) in the clots were done...
April 20, 2024: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
#3
JOURNAL ARTICLE
Yuan Zhi, Mehdi Madanchi, Giacomo Maria Cioffi, Julian Brunner, Leah Stutz, Eleonora Gnan, Varis Gjergjizi, Adrian Attinger-Toller, Florim Cuculi, Matthias Bossard
BACKGROUND: Patients with acute myocardial infarction (AMI) and large thrombus burden (LTB) still represent a challenge. Afflicted patients have a high morbidity and mortality. Aspiration thrombectomy is often ineffective in those cases. Mechanical thrombectomy devices (MTDs), which are effective for management of ischemic strokes, were recently CE-approved for treatment of thrombotic coronary lesions. Real-world data about their performance in AMI cases with LTB are scarce. This study sought to summarize our early experience with a novel MTD device in this context...
April 20, 2024: Cardiovascular Intervention and Therapeutics
#4
JOURNAL ARTICLE
Cornelius Deuschl, Lukas Goertz, Christoph Kabbasch, Martin Köhrmann, Christoph Kleinschnitz, Ansgar Berlis, Christoph Johannes Maurer, Iris Mühlen, Bernd Kallmünzer, Matthias Gawlitza, Daniel P O Kaiser, Joachim Klisch, Donald Lobsien, Daniel Behme, Maximilian Thormann, Fabian Flottmann, Laurens Winkelmeier, Elke Ruth Gizewski, Lukas Mayer-Suess, Markus Holtmannspoetter, Christoph Moenninghoff, Martin Schlunz-Hendann, Dominik Grieb, Christophe T Arendt, Ferdinand O Bohmann, Jens Altenbernd, Yan Li, Ulrich Sure, Ruben Mühl-Benninghaus, Thomas Rodt, Kai Kallenberg, Alexandru Durutya, Mohamed Elsharkawy, Christian-Paul Stracke, Mathias Gerhard Schumann, Alexander Bock, Omid Nikoubashman, Martin Wiesmann, Hans Henkes, Sebastian Dolff, Aydin Demircioglu, Michael Forsting, Hanna Styczen
BACKGROUND: Data on impact of COVID-19 vaccination and outcomes of patients with COVID-19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience. METHODS AND RESULTS: This was a retrospective analysis of patients with COVID-19 and known vaccination status treated with mechanical thrombectomy for acute ischemic stroke at 20 tertiary care centers between January 2020 and January 2023. Baseline demographics, angiographic outcome, and clinical outcome evaluated by the modified Rankin Scale score at discharge were noted...
April 19, 2024: Journal of the American Heart Association
#5
REVIEW
Jessica M Noll, Arya A Sherafat, Gregory D Ford, Byron D Ford
Ischemic stroke is the leading cause of serious long-term disability and the 5th leading cause of death in the United States. Revascularization of the occluded cerebral artery, either by thrombolysis or endovascular thrombectomy, is the only effective, clinically-approved stroke therapy. Several potentially neuroprotective agents, including glutamate antagonists, anti-inflammatory compounds and free radical scavenging agents were shown to be effective neuroprotectants in preclinical animal models of brain ischemia...
2024: Frontiers in Cellular Neuroscience
#6
JOURNAL ARTICLE
Dominik Wróbel, Paweł Wrona, Tomasz Homa, Klaudia Jakobschy, Gabriela Wrona, Katarzyna Sawczyńska, Mateusz Giełczyński, Tadeusz Popiela, Agnieszka Słowik, Wojciech Turaj
INTRODUCTION: The discourse surrounding differences in cerebral hemodynamics and clinical outcomes among male and female patients treated with mechanical thrombectomy (MT) for acute ischemic stroke (AIS) remains unresolved. We aimed to elucidate these differences by employing computed tomography perfusion (CTP) imaging before MT and examining the influence of perfusion deficits on the 90-day functional outcome. METHODS: This single-center retrospective analysis involved patients with anterior circulation AIS treated with MT at the Comprehensive Stroke Center, University Hospital, Krakow from January 2019 to July 2023...
April 17, 2024: Cerebrovascular Diseases
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JOURNAL ARTICLE
Akshay Bhamidipati, Nishit Mummareddy, Seoiyoung Ahn, Gabriel Bendfeldt, Alexander T Lyons, Surya Gangavarapu, Jeffrey Chen, Jacob Jo, Naveed Kamal, Steven G Roth, Michael T Froehler, Rohan V Chitale, Matthew R Fusco
BACKGROUND: Post-mechanical thrombectomy (MT) intracranial hemorrhage (ICH) is a major source of morbidity in treated acute ischemic stroke patients with large vessel occlusion. ICH expansion may further contribute to morbidity. We sought to identify factors associated with ICH expansion on imaging evaluation post-MT. METHODS: We performed a retrospective cohort study of patients undergoing MT at a single comprehensive stroke center. Per protocol, patients underwent dual-energy head CT (DEHCT) post-MT followed by a 24-h interval non-contrast enhanced MRI...
April 17, 2024: Interventional Neuroradiology
#8
REVIEW
Yudai Hirano, Satoru Miyawaki, Yusuke Sakaguchi, Satoshi Koizumi, Hiroki Hongo, Nobuhito Saito
BACKGROUND: Intracranial arterial stenosis (ICAS), caused by intracranial atherosclerosis, is one of the major causes of ischemic stroke. This study identified the top 100 most-cited publications on ICAS through a bibliometric analysis. METHODS: Two independent authors conducted a search in the Web of Science database for clinical articles on ICAS published between 1993 and 2022. The top 100 most-cited articles were then extracted. For each article, the analysis covered the title, author, country of origin/affiliation, journal, total number of citations, number of citations per year, and type of study...
2024: Surgical Neurology International
#9
JOURNAL ARTICLE
Junliu Zhang, Ling Long, Jie Li, Heng Zhang, Wei Yan, Adilijiang Abulimiti, Nuerbiya Abulajiang, Qingbo Lu, Thanh N Nguyen, Xiaodong Cai
PURPOSE: The first-pass effect (FPE), defined as complete revascularization after a single thrombectomy pass in large vessel occlusion, is a predictor of good prognosis in patients with acute ischemic stroke (AIS) receiving mechanical thrombectomy (MT). We aimed to evaluate obesity-related indicators if possible be predictors of FPE. METHODS: We consecutively enrolled patients with AIS who were treated with MT between January 2019 and December 2021 at our institution...
April 16, 2024: Neuroradiology
#10
JOURNAL ARTICLE
Nils C Lehnen, Franziska Dorn, Isabella C Wiest, Hanna Zimmermann, Alexander Radbruch, Jakob Nikolas Kather, Daniel Paech
Background Procedural details of mechanical thrombectomy in patients with ischemic stroke are important predictors of clinical outcome and are collected for prospective studies or national stroke registries. To date, these data are collected manually by human readers, a labor-intensive task that is prone to errors. Purpose To evaluate the use of the large language models (LLMs) GPT-4 and GPT-3.5 to extract data from neuroradiology reports on mechanical thrombectomy in patients with ischemic stroke. Materials and Methods This retrospective study included consecutive reports from patients with ischemic stroke who underwent mechanical thrombectomy between November 2022 and September 2023 at institution 1 and between September 2016 and December 2019 at institution 2...
April 2024: Radiology
#11
JOURNAL ARTICLE
Giovanni Merlino, Michele Romoli, Raffaele Ornello, Matteo Foschi, Caterina Del Regno, Francesco Toraldo, Alessandro Marè, Francesco Cordici, Alessio Trosi, Marco Longoni, Fedra Kuris, Yan Tereshko, Simone Lorenzut, Carolina Gentile, Francesco Janes, Francesco Bax, Massimo Sponza, Vladimir Gavrilovic, Soma Banerjee, Simona Sacco, Gian Luigi Gigli, Lucio D'Anna, Mariarosaria Valente
INTRODUCTION: Mechanical thrombectomy (MT) is the standard treatment for acute ischemic stroke (AIS) due to anterior large vessel occlusion (LVO). Despite successful recanalization, some patients remain disabled after 3 months. Mechanisms that can cause futile recanalization (FR) are still largely unknown. We investigated if stress hyperglycemia might be associated with FR. PATIENTS AND METHODS: This is a retrospective analysis of consecutive patients with successful recanalization treated in four participating centers between January 2021 and December 2022...
April 16, 2024: European Stroke Journal
#12
Yuki Kubota, Fusakazu Oya, Fumiko Higashiyama
When starting a mechanical thrombectomy, manual aspiration with balloon guide catheters inserted into the internal carotid artery (ICA) is an efficient method for thrombus aspiration. However, no complications associated with this procedure have been reported. This study describes the case of a 76-year-old man who presented to our hospital with total aphasia and complete right-sided paralysis due to chronic atrial fibrillation and left occlusion of the ICA. When the balloon guide catheter was inserted and inflated at the origin of the left ICA, the patient's systolic blood pressure suddenly decreased from 114 mm Hg to 44 mm Hg...
March 2024: Curēus
#13
JOURNAL ARTICLE
Salman Hashim, Nishita Patel, Ala Nozari, Wissam Mustafa
A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a large epiglottis. Two-handed, 2-provider mask ventilation with an oral airway proved difficult. The team successfully placed a supraglottic airway (SGA) through which an oral endotracheal tube (ETT) was advanced over a fiberoptic bronchoscope into the trachea...
April 1, 2024: A&A Practice
#14
JOURNAL ARTICLE
Cansu Sahin, Alice Giraud, Duaa Jabrah, Smita Patil, Pierluca Messina, Franz Bozsak, Jean Darcourt, Federico Sacchetti, Anne-Christine Januel, Guillaume Bellanger, Jorge Pagola, Jesus Juega, Hirotoshi Imamura, Tsuyoshi Ohta, Laurent Spelle, Vanessa Chalumeau, Uros Mircic, Predrag Stanarčević, Ivan Vukašinović, Marc Ribo, Nobuyuki Sakai, Christophe Cognard, Karen Doyle
BACKGROUND: Electrochemical impedance spectroscopy can determine characteristics such as cell density, size, and shape. The development of an electrical impedance-based medical device to estimate acute ischemic stroke (AIS) clot characteristics could improve stroke patient outcomes by informing clinical decision making. OBJECTIVES: To assess how well electrical impedance combined with machine learning identified red blood cell (RBC)-rich composition of AIS clots ex vivo , which is associated with a successfully modified first-pass effect...
March 2024: Research and Practice in Thrombosis and Haemostasis
#15
JOURNAL ARTICLE
Yiqiao Xu, Xin Liu, Hao Li
OBJECTIVE: Endovascular therapy (EVT) is recommended for patients with acute large-vessel occlusion (LVO) However, its efficacy and safety compared to medical management (MM) in patients with a National Institutes of Health Stroke Scale (NIHSS) score of ≤6 remains unclear. This meta-analysis compared EVT with medical MM in patients with large vessel occlusion mild stroke treated between 2015 and 2023, following the publication of the first randomized controlled trial. MATERIALS AND METHODS: Biomedical database searches (inception to March 21, 2023) retrieved articles reporting favorable functional outcome(modified Rankin Scale [mRS] 0-1) and functional independence (mRS 0-2), 90-day mortality and symptomatic intracranial hemorrhage (sICH)...
April 12, 2024: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
#16
JOURNAL ARTICLE
Shadi M Ramadan, Bernard Esisi
Mechanical thrombectomy (MT) is indicated for patients with acute ischemic stroke resulting from large vessel occlusion (LVO). At Hull Royal Infirmary (HRI), the MT service is available from 08:00 h to 16:00 h, Monday to Friday. Consequently, many patients who present outside of those times are denied a chance of having this treatment. The objective of this audit was to detect the percentage of patients who had presented out of hours and managed to have MT and to identify why the remaining proportion of patients did not receive this treatment...
September 2023: Clinical Medicine: Journal of the Royal College of Physicians of London
#17
JOURNAL ARTICLE
Ana Clara Felix De Farias Santos, Luciano Lobão Salim Coelho, Guilherme de Carvalho Caldas, Luziany Carvalho Araújo, Vivian Dias Baptista Gagliardi, Leonardo Augusto Carbonera
BACKGROUND: After recently published randomized clinical trials, the choice of the best anesthetic procedure for mechanical thrombectomy (MT) in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) is not definite. OBJECTIVE: To compare the efficacy and safety of general anesthesia (GA) versus conscious sedation (CS) in patients with AIS who underwent MT, explicitly focusing on procedural and clinical outcomes and the incidence of adverse events...
April 2024: Arquivos de Neuro-psiquiatria
#18
JOURNAL ARTICLE
Madona Pakkam, Atakan Orscelik, Basel Musmar, Hatem Tolba, Sherief Ghozy, Yigit Can Senol, Cem Bilgin, Sandeep Samethadka Nayak, Ramanathan Kadirvel, Waleed Brinjikji, Alejandro A Rabinstein, David F Kallmes
OBJECTIVES: Stroke is a leading cause of mortality and disability globally, with limited treatment options available for acute ischemic stroke (AIS) patients. Type 2 diabetes mellitus (T2DM) is not only widespread but also a known risk factor for stroke. Our meta-analysis aims to assess the influence of pre-stroke metformin use on the clinical outcomes in AIS patients with T2DM. MATERIALS AND METHODS: We conducted this study following PRISMA guidelines, searching the following databases: Medline, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials up to February 29, 2024...
April 9, 2024: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
#19
JOURNAL ARTICLE
Yongchang Liu, Yan Li, Shaoquan Li, Songwang Xie, Junyong Wang, Jian Wang, Zhen Hong
OBJECTIVE: To observe and analyze the efficacy of recombinant tissue-plasminogen activator (rt-PA) thrombolysis combined with Solitaire AB stent mechanical thrombectomy in patients with acute ischemic stroke. METHODS: Clinical efficacy, neurological function, oxidative stress response, adverse reactions, and quality of life were compared between the two groups. RESULTS: Lower NIHSS scores were observed among patients who received treatment within 2 hours after stroke onset when compared with those in a timeframe of 2-6 hours, suggesting better neurological function recovery of the patients with early intervention and thus emphasizing the importance of early treatment for patients with stroke onset...
April 10, 2024: International Journal of Neuroscience
#20
JOURNAL ARTICLE
Yanxiang Bao, Bo Ning
OBJECTIVE: To analyze the effectiveness of stent retriever mechanical thrombectomy combined with tirofiban in treating acute ischemic stroke. METHODS: Markedly effective is defined as an SIS score of over 90, effective is indicated by an SIS score of between 50-90, and a score of below 50 suggests ineffective treatment results. RESULTS: ①The treatment's overall effectiveness in the observation group (91.30%) was significantly higher than that in the control group (75...
April 10, 2024: International Journal of Neuroscience
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