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Acute ischemic stroke AND mechanical thrombectomy

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https://www.readbyqxmd.com/read/29149357/recommendations-for-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke-a%C3%A2-clinical-guide-by-the-hellenic-stroke-organization
#1
REVIEW
Panagiotis Papanagiotou, George Ntaios, Vasileios Papavasileiou, Klearchos Psychogios, Marios Psychogios, Anastasios Mpotsaris, Timolaos Rizos, Konstantinos Spengos, Miltiadis Gravanis, Sofia Vassilopoulou, Christos Gkogkas, Petros Zampakis, Panagiotis Zis, Apostolos Karantanas, Michail Karygiannis, Georgios Karydas, Eleni Korompoki, Konstantinos Makaritsis, Konstantinos Marmagkiolis, Haralambos Milionis, Dimos Mitsikostas, Dimitrios Nikas, Androniki Plomaritoglou, Maria Politi, Nikolaos Ptochis, Christos Savopoulos, Konstantinos Takis, Nikolaos Tsamopoulos, Dimitrios Tsetis, Adam Hatzidakis, Achilleas Chatziioannou, Apostolos Hatzitolios, Konstantinos Vemmos
This document presents the consensus recommendations of the Hellenic Stroke Organization which can be of assistance to the treating stroke physicians.
November 17, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#2
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29142624/significances-and-outcomes-of-mechanical-thrombectomy-for-acute-infarction-in-very-elderly-patients-a-single-center-experience
#3
Dong Hun Kim, Sang Uk Kim, Jae Hoon Sung, Dong Hoon Lee, Ho Jun Yi, Sang Won Lee
Objective: Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ≥80 years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods: Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142621/mechanical-thrombectomy-with-solitaire-stent-retrieval-for-acute-cardioembolic-stroke
#4
Hokyun Han, Hyunho Choi, Keun-Tae Cho, Byong-Cheol Kim
Objective: Few studies have reported the outcome of mechanical thrombectomy with Solitaire stent retrival (MTSR) in subtypes of acute ischemic stroke. The purpose of this study was to evaluate the efficacy and result of MTSR in acute cardioembolic stroke. Methods: Twenty consecutive patients with acute cardioembolic stroke were treated by MTSR. The angiographic outcome was assessed by thrombolysis in cerebral infarction (TICI) grade. TICI grade 2a, 2b, or 3 with a measurable thrombus that was retrieved was considered as a success when MTSR was performed in the site of primary vessel occlusion, and TICI grade 2b or 3 was considered as a success when final result was reported...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29137863/results-and-functional-outcomes-of-acute-ischemic-stroke-patients-who-underwent-mechanical-thrombectomy-admitted-to-intensive-care-unit
#5
L Viña Soria, L Martín Iglesias, L López Amor, I Astola Hidalgo, R Rodríguez García, L Forcelledo Espina, J A Gonzalo Guerra, S de Cima Iglesias, E Murias Quintana, P Vega Valdés, S Calleja Puerta, D Escudero Augusto
PURPOSE: To study the results and complications of endovascular treatment (EVT) in acute ischemic stroke patients admitted to Intensive Care Unit (ICU). To analyse the possible factors related to mortality and level of disability at ICU discharge and one year after stroke. DESIGN: Observational prospective study. SETTING: Mixed ICU. Third level hospital. PATIENTS: Sixty adult patients. Consecutive sample. INTERVENTIONS: None...
November 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29136121/mechanical-thrombectomy-for-acute-ischemic-stroke-secondary-to-infective-endocarditis
#6
Juan Ambrosioni, Xabier Urra, Marta Hernández-Meneses, Manel Almela, Carlos Falces, Adrian Tellez, Eduard Quintana, David Fuster, Elena Sandoval, Barbara Vidal, Jose M Tolosana, Asunción Moreno, Angel Chamorro, José M Miró
Intravenous thrombolysis is contraindicated in acute ischemic stroke secondary to infective endocarditis. We report our initial experience of six cases with proximal vessel occlusion treated with mechanical thrombectomy. It was safe (no bleeding) and effective (significant, early neurological improvement) and might therefore be useful in this clinical setting.
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29127270/low-dose-tirofiban-improves-functional-outcome-in-acute-ischemic-stroke-patients-treated-with-endovascular-thrombectomy
#7
Wenbo Zhao, Ruiwen Che, Shuyi Shang, Chuanjie Wu, Chuanhui Li, Longfei Wu, Jian Chen, Jiangang Duan, Haiqing Song, Hongqi Zhang, Feng Ling, Yuping Wang, David Liebeskind, Wuwei Feng, Xunming Ji
BACKGROUND AND PURPOSE: Chinese patients largely experience acute ischemic stroke (AIS) because of large artery atherosclerosis rather than cardioembolism, and whether tirofiban is safe and effective in these patients treated with endovascular thrombectomy (ET) is unknown. This study evaluated the safety and efficacy of tirofiban in Chinese patients with AIS treated with ET. METHODS: This observational study is based on a single-center prospective registry study...
November 10, 2017: Stroke; a Journal of Cerebral Circulation
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
#8
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/29119876/endovascular-treatment-outcomes-using-the-stroke-triage-education-procedure-standardization-and-technology-steps-t-program
#9
Ameer E Hassan, Christina Sanchez, Angela N Johnson
Background "Door to treatment" time affects outcomes of acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT). However, the correlation between staff education and accessible technology with stroke outcomes has not been demonstrated. Objective The objective of this paper is to demonstrate the five-year impact of the Stroke Triage Education, Procedure Standardization, and Technology (STEPS-T) program on time-to-treat and clinical outcomes. Methods The study analyzed a prospectively maintained database of AIS patients who benefited from EVT through implementation of STEPS-T...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29118798/internal-carotid-artery-and-the-proximal-m1-segment-are-optimal-targets-for-mechanical-thrombectomy
#10
Niko Sillanpää, Sara Protto, Jukka T Saarinen, Juha-Pekka Pienimäki, Janne Seppänen, Heikki Numminen, Harri Rusanen
Background and Purpose: Mechanical thrombectomy (MT) is an established treatment of acute anterior circulation stroke caused by large vessel occlusion (LVO). We compared the clinical outcome (3-month modified Rankin Scale, mRS) in hyperacute (<3h from the onset of symptoms) ischemic stroke between an MT and an intravenous thrombolysis (IVT) cohort in proximal (ICA and the proximal M1 segment of the middle cerebral artery) and distal (the distal M1 and the M2 segment) LVOs. Methods: We prospectively reviewed 67 patients who underwent MT with newer-generation stent retrievers...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29113900/dwell-time-of-stentriever-influences-complete-revascularisation-and-first-pass-tici3-revascularisation-in-acute-large-vessel-occlusive-stroke
#11
Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sylaja Padmavathy N, Sankara Sarma P, Sajith Sukumaran, Sapna Erat Sreedharan, Tirur Raman Kapilamoorthy
BACKGROUND AND OBJECTIVE: In acute ischemic stroke with large vessel occlusion, the interaction between the clot retriever and the stent is critical for achieving successful recanalization. The ideal time of stent deployment (dwell time, DT) to improve revascularization is currently unknown., We systematically analysed the effect of different DT on final angiographic and clinical outcome of of patients who underwent mechanical thrombectomy. METHODS: The DT was progressively increased from 3 minutes to 5 minutes and later, 8 minutes during the study period...
November 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#12
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29089458/mechanical-thrombectomy-for-minor-and-mild-stroke-patients-harboring-large-vessel-occlusion-in-the-anterior-circulation-a-multicenter-cohort-study
#13
Cyril Dargazanli, Caroline Arquizan, Benjamin Gory, Arturo Consoli, Julien Labreuche, Hocine Redjem, Omer Eker, Jean-Pierre Decroix, Astrid Corlobé, Isabelle Mourand, Nicolas Gaillard, Xavier Ayrignac, Mahmoud Charif, Alain Duhamel, Paul-Emile Labeyrie, Carlos Riquelme, Gabriele Ciccio, Stanislas Smajda, Jean-Philippe Desilles, Grégory Gascou, Pierre-Henri Lefèvre, Daniel Mantilla-García, Federico Cagnazzo, Oguzhan Coskun, Mikael Mazighi, Roberto Riva, Frédéric Bourdain, Pierre Labauge, Georges Rodesch, Michael Obadia, Alain Bonafé, Francis Turjman, Vincent Costalat, Michel Piotin, Raphaël Blanc, Bertrand Lapergue
BACKGROUND AND PURPOSE: Proximal large vessel occlusion (LVO) is present in up to 30% of minor strokes. The effectiveness of mechanical thrombectomy (MT) in the subgroup of minor stroke with LVO in the anterior circulation is still open to debate. Data about MT in this subgroup of patients are sparse, and their optimal management has not yet been defined. The purpose of this multicenter cohort study was to evaluate the effectiveness of MT in patients experiencing acute ischemic stroke (AIS) because of LVO in the anterior circulation, presenting with minor-to-mild stroke symptoms (National Institutes of Health Stroke Scale score of <8)...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29089454/cerebral-near-infrared-spectroscopy-a-potential-approach-for-thrombectomy-monitoring
#14
Thomas Ritzenthaler, Tae-Hee Cho, Laura Mechtouff, Elodie Ong, Francis Turjman, Philip Robinson, Yves Berthezène, Norbert Nighoghossian
BACKGROUND AND PURPOSE: Regional brain oxygen saturation (rSO2) changes, assessed by cerebral near-infrared spectroscopy, are likely influenced by cerebral hemodynamic fluctuations induced by thrombectomy of acute proximal occlusion. We studied the correlations between rSO2 and baseline magnetic resonance imaging perfusion parameters and the relationship between rSO2 changes, recanalization, and clinical outcome. METHODS: Seventeen acute ischemic stroke patients, treated with mechanical thrombectomy, were monitored using bilateral near-infrared spectroscopy before, during, and continuously for 24 hours after the procedure...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29084408/influence-of-renal-function-on-treatment-results-after-stroke-thrombectomy
#15
Mona Laible, Markus Alfred Möhlenbruch, Johannes Pfaff, Ekkehart Jenetzky, Peter Arthur Ringleb, Martin Bendszus, Timolaos Rizos
BACKGROUND: Renal dysfunction (RD) may be associated with poor outcome in ischemic stroke patients treated with mechanical thrombectomy (MT), but data concerning this important and emerging comorbidity do not exist so far. Here, we investigated the influence of RD on postprocedural intracerebral hemorrhage (ICH), clinical outcome, and mortality in a large prospectively collected cohort of acute ischemic stroke patients treated with MT. METHODS: Consecutive patients with anterior-circulation stroke treated with MT between October 2010 and January 2016 were included...
October 31, 2017: Cerebrovascular Diseases
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
#16
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/29076879/managing-high-blood-pressure-during-acute-ischemic-stroke-and-intracerebral-hemorrhage
#17
Karen O Appiah, Jatinder S Minhas, Thompson G Robinson
PURPOSE OF REVIEW: Blood pressure (BP) elevations above premorbid levels are observed in at least 60% of acute ischemic and hemorrhagic stroke patients, within the first 24 h of symptom onset. A number of potential causes have been hypothesized, and high BP may be associated with poor stroke outcome. This review discusses management strategies of high BP in acute stroke, in the context of current guidelines. RECENT FINDINGS: Excessive BP elevation can impact acute stroke therapeutic strategies, particularly in modifying intervention safety and efficacy...
October 25, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29071134/solitaire-stent-in-the-treatment-of-acute-ischemic-stroke-with-large-cerebral-artery-occlusion
#18
Wenbao Liang, Zhijie Ou, Rui Luo
OBJECTIVE: To investigate the effect of mechanical thrombectomy with solitaire stent in the treatment of acute ischemic stroke with large cerebral artery occlusion. METHODS: Fifteen acute ischemic stroke patients with a proximal intracranial occlusion in the anterior circulation were included within 6 hours after symptom onset (unknown time of onset allowed in wake upstroke). Patients with a large infarct core or poor collateral circulation on computed tomography (CT) and CT angiography were excluded...
2017: Translational Neuroscience
https://www.readbyqxmd.com/read/29063260/-childhood-stroke-what-are-the-special-features-of-childhood-stroke
#19
REVIEW
L Gerstl, M V Bonfert, T Nicolai, M Dieterich, C Adamczyk, F Heinen, M Olivieri, M Steinlin
Childhood arterial ischemic stroke differs in essential aspects from adult stroke. It is rare, often relatively unknown among laypersons and physicians and the wide variety of age-specific differential diagnoses (stroke mimics) as well as less established care structures often lead to a considerable delay in the diagnosis of stroke. The possible treatment options in childhood are mostly off-label. Experiences in well-established acute treatment modalities in adult stroke, such as thrombolysis and mechanical thrombectomy are therefore limited in children and only based on case reports and case series...
October 23, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/29058984/impact-of-histological-thrombus-composition-on-preinterventional-thrombus-migration-in-patients-with-acute-occlusions-of-the-middle-cerebral-artery
#20
Christian Maegerlein, Benjamin Friedrich, Maria Berndt, Kristin Elizabeth Lucia, Lucas Schirmer, Holger Poppert, Claus Zimmer, Jaroslav Pelisek, Tobias Boeckh-Behrens, Johannes Kaesmacher
Purpose The occurrence of thrombus migration (TM) in middle cerebral arteries (MCAs) prior to mechanical thrombectomy (MT) in patients suffering from acute ischemic strokes is a crucial aspect as TM is associated with lower rates of complete reperfusion and worse clinical outcomes. In this study, we sought to clarify whether histological thrombus composition influences TM. Methods We included 64 patients with acute MCA occlusions who had undergone MT. In 11 of the cases (17.2%) we identified TM prior to the interventions...
January 1, 2017: Interventional Neuroradiology
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