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https://www.readbyqxmd.com/read/28446535/direct-transfer-to-angiosuite-to-reduce-door-to-puncture-time-in-thrombectomy-for-acute-stroke
#1
Marc Ribo, Sandra Boned, Marta Rubiera, Alejandro Tomasello, Pilar Coscojuela, David Hernández, Jorge Pagola, Jesús Juega, Noelia Rodriguez, Marian Muchada, David Rodriguez-Luna, Carlos A Molina
OBJECTIVE: To evaluate direct transfer to the angiosuite protocol of patients with acute stroke, candidates for endovascular treatment (EVT). METHODS: We studied workflow metrics of all patients with stroke who had undergone EVT in the past 12 months. Patients followed three protocols: direct transfer to emergency room (DTER), CT room (DTCT) or angiosuite (DTAS, only last 6 months if admission National Institute of Health Stroke Scale (NIHSS) score >9 and time from onset <4...
April 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28443484/manual-aspiration-thrombectomy-with-a-penumbra-catheter-for-acute-anterior-cerebral-artery-occlusion
#2
Gyung Ho Chung, Hyo Sung Kwak, Jung Soo Park, Jong Myong Lee
Purpose The purpose of this article is to assess the efficacy and safety of manual aspiration thrombectomy (MAT) using a Penumbra catheter in patients with anterior cerebral artery (ACA) occlusions. Materials and methods From January 2012 to March 2016, 16 patients underwent MAT with Penumbra catheters using a proximal and distal supporting technique to treat ACA occlusions. We evaluated immediate angiographic results and clinical outcomes by reviewing patient electrical medical records. Results Of these patients, 11 had a complete obstruction of the distal internal carotid artery (ICA) and five had ACA and middle cerebral artery (MCA) occlusions...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#3
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439045/correction-to-successful-reperfusion-with-mechanical-thrombectomy-is-associated-with-reduced-disability-and-mortality-in-patients-with-pretreatment-diffusion-weighted-imaging-alberta-stroke-program-early-computed-tomography-score-%C3%A2-6
#4
https://www.readbyqxmd.com/read/28437037/use-of-fondaparinux-for-thromboprophylaxis-in-an-unfractionated-heparin-intolerant-pregnant-woman-with-thrombotic-predisposition
#5
Shoji Haruta, Kana Maruta, Yoshiyuki Nakajima, Naoki Masaoka
A 34-year-old primigravida who had undergone thrombectomy for deep venous thrombosis (DVT) in her leg and exhibited low protein S activity, indicating predisposition to thrombosis, developed DVT of the leg. No pulmonary embolism was detected. After anticoagulant therapy with unfractionated heparin was discontinued because of liver dysfunction, danaparoid treatment was administered in hospital. The patient had a normal delivery after 39 weeks' gestation with no recurrence of thrombosis. During her second pregnancy four years later, she gave herself fondaparinux injections...
April 24, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28436411/benign-mixed-epithelial-and-stromal-tumor-of-the-kidney-with-inferior-vena-cava-tumor-thrombus-a-rare-case-report-and-review-of%C3%A2-literature
#6
Chi Zhang, Xiaofei Li, Chengqiang Mo, Zhenpeng Peng, Ruilin Yang, Yiming Tang, Yuanyuan Zhang, Rongpei Wu
Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare renal tumor composed of epithelial and stromal cells. In this study, we report a rare case of MESTK, which was pathologically benign but complicated with renal vein and inferior vena cava tumor thrombus. The 50-year-old female patient was admitted to hospital for a mass on the left kidney. Computed tomography showed a 32 mm×18 mm mass with slight delayed enhancement in the left renal sinus, and neoplastic thrombus was detected in left renal vein and inferior vena cava...
April 18, 2017: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/28436277/single-pass-endovascular-thrombectomy-for-massive-carotid-cerebral-occlusion
#7
Naif M Alotaibi, Francesca Sarzetto, Karl Boyle, Peter Howard, Victor X D Yang
Acute concomitant occlusions of the extracranial internal carotid artery and intracranial vessels frequently require multiple passes with stent-retrievers for mechanical thrombectomy. Due to the large clot burden associated with these occlusions, their response to intravenous thrombolysis is poor. We herein report a successful case of evacuating a massive clot (>14 cm) in a single-pass using a stent-retrieval device.
April 24, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28433335/treatment-of-peripheral-arterial-disease-via-percutaneous-brachial-artery-access
#8
Randall W Franz, Christopher F Tanga, Joseph W Herrmann
OBJECTIVE: This review was conducted to evaluate the types of endovascular procedures that can be performed via brachial artery access, evaluate the access success rate, and determine the incidence of technical complications. METHODS: A retrospective 10-year record review at a tertiary facility from January 1, 2005, through June 30, 2015, was completed. Patients who underwent attempted brachial artery access were eligible for review. Outcomes intended to be evaluated included ability to access the vessel, reach an identified lesion, and perform an indicated procedure, while describing the incidence and type of complications that occurred to clarify the utility and safety of brachial artery access...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431023/safety-and-efficacy-of-the-sofia-6f-plus-distal-access-reperfusion-catheter-in-the-endovascular-treatment-of-acute-ischemic-stroke
#9
Hussain Shallwani, Hakeem J Shakir, Leonardo Rangel-Castilla, Jason M Davies, Ashish Sonig, Mithun G Sattur, Bernard R Bendok, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Neuroendovascular intervention has become a key treatment option for acute ischemic stroke. The Sofia (6F) PLUS catheter was designed for neurovascular access for diagnostic or therapeutic interventions. OBJECTIVE: To report the first series describing use of the Sofia PLUS intermediate/distal access reperfusion catheter in the treatment of acute ischemic stroke. METHODS: In this retrospective study, 41 stroke cases were identified in which the catheter was utilized for thrombolysis/thrombectomy...
April 19, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28429604/intra-arterial-verapamil-post-thrombectomy-is-feasible-safe-and-neuroprotective-in-stroke
#10
Justin F Fraser, Michael Maniskas, Amanda Trout, Doug Lukins, Lindsey Parker, W Lane Stafford, Abdulnasser Alhajeri, Jill Roberts, Gregory J Bix
Large vessel ischemic stroke represents the most disabling subtype. While t-PA and endovascular thrombectomy can recanalize the occluded vessel, good clinical outcomes are not uniformly achieved. We propose that supplementing endovascular thrombectomy with superselective intra-arterial (IA) verapamil immediately following recanalization could be safe and effective. Verapamil, a calcium channel blocker, has been shown to be an effective IA adjunct in a pre-clinical mouse focal ischemia model. To demonstrate translational efficacy, mechanism, feasibility, and safety, we conducted a group of translational experiments...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#11
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
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
#12
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/28427984/effect-of-baseline-characteristics-on-the-outcome-of-stent-retriever-based-thrombectomy-in-acute-basilar-artery-occlusions-a-single-center-experience-and-pooled-data-analysis
#13
Wan-Ling Wen, Zi-Fu Li, Yong-Wei Zhang, Peng-Fei Yang, Keith Simfukwe, Yi-Bin Fang, Tian-Yi Zhang, Ben-Qiang Deng, Bo Hong, Jian-Min Liu, Qing-Hai Huang
OBJECTIVES: -To explore the association of baseline characteristics and the outcome of acute basilar artery occlusion (BAO) patients following stent retriever based thrombectomy (SRT). METHODS: -Clinical and imaging information of consecutive SRT treated BAO patients from a comprehensive stroke center and up-to-date literatures were reviewed respectively. The impact of baseline variables towards favorable outcome was evaluated using subgroup analysis and odds ratio extracted from published data resource together with single center records using pooled analysis...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427054/preceding-intravenous-thrombolysis-in-patients-receiving-endovascular-therapy
#14
Hong-Kyun Park, Jong-Won Chung, Jeong-Ho Hong, Min Uk Jang, Hyun-Du Noh, Jong-Moo Park, Kyusik Kang, Soo Joo Lee, Youngchai Ko, Jae Guk Kim, Jae-Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Moon-Ku Han, Beom Joon Kim, Tai Hwan Park, Sang-Soon Park, Kyung Bok Lee, Jun Lee, Keun-Sik Hong, Yong-Jin Cho, Byung-Chul Lee, Kyung-Ho Yu, Mi-Sun Oh, Ki-Hyun Cho, Joon-Tae Kim, Dong-Eog Kim, Wi-Sun Ryu, Jay Chol Choi, Wook-Joo Kim, Dong-Ick Shin, Min-Ju Yeo, Sung Il Sohn, Ji Sung Lee, Juneyoung Lee, Byung-Woo Yoon, Hee-Joon Bae
BACKGROUND: The beneficial effects of endovascular therapy (EVT) in acute ischemic stroke have been demonstrated in recent clinical trials using new-generation thrombectomy devices. However, the comparative effectiveness and safety of preceding intravenous thrombolysis (IVT) in this population has rarely been evaluated. METHODS: From a prospective multicenter stroke registry database in Korea, we identified patients with acute ischemic stroke who were treated with EVT within 8 h of onset and admitted to 14 participating centers during 2008-2013...
April 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28424039/endovascular-treatment-of-ischemic-stroke-an-updated-meta-analysis-of-efficacy-and-safety
#15
Simone Vidale, Elio Agostoni
BACKGROUND: Recent randomized trials demonstrated the superiority of the mechanical thrombectomy over the best medical treatment in patients with acute ischemic stroke due to an occlusion of arteries of proximal anterior circulation. In this updated meta-analysis, we aimed to summarize the total clinical effects of the treatment, including the last trials. METHODS: We performed literature search of Randomized Crontrolled Trials (RCTs) published between 2010 and October 2016, comparing endovenous thrombolysis plus mechanical thrombectomy (intervention group) with best medical care alone (control group)...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#16
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28422279/efficacy-and-safety-of-mechanical-thrombectomy-in-older-adults-with-acute-ischemic-stoke
#17
Fabrizio Sallustio, Giacomo Koch, Caterina Motta, Marina Diomedi, Fana Alemseged, Vittoria C D'Agostino, Simone Napolitano, Domenico Samà, Alessandro Davoli, Daniel Konda, Daniele Morosetti, Enrico Pampana, Roberto Floris, Roberto Gandini
OBJECTIVES: To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke. DESIGN: Retrospective cohort study. SETTING: Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy. PARTICIPANTS: Elderly adults treated for acute ischemic stroke (N = 219). MEASUREMENTS: Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, <80)...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28420654/changes-in-the-profile-of-endovascular-procedures-performed-in-freestanding-dialysis-access-centers-over-15-years
#18
Gerald A Beathard, Aris Urbanes, Terry Litchfield
BACKGROUND AND OBJECTIVES: Marked changes occurred in the vascular access profile of patients receiving hemodialysis in the United States over the 15-year period of 2001-2015. This study was undertaken to evaluate how these changes have affected dialysis access maintenance and salvage procedures performed in freestanding dialysis access centers and to examine the effectiveness, efficiency, and safety of these procedures in this setting. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were collected from freestanding, dedicated dialysis access centers operating under a common system of management...
April 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28419620/comparing-emergency-department-patients-to-inpatients-receiving-a-pulmonary-embolism-response-team-pert-activation
#19
Erin K Deadmon, Nicholas J Giordano, Kenneth Rosenfield, Rachel Rosovsky, Blair Alden Parry, Rasha Fahad Al-Bawardy, Yuchiao Chang, Christopher Kabrhel
OBJECTIVES: The development of Pulmonary Embolism Response Teams (PERTs) has been widely adopted nationally with the goal of providing multidisciplinary care to patients with high-risk PE. Most PERT activations originate from the Emergency Department (ED), while others are from the intensive care unit (ICU) or inpatient floors. It is unclear if ED PERT activations differ from non-ED PERT activation in terms of presentation, management, and outcome. METHODS: We enrolled a consecutive cohort of patients for whom PERT was activated at an urban academic medical center...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28416407/relationship-between-hemorrhagic-complications-and-target-vessels-in-acute-thrombectomy
#20
Manabu Shirakawa, Shinichi Yoshimura, Kazutaka Uchida, Seigo Shindo, Kiyofumi Yamada, Junko Kuroda, Toshinori Takagi, Yoshihiro Takada, Reiichi Ishikura
PURPOSE: Intracranial hemorrhage after thrombectomy using a catheter to treat acute major cerebral artery occlusion is known to exacerbate patient outcomes. This study was performed to determine the relationship between middle cerebral artery (MCA) tortuosity and postoperative hemorrhage. METHODS: We examined 111 consecutive patients who underwent acute thrombectomy for major intracranial artery occlusion in the anterior circulation at our hospital between September 2013 and June 2016...
April 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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