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Acute ischemic stroke AND mechanical thrombectomy

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https://www.readbyqxmd.com/read/29783014/comparison-of-micro-clamping-stent-retriever-thrombectomy-with-conventional-stent-retriever-thrombectomy-in-intracranial-large-vessel-embolism
#1
Zhen-Sheng Liu, Gang Deng, Long-Jiang Zhou, Yong Sun, Xin-Jiang Zhang, Xiong-Wei Kuang, Yong-Lin Qin, Jia-Xiang Wang, Qing Shan
OBJECTIVE: To evaluate the effectiveness of micro-clamping stent-retriever thrombectomy (MSRT) in acute ischemic stroke patients with intracranial large vessel embolism (ILVE), and compare the same with conventional stent-retriever thrombectomy (CSRT). MATERIALS AND METHODS: We retrospectively evaluated a total of 108 ILVE patients treated by MSRT (n=52) and CSRT (n=56) from the two participating institutions between January 2016 and November 2017. The rates of successful (mTICI 2b or 3) and complete reperfusion (mTICI 3), time from guide catheter placement to reperfusion, rates of first-pass success, and the number of passes for reperfusion were compared between the MSRT and CSRT groups...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29773715/embolus-retriever-with-interlinked-cages-versus-other-stent-retrievers-in-acute-ischemic-stroke-an-observational-comparative-study
#2
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#3
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29768352/effectiveness-of-trevo-stent-retriever-in-acute-ischemic-stroke-comparison-with-solitaire-stent
#4
Ho Jun Yi, Dong Hoon Lee, Sang Uk Kim
Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29761220/transcriptomic-analysis-of-the-harvested-endothelial-cells-in-a-swine-model-of-mechanical-thrombectomy
#5
Nasren Jaff, Rikard Grankvist, Lars Muhl, Arvin Chireh, Mikael Sandell, Stefan Jonsson, Fabian Arnberg, Ulf Eriksson, Staffan Holmin
PURPOSE: In mechanical thrombectomy (MT) for ischemic stroke, endothelial cells (ECs) from intracranial blood vessels adhere to the stent retriever device and can be harvested. However, understanding the molecular biology and the role of the endothelium in different pathological conditions remains insufficient. The purpose of the study was to characterize and analyze the molecular aspect of harvested ECs using cell culture and transcriptomic techniques in an MT swine model relevant to clinical ischemic stroke...
May 14, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29758114/time-well-spent-in-recanalizing-complex-cerebrovascular-occlusions
#6
Perttu J Lindsberg
After publication of several randomized, controlled trials demonstrating the efficacy of mechanical thrombectomy (MT) following intravenous t-PA (IV t-PA) the current guidelines of acute management of cerebrovascular have been revised (1,2). In addition to IV t-PA within 4,5 hours applied in a wide spectrum of ischemic stroke subtypes, MT has been proven as the second therapeutic target in a longer time window in much more selected cases of large vessel occlusions (LVO). This article is protected by copyright...
May 14, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29755897/improving-door-to-groin-puncture-time-for-mechanical-thrombectomy-via-iterative-quality-protocol-interventions
#7
Vincent J Cheung, Arvin R Wali, David R Santiago-Dieppa, Robert C Rennert, Michael G Brandel, Jeffrey A Steinberg, Brian R Hirshman, Kevin Porras, Peter Abraham, Julie Jurf, Emily Botts, Scott Olson, J Scott Pannell, Alexander A Khalessi
INTRODUCTION: Delays in door to groin puncture time (DGPT) for patients with ischemic stroke caused by acute large vessel occlusions (LVO) are associated with worse clinical outcomes. We present the results of a quality improvement protocol for endovascular stroke treatment at the University of California, San Diego (UCSD) that aimed to minimize DGPT. MATERIALS AND METHODS: Our stroke team implemented a series of quality improvement measures to decrease DGPT, with a target of 90 minutes or less...
March 10, 2018: Curēus
https://www.readbyqxmd.com/read/29744519/mechanical-thrombectomy-a-brief-review-of-a-revolutionary-new-treatment-for-thromboembolic-stroke
#8
REVIEW
Pervinder Bhogal, Tommy Andersson, Volker Maus, Anastasios Mpotsaris, Leonard Yeo
The recent success of endovascular stroke treatment has heralded a new era in the management of acute ischemic stroke (AIS) with significantly improved outcome for patients. A large number of patients may be amenable to this new treatment and as the evidence expands the number of patients eligible for mechanical thrombectomy continues to increase. Recent evidence suggests that the time window for treatment can be extended up to 24 h after symptom onset for patients with anterior circulation strokes; however, many clinicians and medical professionals may not be aware of these recent changes and it is important that they are kept up-to-date with this rapidly evolving treatment...
May 9, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29741126/cost-effectiveness-of-mechanical-thrombectomy-for-acute-ischemic-stroke-an-australian-payer-perspective
#9
Nimita Arora, Koji Makino, Dominic Tilden, Kyriakos Lobotesis, Peter Mitchell, John Gillespie
AIMS: The goal of this study was to assess the cost-effectiveness of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) from an Australian payer perspective. METHODS: We used a Markov model that employed a life-time time horizon, modelling patients from symptom onset of stroke until end of life. Clinical efficacy and safety data were taken from an individual patient level data (IPD) meta-analysis of clinical studies. The treatment effect of MT compared to usual care was measured by changes in modified Rankin Score (mRS)...
May 9, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29739912/early-cerebral-vein-after-endovascular-ischemic-stroke-treatment-predicts-symptomatic-reperfusion-hemorrhage
#10
Samuel C D Cartmell, Robyn L Ball, Rajani Kaimal, Nicholas A Telischak, Michael P Marks, Huy M Do, Robert L Dodd, Gregory W Albers, Maarten G Lansberg, Jeremy J Heit
BACKGROUND AND PURPOSE: Parenchymal hemorrhage (PH) after endovascular mechanical thrombectomy in acute ischemic stroke leads to worse outcomes. Better clinical and imaging biomarkers of symptomatic reperfusion PH are needed to identify patients at risk. We identified clinical and imaging predictors of reperfusion PH after endovascular mechanical thrombectomy with attention to early cerebral veins (ECVs) on postreperfusion digital subtraction angiography. METHODS: We performed a retrospective cohort study of consecutive acute ischemic stroke patients undergoing endovascular mechanical thrombectomy at our neurovascular referral center...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29721400/a-direct-aspiration-first-pass-technique-for-mechanical-thrombectomy-in-the-setting-of-a-suspected-cerebral-aneurysm
#11
Ali S Haider, Suraj Sulhan, Dean Leonard, Haris Rana, Umair Khan, Tijani Osumah, Steven Vayalumkal, Richa Thakur, Kennith F Layton
There is little guidance in the literature on which thrombectomy technique is preferred in patients with acute ischemic stroke and concomitant aneurysms. Here, we present the case of a 58-year-old female with an acute ischemic stroke requiring emergent thrombectomy that was complicated by the presence of multiple, nonruptured intracranial aneurysms. Imaging confirmed an occlusion of the right middle cerebral artery and multiple nonruptured intracranial aneurysms. The patient was administered intravenous recombinant tissue plasminogen activator and the thrombus was aspirated via a direct aspiration first pass technique (ADAPT)...
March 1, 2018: Curēus
https://www.readbyqxmd.com/read/29719556/association-of-blood-glucose-and-clinical-outcome-after-mechanical-thrombectomy-for-acute-ischemic-stroke
#12
Weston R Gordon, Russell M Salamo, Anit Behera, John Chibnall, Amer Alshekhlee, Richard C Callison, Randall C Edgell
Background: Elevated blood glucose levels following acute ischemic stroke have been associated with adverse clinical outcomes in thrombolytic and nonthrombolytic treated patients. The current study examined multiple blood glucose parameters and their association with modified Rankin Scale (mRS) score at 3 months following mechanical thrombectomy and hospital discharge. Methods: Acute ischemic stroke patients undergoing mechanical thrombectomy with a retrievable stent at two stroke centers were studied...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29713305/periprocedural-antithrombotic-treatment-during-acute-mechanical-thrombectomy-for-ischemic-stroke-a-systematic-review
#13
Rob A van de Graaf, Vicky Chalos, Gregory J Del Zoppo, Aad van der Lugt, Diederik W J Dippel, Bob Roozenbeek
Background: More than one-third of the patients with ischemic stroke caused by an intracranial large vessel occlusion do not recover to functional independence despite fast and successful recanalization by acute mechanical thrombectomy (MT). This may partially be explained by incomplete microvascular reperfusion. Some antithrombotics, e.g., antiplatelet agents and heparin, may be able to restore microvascular reperfusion. However, antithrombotics may also increase the risk of symptomatic intracranial hemorrhage (sICH)...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29663986/-interpretation-of-2018-guidelines-for-the-early-management-of-patients-with-acute-ischemic-stroke
#14
Gang Wang, Bangjiang Fang, Xuezhong Yu, Zhijun Li
In 2018, the American Heart Association/American Stroke Association (AHA/ASA) has developed the latest 2018 guidelines for the early management of patients with acute ischemic stroke (AIS), based on the latest evidences. The 2018 guidelines including recommendations on pre-hospital and in-hospital management treatment, has revised and add new recommendations from 2013 guideline. The major changes in 2018 guideline involve applications of brain imaging in early stage, intravenous thrombolysis and mechanical thrombectomy, et al...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29643261/primary-results-of-the-multicenter-arise-ii-study-analysis-of-revascularization-in-ischemic-stroke-with-embotrap
#15
Osama O Zaidat, Hormozd Bozorgchami, Marc Ribó, Jeffrey L Saver, Heinrich P Mattle, René Chapot, Ana Paula Narata, Olivier Francois, Ashutosh P Jadhav, Jonathan A Grossberg, Christian H Riedel, Alejandro Tomasello, Wayne M Clark, Hannes Nordmeyer, Eugene Lin, Raul G Nogueira, Albert J Yoo, Tudor G Jovin, Adnan H Siddiqui, Thierry Bernard, Mairsíl Claffey, Tommy Andersson
BACKGROUND AND PURPOSE: EmboTrap is a novel stent retriever designed to achieve rapid and substantial flow restoration in acute ischemic stroke secondary to large-vessel occlusions. Here, we evaluated EmboTrap's safety and efficacy compared with established stent retrievers. METHODS: ARISE II (Analysis of Revascularization in Ischemic Stroke With EmboTrap) was a single-arm, prospective, multicenter study, comparing the EmboTrap device to a composite performance goal criterion derived using a Bayesian meta-analysis from the pivotal SWIFT (Solitaire device) and TREVO 2 (Trevo device) trials...
April 11, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29628942/clinical-and-angiographic-outcomes-with-the-combined-local-aspiration-and-retriever-in-the-north-american-solitaire-stent-retriever-acute-stroke-nasa-registry
#16
Tim W Malisch, Osama O Zaidat, Alicia C Castonguay, Franklin A Marden, Rishi Gupta, Chung-Huan J Sun, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey English, Italo Linfante, Guilherme Dabus, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Hashem Shaltoni, Robin Novakovic, Albert J Yoo, Alex Abou-Chebl, Peng Roc Chen, Gavin W Britz, Ritesh Kaushal, Ashish Nanda, Raul G Nogueira
Background: Various techniques are used to enhance the results of mechanical thrombectomy with stent-retrievers, including proximal arrest with balloon guide catheter (BGC), conventional large bore proximal catheter (CGC), or in combination with local aspiration through a large-bore catheter positioned at the clot interface (Aspiration-Retriever Technique for Stroke [ARTS]). We evaluated the impact of ARTS in the North American Solitaire Acute Stroke (NASA) registry. Summary: Data on the use of the aspiration technique were available for 285 anterior circulation patients, of which 29 underwent ARTS technique, 131 CGC, and 125 BGC...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29628940/moderate-to-severe-anemia-is-associated-with-poor-functional-outcome-in-acute-stroke-patients-treated-with-mechanical-thrombectomy
#17
Cetin Kursad Akpinar, Erdem Gurkas, Emrah Aytac
Background: Anemia will negatively affect cerebral collaterals and penumbra. Eventually, it may cause worse clinical outcomes and even increase mortality rates in stroke patients. Anemia has recently been suggested to be an independent risk factor for ischemic stroke. Therefore, we aimed to investigate the effects of the presence of anemia on clinical outcomes in ischemic stroke patients undergoing mechanical thrombectomy. Methods: This was a retrospective study involving the prospectively and consecutively collected data of 90 adult patients between January 2015 and August 2016...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29627789/late-recanalization-of-basilar-artery-occlusion-in-a-previously-healthy-17-month-old-child
#18
D Andrew Wilkinson, Aditya S Pandey, Hugh J Garton, Luis Savastano, Julius Griauzde, Neeraj Chaudhary, Joseph J Gemmete
Endovascular treatment of acute ischemic stroke in children is increasingly being reported, although the time window for intervention is unclear. We describe a previously healthy 17-month-old child who presented with vertebral artery thrombosis and cerebellar stroke requiring posterior fossa decompression. She later progressed to basilar artery thrombosis treated with mechanical thrombectomy 50 hours after clinical decline. At 3 month follow-up, the patient had a modified Rankin Scale score of 0.
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29618102/comparative-safety-and-efficacy-of-modified-tici-2b-and-tici-3-reperfusion-in-acute-ischemic-strokes-treated-with-mechanical-thrombectomy
#19
Nitin Goyal, Georgios Tsivgoulis, Donald Frei, Aquilla Turk, Blaise Baxter, Michael T Froehler, J Mocco, Muhammad Fawad Ishfaq, Konark Malhotra, Jason J Chang, Daniel Hoit, Lucas Elijovich, David Loy, Raymond D Turner, Justin Mascitelli, Kiersten Espaillat, Andrei V Alexandrov, Adam S Arthur
BACKGROUND: Mechanical thrombectomy (MT) is the current standard of care for acute ischemic stroke (AIS) patients with emergent large-vessel occlusions (ELVO). Successful reperfusion of ELVO is traditionally defined by modified Thrombolysis in Cerebral Infarction (mTICI) grades of 2b or 3. OBJECTIVE: To evaluate the comparative safety and efficacy of mTICI 2b and mTICI 3 reperfusion in AIS patients treated with MT. METHODS: Consecutive ELVO patients who underwent MT at 6 high-volume centers were included in this analysis...
March 30, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29602862/safety-and-efficacy-of-mechanical-thrombectomy-in-acute-ischemic-stroke-of-anticoagulated-patients
#20
Vincent L'Allinec, Marielle Ernst, Mathieu Sevin-Allouet, Nathalie Testard, Béatrice Delasalle-Guyomarch, Benoit Guillon, Mikael Mazighi, Hubert Desal, Romain Bourcier
BACKGROUND: Anticoagulated patients (APs) are currently excluded from acute ischemic stroke reperfusion therapy with intravenous recombinant tissue plasminogen activator (IV-rtPA); however, these patients could benefit from mechanical thrombectomy (MT). Evidence for MT in this condition remains scarce. The aim of this study was to analyze the safety and efficacy of MT in APs. METHODS: We analyzed three patient groups from two prospective registries: APs with MT (AP-MT group), non-anticoagulated patients treated with MT (NAP-MT group), and non-anticoagulated patients treated with IV-rtPA and MT (NAP-IVTMT group)...
March 30, 2018: Journal of Neurointerventional Surgery
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