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https://www.readbyqxmd.com/read/28138001/multiparametric-magnetic-resonance-imaging-for-prediction-of-parenchymal-hemorrhage-in-acute-ischemic-stroke-after-reperfusion-therapy
#1
Kambiz Nael, James R Knitter, Reza Jahan, Jeffery Gornbein, Zahra Ajani, Lei Feng, Brett C Meyer, Lee H Schwamm, Albert J Yoo, Randolph S Marshall, Philip M Meyers, Dileep R Yavagal, Max Wintermark, David S Liebeskind, Judy Guzy, Sidney Starkman, Jeffrey L Saver, Chelsea S Kidwell
BACKGROUND AND PURPOSE: Patients with acute ischemic stroke are at increased risk of developing parenchymal hemorrhage (PH), particularly in the setting of reperfusion therapies. We have developed a predictive model to examine the risk of PH using combined magnetic resonance perfusion and diffusion parameters, including cerebral blood volume (CBV), apparent diffusion coefficient, and microvascular permeability (K2). METHODS: Voxel-based values of CBV, K2, and apparent diffusion coefficient from the ischemic core were obtained using pretreatment magnetic resonance imaging data from patients enrolled in the MR RESCUE clinical trial (Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy)...
January 30, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28118796/mechanical-recanalization-for-acute-embolic-occlusion-at-the-origin-of-the-superior-mesenteric-artery
#2
Yoichi Miura, Tomohiro Araki, Mio Terashima, Junya Tsuboi, Yasuhiro Saito, Kenji Kanamaru, Hidenori Suzuki
PURPOSE: We report a combined technique consisting of thrombectomy and thromboaspiration for the treatment of acute embolic occlusion of the superior mesenteric artery (SMA) at the origin. CASE: A 90-year-old female with chronic atrial fibrillation had a sudden onset of abdominal pain and hematochezia due to acute embolic occlusion at the origin of the SMA. Computed tomographic findings showed reversible bowel wall ischemia. We performed mechanical thrombectomy using the Solitaire FR revascularization device, a self-expanding and fully retrievable stent-based thrombectomy system for acute intracranial large artery occlusion, combined with manual aspiration through a 6F guiding sheath placed at the SMA origin via a right brachial approach...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28100995/a-rare-case-of-intraductal-papillary-mucinous-neoplasm-of-the-biliary-duct-in-a-patient-with-prostate-adenocarcinoma
#3
Ravish Parekh, Gregory Krol, Cyrus Piraka, Surinder Batra
Intraductal papillary mucinous neoplasms (IPMNs) are mucin-producing papillary neoplasms of the pancreatic or biliary ductal system that exhibit variable cellular atypia and cause ductal dilation. There are few reported cases of IPMN arising from the biliary tree in the literature. It has a higher propensity to undergo malignant transformation compared to IPMN arising from the pancreatic duct. An 80-year-old male underwent cross-sectional tomography (CT) imaging of the abdomen for evaluation of prostate adenocarcinoma, which revealed an incidental 2...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28062805/intravenous-thrombolysis-before-endovascular-therapy-for-large-vessel-strokes-can-lead-to-significantly-higher-hospital-costs-without-improving-outcomes
#4
Ansaar T Rai, SoHyun Boo, Chelsea Buseman, Amelia K Adcock, Abdul R Tarabishy, Maurice M Miller, Thomas D Roberts, Jennifer R Domico, Jeffrey S Carpenter
BACKGROUND: Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. PURPOSE: To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). METHODS: A single-center retrospective analysis was performed...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27929569/disappearance-of-the-hyperdense-mca-sign-after-stroke-thrombolysis-implications-for-prognosis-and-early-patient-selection-for-clot-retrieval
#5
P Elofuke, J M Reid, A Rana, M-J Macleod
Disappearance of the hyperdense middle cerebral artery sign (HMCAS) following intravenous thrombolysis for ischaemic stroke is associated with improved outcome. Debate exists over which radiological thrombus characteristics can predict disappearance of the HMCAS after thrombolysis such as vessel attenuation or extent of thrombus length. Methods Ischaemic stroke patients treated with intravenous thrombolysis from our hospital were entered into a European registry. Patient demographics, stroke severity pre- and 24 hours post-thrombolysis were recorded...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27863833/rapid-systematic-review-intra-arterial-thrombectomy-clot-retrieval-for-selected-patients-with-acute-ischemic-stroke
#6
William J Meurer, Bradley E Barth, Gary Gaddis, Gary M Vilke, Samuel H F Lam
BACKGROUND: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality. However, precisely defining the optimal treatment for individual patients early after AIS onset remains elusive. There has recently been a surge in published studies documenting the effectiveness of mechanical intra-arterial thrombectomy for treatment of a subset of patients with AIS. This therapy has been proposed and studied for the small (<1.2%) subgroup of patients with ischemic strokes who have "large vessel" strokes or strokes that fail to improve after the administration of tissue plasminogen activator (t-PA)...
February 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27790793/evaluation-of-the-computed-tomographic-sentinel-clot-sign-to-identify-bleeding-abdominal-organs-in-dogs-with-hemoabdomen
#7
Swan Specchi, Edoardo Auriemma, Simona Morabito, Filippo Ferri, Eric Zini, Valentina Piola, Pascaline Pey, Federica Rossi
The CT "sentinel clot sign" has been defined as the highest attenuation hematoma adjacent to a bleeding organ in humans with hemoabdomen. The aims of this retrospective descriptive multicenter study were to describe CT findings in a sample of dogs with surgically or necropsy confirmed intra-abdominal bleeding and determine prevalence of the "sentinel clot sign" adjacent to the location of bleeding. Medical records between 2012 and 2014 were searched for dogs with hemoabdomen and in which the origin of the bleeding was confirmed either with surgery or necropsy...
January 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/27789155/guidelines-of-the-french-society-of-otorhinolaryngology-sforl-first-line-treatment-of-epistaxis-in-adults
#8
E Bequignon, B Vérillaud, L Robard, J Michel, V Prulière Escabasse, L Crampette, O Malard
OBJECTIVES: The authors present the guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL) on first-line treatment of epistaxis in adults. METHODS: A multidisciplinary work-group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work-group. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence...
October 24, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/27779589/extracorporeal-life-support-in-trauma-worth-the-risks-a-systematic-review-of-published-series
#9
Kareem Bedeir, Raghu Seethala, Edward Kelly
BACKGROUND: Extracorporeal life support (ECLS) is a potentially life-saving procedure for trauma patients with severe respiratory failure. Despite this, only a limited number of publications report series of trauma patients who underwent ECLS. The performance and safety of this technology in trauma patients is not fully understood. We described the efficacy and complications of ECLS in trauma patients with respiratory failure. METHODS: A systematic review of published reports was performed utilizing the Medical Literature Analysis and Retrieval System Online (MEDLINE)...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27733029/direct-thrombus-imaging-in-stroke
#10
REVIEW
Jongseong Kim, Jung E Park, Matthias Nahrendorf, Dong-Eog Kim
There is an emergent need for imaging methods to better triage patients with acute stroke for tissue-plasminogen activator (tPA)-mediated thrombolysis or endovascular clot retrieval by directly visualizing the size and distribution of cerebral thromboemboli. Currently, magnetic resonance (MR) or computed tomography (CT) angiography visualizes the obstruction of blood flow within the vessel lumen rather than the thrombus itself. The present visualization method, which relies on observation of the dense artery sign (the appearance of cerebral thrombi on a non-enhanced CT), suffers from low sensitivity...
September 2016: Journal of Stroke
https://www.readbyqxmd.com/read/27692532/retrievable-inferior-vena-cava-filters-in-trauma-patients-prevalence-and-management-of-thrombus-within-the-filter
#11
Y Pan, J Zhao, J Mei, M Shao, J Zhang, H Wu
OBJECTIVE: The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS: The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27683755/remote-aspiration-thrombectomy-in-large-vessel-acute-ischemic-stroke
#12
Diogo C Haussen, Mehdi Bouslama, Jonathan A Grossberg, Raul G Nogueira
The use of balloon guide catheters in acute ischemic stroke intervention has been associated with improved reperfusion rates and clinical outcomes. This technique acts by promoting flow arrest and subsequent reversal to capture the thrombus debris that may be generated during the clot retrieval process. However, to the best of our knowledge, the use of BGC to remotely aspirate and remove intracranial thrombus has not been previously described. We report a three case series of patients with acute ischemic stroke from supraclinoidal internal carotid artery occlusions treated with remote aspiration thrombectomy through a BGC placed at the cervical internal carotid artery, leading to complete reperfusion without the need for intracranial catheterization...
September 28, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27658470/direct-oral-anticoagulants-in-emergency-trauma-admissions
#13
Marc Maegele, Oliver Grottke, Herbert Schöchl, Oliver A Sakowitz, Michael Spannagl, Jürgen Koscielny
BACKGROUND: Direct (non-vitamin-K-dependent) oral anticoagulants (DOAC) are given as an alternative to vitamin K antagonists (VKA) to prevent stroke and embolic disease in patients with atrial fibrillation that is not due to pathology of the heart valves. Fatal hemorrhage is rarer when DOACs are given (nonvalvular atrial fibrillation: odds ratio [OR] 0.68; 95% confidence interval [95% CI: 0.48; 0.96], and venous thromboembolism: OR 0.54; [0.22; 1.32]). 48% of emergency trauma patients need an emergency operation or early surgery...
September 5, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27651872/treatment-of-the-superior-sagittal-sinus-thrombosis-with-the-mechanical-thrombectomy-using-stent-retriever-device
#14
Hoon Kim, Seong Rim Kim, Ik Seong Park, Young Woo Kim
Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment...
September 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27634955/impact-of-thrombus-length-on-recanalization-and-clinical-outcome-following-mechanical-thrombectomy-in-acute-ischemic-stroke
#15
Fatih Seker, Johannes Pfaff, Marcel Wolf, Silvia Schönenberger, Simon Nagel, Christian Herweh, Mirko Pham, Martin Bendszus, Markus A Möhlenbruch
PURPOSE: The impact of thrombus length on recanalization in IV thrombolysis for acute intracranial artery occlusion has been well studied. Here we analyzed the influence of thrombus length on the number of thrombectomy maneuvers needed for recanalization, intraprocedural complications, recanalization success, and clinical outcome after mechanical thrombectomy. METHODS: We retrospectively analyzed angiographic and clinical data from 72 consecutive patients with acute occlusion of the M1 segment of the middle cerebral artery who were treated with mechanical thrombectomy using stent retrievers...
September 15, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27634952/association-of-clot-burden-score-with-radiographic-and-clinical-outcomes-following-solitaire-stent-retriever-thrombectomy-analysis-of-the-swift-prime-trial
#16
Maxim Mokin, Elad I Levy, Adnan H Siddiqui, Mayank Goyal, Raul G Nogueira, Dileep R Yavagal, Vitor M Pereira, Jeffrey L Saver
BACKGROUND: The clot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. CBS is based on the presence or absence of contrast opacification on CT angiography (CTA). Its value in predicting radiographic and clinical outcomes in patients given endovascular stroke therapy remains unknown. OBJECTIVE: To evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial...
September 15, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27621884/penetrating-thoracic-injury-with-retained-foreign-body-can-video-assisted-thoracic-surgery-take-up-the-leading-role-in-acute-management
#17
Peter S Y Yu, Herman H M Chan, Rainbow W H Lau, Freddie G Capili, Malcolm J Underwood, Innes Y P Wan
Video-assisted thoracic surgery (VATS) is widely adopted in acute management of patient with thoracic trauma, but its use in penetrating thoracic injuries with retained foreign bodies were rarely reported. We described three of such cases using VATS as the first line approach. Identification of injuries, control of bleeders, clot evacuation, resection of damaged lung parenchyma and safe retrieval of foreign bodies were all performed via complete VATS within short operative time. Patient were uneventfully discharged during early post-operative period...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27578909/treatment-protocol-based-on-assessment-of-clot-quality-during-endovascular-thrombectomy-for-acute-ischemic-stroke-using-the-trevo-stent-retriever
#18
Kojiro Ishikawa, Tomotaka Ohshima, Masahiro Nishihori, Tasuku Imai, Shunsaku Goto, Taiki Yamamoto, Toshihisa Nishizawa, Shinji Shimato, Kyozo Kato
The optional endovascular approach for acute ischemic stroke is unclear. The Trevo stent retriever can be used as first-line treatment for fast mechanical recanalization. The authors developed a treatment protocol for acute ischemic stroke based on the assessment of clot quality during clot removal with the Trevo. This prospective single-center study included all patients admitted for acute ischemic stroke between July 2014 and February 2015, who underwent emergency endovascular treatment. According to the protocol, the Trevo was used for first-line treatment...
August 2016: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/27543628/interaction-between-the-stent-strut-and-thrombus-characterized-by-contrast-enhanced-high-resolution-cone-beam-ct-during-deployment-of-the-solitaire-stent-retriever
#19
Tomoyuki Tsumoto, Yuichiro Tsurusaki, So Tokunaga
BACKGROUND: The mechanism by which a stent retriever removes intraluminal thrombus from an occluded vessel in humans has not previously been studied. This study performed contrast-enhanced high-resolution cone beam CT (CE-HRCBCT) during deployment of the stent retriever to observe the interaction between the strut and intraluminal thrombus intraoperatively. We also discuss the mechanism by which the thrombus is retrieved. METHODS: In 11 patients, mechanical thrombectomy was performed with a Solitaire stent retriever...
August 19, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27535287/intracardiac-bone-cement-embolism-as-a-complication-of-vertebroplasty-management-strategy
#20
Catherine Hatzantonis, Marcin Czyz, Renata Pyzik, Bronek M Boszczyk
BACKGROUND: Vertebroplasty carries multiple complications due to the leakage of polymethylmethacrylate (PMMA) into the venous system through the iliolumbar or epidural veins. The rate of venous cement complications may vary from 1 to 10 %, with cement extravasation into the venous system in 24 % of patients. Emboli may further migrate into the right heart chambers and pulmonary arteries. Patients may vary in presentation from asymptomatic or symptoms such as syncope to life-threatening complications...
August 17, 2016: European Spine Journal
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