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https://www.readbyqxmd.com/read/28428348/predictors-of-the-aspiration-component-success-of-a-direct-aspiration-first-pass-technique-adapt-for-the-endovascular-treatment-of-stroke-reperfusion-strategy-in-anterior-circulation-acute-stroke
#1
Raphaël Blanc, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Jean-Philippes Desilles, Eliane Orng, Guillaume Taylor, Elodie Drumez, Robert Fahed, Julien Labreuche, Mikael Mazighi, Bertrand Lapergue, Michel Piotin
BACKGROUND AND PURPOSE: The technique of a direct aspiration first pass technique (ADAPT) for the endovascular treatment of stroke has been reported to be fast, safe, and effective for the treatment of acute ischemic stroke. The aim of this study is to determine the preoperative factors that affect success of the aspiration component of the technique in ischemic stroke patients with large vessel occlusion in the anterior circulation. METHODS: We enrolled all 347 consecutive patients with anterior circulation acute ischemic stroke admitted for mechanical thrombectomy at our institution from August 2013 to October 2015 and treated by ADAPT for the endovascular treatment of stroke...
April 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28385037/new-for-old-coagulum-lithotomy-versus-a-novel-bioadhesive-for-complete-removal-of-stone-fragments-in-a-comparative-study-in-an-ex-vivo-porcine-model
#2
Dominik Stefan Schoeb, Martin Schoenthaler, Daniel Schlager, Ralf Petzold, Katharina Richter, Ingo Grunwald, Ulrich Wetterauer, Arkadiusz Miernik, Simon Hein
OBJECTIVES: To evaluate a recently reported new bioadhesive system for the retrieval of small residual fragments after intracorporeal lithotripsy, we systematically compared this system with coagulum lithotomy in retrograde intrarenal surgery. MATERIALS AND METHODS: We extracted 30 human stone fragments (≤1 mm) in an ex vivo porcine kidney model using a flexible ureteroscope for three groups: 1) the novel bioadhesive, 2) autologous blood as a natural adhesive, and 3) (control group) a conventional retrieval basket...
April 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28381131/severe-brachycephalic-obstructive-airway-syndrome-is-associated-with-hypercoagulability-in-dogs
#3
Courtney Crane, Elizabeth A Rozanski, Amanda L Abelson, Armelle deLaforcade
We evaluated whether dogs with severe brachycephalic obstructive airway syndrome (BOAS) developed a hypercoagulable state similar to people with obstructive sleep apnea. Five dogs with grade 3 BOAS were included as well as 5 healthy control Labrador Retrievers. Venous blood samples were collected from each dog for performance of thromboelastography and determination of hematocrit and platelet count. Groups were compared using a t-test, with p < 0.05 considered significant. Thromboelastography results identified that all BOAS dogs were hypercoagulable compared to the Labradors, having significantly shortened clotting time with increased angle, maximal amplitude, and clot rigidity...
April 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28366060/novel-balloon-and-aspiration-method-for-cerebral-venous-sinus-thrombosis-dental-floss-technique
#4
Yoshikazu Matsuda, Hideo Okada, Joonho Chung, R Webster Crowley, Demetrius K Lopes
Cerebral venous sinus thrombosis is sometimes fatal. The standard treatment for sinus thrombosis is anticoagulation, but endovascular intervention must be considered when medical treatment fails. Mechanical thrombectomy is usually required when a large clot burden exits. Unfortunately, in sinus thrombosis attributable to a clot burden larger than that in an intracranial artery, the conventional technique used for intraarterial acute stroke intervention with a stent retriever and/or aspiration is not very effective...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28366057/development-of-a-recalcitrant-large-clot-burden-bifurcation-occlusion-model-for-mechanical-thrombectomy
#5
Visish M Srinivasan, Stephen R Chen, Kevin M Camstra, Gouthami Chintalapani, Peter Kan
OBJECTIVE Stroke is a major cause of disability and death in adults. Several large randomized clinical trials have shown the significant benefit of mechanical thrombectomy with modern stent retrievers in the treatment of large-vessel occlusions. However, large clots located at bifurcations remain challenging to treat. An in vivo model of these recalcitrant clots needs to be developed to test future generations of devices. METHODS Autologous blood was drawn from anesthetized swine via a femoral sheath. Blood was then mixed with thrombin, calcium chloride, and saline, and injected into silicone tubing to form cylindrical clots in the standard fashion...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28356438/googling-service-boundaries-for-endovascular-clot-retrieval-hub-hospitals-in-a-metropolitan-setting-proof-of-concept-study
#6
Thanh G Phan, Richard Beare, Jian Chen, Benjamin Clissold, John Ly, Shaloo Singhal, Henry Ma, Velandai Srikanth
BACKGROUND AND PURPOSE: There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. METHODS: Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface...
March 29, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28318956/carotid-endarterectomy-to-remove-retained-solitaire-stent-retriever-inside-carotid-stent-after-mechanical-thrombectomy
#7
Mary In-Ping Huang Cobb, Tony P Smith, Patrick A Brown, L Fernando Gonzalez, Ali R Zomorodi
BACKGROUND: Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important. CASE REPORT: A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot...
March 16, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28286654/it-s-better-to-be-lucky%C3%A2-%C3%A2-%C3%A2-successful-management-of-an-acute-endobronchial-tumour-embolism-in-the-icu-a-case-report-and-review-of-the-literature
#8
Christopher J Walsh, Ron Olivenstein, Eric Forget, Anne V Gonzalez
Endobronchial tumour embolism is a rare cause of acute central airway obstruction. It is primarily reported during pneumonectomy, and the outcome is frequently fatal. Successful management requires the urgent removal of tumour with rigid or flexible bronchoscopy. We present the case of a 62-year-old woman with poorly differentiated non-small cell lung cancer (NSCLC), referred to our institution for Nd:YAG laser photoresection of endobronchial tumour completely obstructing the right mainstem bronchus (RMSB)...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28284999/granulocyte-macrophage-colony-stimulating-factor-gm-csf-significantly-enhances-articular-cartilage-repair-potential-by-microfracture
#9
M-D Truong, B H Choi, Y J Kim, M S Kim, B-H Min
OBJECTIVE: To investigate whether granulocyte macrophage-colony stimulating factor (GM-CSF) can be used to increase the number of mesenchymal stem cells (MSCs) in blood clots formed by microfracture arthroplasty (MFX) and whether it can improve the therapeutic outcome for cartilage repair. METHODS: Thirty-six New Zealand white rabbits were divided into four groups: (1) control, (2) GM-CSF, (3) MFX, and (4) GM-CSF + MFX. GM-CSF was administrated intravenously (IV) at 10 μg/kg body weight 20 min before the MFX surgery...
March 8, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28279987/risk-of-thrombus-fragmentation-during-endovascular-stroke-treatment
#10
J Kaesmacher, T Boeckh-Behrens, S Simon, C Maegerlein, J F Kleine, C Zimmer, L Schirmer, H Poppert, T Huber
BACKGROUND AND PURPOSE: Periprocedural thrombus fragmentation is a relevant risk in endovascular stroke treatment. Because factors influencing its occurrence are largely unknown, this study addresses a potential relationship between thrombus histology and clot stability. MATERIALS AND METHODS: Eighty-five patients with anterior circulation stroke treated with thrombectomy were included in this retrospective study. The number and location of emboli after retrieving the primary thrombus, the number of maneuvers, and TICI scores were evaluated...
March 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28275555/endovascular-stroke-treatment-now-and-then-procedural-and-clinical-effectiveness-and-safety-of-different-mechanical-thrombectomy-techniques-over-time
#11
Niels von Gadow, Omid Nikoubashman, Jessica Freiherr, Frank Block, Arno Reich, Gunther Fesl, Martin Wiesmann
BACKGROUND: The most essential development in endovascular stroke treatment (EST) was the shift from intra-arterial thrombolysis to endovascular thrombectomy with dedicated thrombectomy devices, most notably the introduction of stent-retrievers. We evaluated procedural and clinical effectiveness and safety of different EST techniques over time. METHODS: We retrospectively analyzed EST cases that were treated by the same interventionalist before (n=36) and after (n=50) stent-retrievers were established as the treatment device of first choice...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28270000/retrograde-semi-retrieval-technique-for-combined-stentriever-plus-aspiration-thrombectomy-in-acute-ischemic-stroke
#12
Ming Wei, Zhiqiang Wei, Xin Li, Hong Li
The endovascular treatment of acute ischemic stroke has become a standard procedure. The combination of multiple neuroendovascular devices provides more possibilities for the improvement of the thrombectomy technique. We describe a modified retrieval technique using a distal intracranial catheter (DIC) for the semi-retrieval of stentriever during the thrombectomy procedure. The retrograde semi-retrieval technique involves completely unfolding the stent retriever by pulling a Navien catheter and the partial re-sheath of a retrievable stent forming a tapered configuration by pushing the Navien catheter, which results in the thrombi being embedded into the strut, securing the clot within the stent and there being a shorter distance for the clot to travel...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28255997/successful-ultrasound-guided-percutaneous-embolization-of-renal-pseudoaneurysm-by-autologous-blood-clot-preliminary-report-of-a-new-method
#13
Mohammad Zare Mehrjardi, Seyed Morteza Bagheri, Mohsen Darabi
We report the case of a 25-year-old female with renal arteriovenous fistula and pseudoaneurysm (PA) formation following renal core-needle biopsy, treated successfully by ultrasound-guided percutaneous embolization with autologous blood clot injection. After inserting a 15-gauge needle within the PA sac, 10 ml of blood was retrieved from the sac, and then reinjected into the PA as well as in the needle tract after the obtained blood completely clotted. The procedure was completed by manual compression of the flank...
March 3, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28138001/multiparametric-magnetic-resonance-imaging-for-prediction-of-parenchymal-hemorrhage-in-acute-ischemic-stroke-after-reperfusion-therapy
#14
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)...
March 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
#15
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...
February 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
#16
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
#17
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
#18
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
#19
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
#20
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
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