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https://www.readbyqxmd.com/read/28904450/acute-ischemic-stroke-treatment-using-mechanical-thrombectomy-a-study-of-137-patients
#1
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#2
Waleed Brinjikji, Jeffrey Pasternak, Mohammad H Murad, Harry J Cloft, Tasha L Welch, David F Kallmes, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28895453/extracranial-internal-carotid-artery-vasospasm-during-thrombectomy
#3
Isamu Miura, Akitsugu Kawashima, Masataka Hayashi, Akane Tanda, Tomomi Ishikawa, Takakazu Kawamata
The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient's National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28864867/safety-of-the-solitaire-4%C3%A2-%C3%A3-%C3%A2-40%C3%A2-mm-stent-retriever-in-the-treatment-of-ischemic-stroke
#4
Felix Zibold, Pasquale Mordasini, Pascal Mosimann, Eike Piechowiak, Tomas Dobrocky, Urs Fischer, Marcel Arnold, Sebastian Bellwald, Jan Gralla
PURPOSE: Stent retrievers apply mechanical force to the intracranial vasculature. Our aim was to evaluate the safety and efficacy of the long Solitaire 4 × 40 mm stent retriever for large vessel occlusion in stroke patients. METHODS: We conducted a retrospective analysis of all patients treated for acute ischemic large vessel occlusion stroke with the Solitaire 2 FR 4 × 40 device between May and October 2016 at our institution. Patient-specific data at baseline and at discharge were documented...
September 1, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28864601/predictive-value-of-computed-tomography-angiography-determined-occlusion-type-in-stent-retriever-thrombectomy
#5
Jang-Hyun Baek, Byung Moon Kim, Joonsang Yoo, Hyo Suk Nam, Young Dae Kim, Dong Joon Kim, Ji Hoe Heo, Oh Young Bang
BACKGROUND AND PURPOSE: We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. METHODS: Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment...
September 1, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28863285/endovascular-treatment-of-acute-ischemic-stroke-in-octogenarians-a-meta-analysis-of-observational-studies
#6
Jin Pyeong Jeon, Sung-Eun Kim, Chul Ho Kim
OBJECTIVES: The aim of this study is to compare procedural outcomes after endovascular treatment (EVT) according to age (≥80 years vs. <80 years) and to examine treatment outcomes after mechanical thrombectomy using a stent retriever between the different age groups. PATIENTS AND METHODS: A systemic literature review of an online database of articles published from January 2004 to February 2017 was conducted. The primary outcome was successful recanalization in the final angiogram and symptomatic intracranial hemorrhage (S-ICH) after EVT...
August 29, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28845749/patterns-of-acute-ischemic-strokes-after-carotid-endarterectomy-and-therapeutic-implications
#7
Fabien Lareyre, Juliette Raffort, Caroline Weill, Claire Marsé, Laurent Suissa, Julien Chikande, Réda Hassen-Khodja, Elixène Jean-Baptiste
AIM: Acute ischemic strokes following surgical treatment of carotid stenosis lead to substantial disability and mortality, and vascular mechanisms underlying their development are not fully elucidated. The goal of this study was to analyze the topographic patterns of acute ischemic stroke following carotid endarterectomy (CEA) on diffusion-weighted and perfusion-weighted magnetic resonance imaging (MRI). MATERIAL AND METHODS: Data were retrospectively collected from consecutive patients who underwent CEA and developed postoperative acute ischemic stroke...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28844911/endovascular-mechanical-thrombectomy-for-acute-middle-cerebral-artery-m2-segment-occlusion-a-systematic-review
#8
REVIEW
Ching-Jen Chen, Connor Wang, Thomas J Buell, Dale Ding, Daniel M Raper, Natasha Ironside, Gabriella M Paisan, Robert M Starke, Andrew M Southerland, Kenneth Liu, Bradford B Worrall
INTRODUCTION: The benefit of endovascular mechanical thrombectomy (EMT) for acute distal occlusions of the middle cerebral artery M2 segment is incompletely defined. The aim of this systematic review is to analyze the recent literature regarding EMT for acute M2 occlusions. METHODS: We reviewed the literature to identify all studies of patients with acute M2 occlusions who underwent EMT which were published after January 1, 2015. Excellent and good outcomes were defined as modified Rankin Scale of 0-1 and 0-2 at 3 months, respectively...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28844524/mechanical-thrombectomy-for-pediatric-acute-stroke-and-ventricular-assist-device
#9
Robert Clinton Stowe, Peter Kan, Day Burruss Breen, Sonika Agarwal
BACKGROUND: Certain pediatric populations have increased risk of ischemic strokes, including those with cardiac disease and those dependent on mechanical circulatory devices such as ventricular assist devices. Due to their need for chronic anticoagulation, patients with mechanical circulatory devices are not candidates for systemic thrombolysis and thus treatment of acute ischemic stroke is limited. CASE: A 9-year-old boy with a ventricular assist device presented with acute onset of dense right hemiparesis, global aphasia, and a pediatric NIHSS score of 23...
August 24, 2017: Brain & Development
https://www.readbyqxmd.com/read/28843804/intra-arterial-alteplase-thrombolysis-during-mechanical-thrombectomy-for-acute-ischemic-stroke
#10
Daniel M Heiferman, Daphne D Li, Nathan C Pecoraro, Angela M Smolenski, Asterios Tsimpas, William W Ashley
BACKGROUND: Intra-arterial alteplase (IA tPA) is commonly used during mechanical thrombectomy for acute ischemic stroke in patients with large-vessel occlusion, but specific indications and applications for its use remain undefined. METHODS: We analyzed 40 patients who underwent stent-retriever mechanical thrombectomy, 28 of whom received adjunctive IA tPA. To our knowledge, this is the largest cohort with this concomitant treatment reported in the literature in the post-mechanical thrombectomy trial era...
August 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28843801/endovascular-stroke-treatment-of-patients-over-80-years-old-cumulative-evidence-from-the-real-world
#11
Sofia Figueiredo, Andreia Carvalho, Marta Rodrigues, André Cunha, Ludovina Paredes, Henrique Costa, Pedro Barros, Tiago Gregório, Manuel Ribeiro, Sérgio Castro, Miguel Veloso
BACKGROUND: Evidence on stent retriever-based thrombectomy (SRT) efficacy in elderly patients is controversial. This study aimed to analyze safety and efficacy outcomes in octogenarians submitted to SRT. METHODS: Analysis was based on a prospective observational registry of patients with stroke because of anterior circulation large-vessel occlusion treated with SRT at our center between January 2015 and September 2016. Patients were dichotomized into 2 age groups: ≤80 and >80 years old...
August 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28830971/systematic-evaluation-of-patients-treated-with-neurothrombectomy-devices-for-acute-ischemic-stroke-primary-results-of-the-stratis-registry
#12
Nils H Mueller-Kronast, Osama O Zaidat, Michael T Froehler, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P Klucznik, Jeffrey L Saver, Frank R Hellinger, Dileep R Yavagal, Tom L Yao, David S Liebeskind, Ashutosh P Jadhav, Rishi Gupta, Ameer E Hassan, Coleman O Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G Nogueira, Ravi H Gandhi, Eric C Peterson, Shervin R Dashti, Curtis A Given, Brijesh P Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H McPherson, Peter Kvamme, Thomas J Grobelny, Muhammad S Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J Monteith, Robert D Ecker, Clemens M Schirmer, Eric Sauvageau, Alex Abou-Chebl, Colin P Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H Siddiqui, Travis M Dumont, Abdulnasser Alhajeri, M Asif Taqi, Khaled Asi, Jeffrey Carpenter, Alan Boulos, Gaurav Jindal, Ajit S Puri, Rohan Chitale, Eric M Deshaies, David H Robinson, David F Kallmes, Blaise W Baxter, Mouhammad A Jumaa, Peter Sunenshine, Aniel Majjhoo, Joey D English, Shuichi Suzuki, Richard D Fessler, Josser E Delgado Almandoz, Jerry C Martin, Diogo C Haussen
BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. METHODS: STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset...
August 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28798266/thrombectomy-of-calcified-emboli-in-stroke-does-histology-of-thrombi-influence-the-effectiveness-of-thrombectomy
#13
Tomas Dobrocky, Eike Piechowiak, Alessandro Cianfoni, Felix Zibold, Luca Roccatagliata, Pascal Mosimann, Simon Jung, Urs Fischer, Pasquale Mordasini, Jan Gralla
BACKGROUND AND PURPOSE: Thrombus composition has been postulated to affect the success of endovascular therapy. Calcified clots are composed of large amounts of calcium phosphate which influences their mechanical properties and may serve as a model for testing this hypothesis. The aim of this study was to evaluate the recanalization and complication rates of calcified thromboemboli in patients with acute ischemic stroke who underwent thrombectomy. MATERIAL AND METHODS: A retrospective analysis was performed of all calcified intracranial thromboemboli in patients suffering an acute ischemic stroke, referred for endovascular therapy at two centers between January 2013 and July 2016...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28767503/neuroendovascular-surgery-for-the-treatment-of-ischemic-stroke
#14
Arthur Wang, Meic H Schmidt
This review discusses modern therapeutic interventions for acute ischemic stroke with a focus on endovascular therapy. In 2015, the American Heart Association (AHA) made major changes to the guidelines for the endovascular treatment of acute ischemic stroke. The Class IA indications for endovascular therapy of stroke patients include symptom onset within 6 hours, proven large vessel occlusion of an artery in the anterior circulation, and the use of a stent retriever as part of the mechanical thrombectomy. Advanced perfusion imaging helps identify patients with a low ratio of ischemic core to salvageable penumbra...
June 22, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28763550/effect-of-endovascular-contact-aspiration-vs-stent-retriever-on-revascularization-in-patients-with-acute-ischemic-stroke-and-large-vessel-occlusion-the-aster-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Bertrand Lapergue, Raphael Blanc, Benjamin Gory, Julien Labreuche, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
Importance: The benefits of endovascular revascularization using the contact aspiration technique vs the stent retriever technique in patients with acute ischemic stroke remain uncertain because of lack of evidence from randomized trials. Objective: To compare efficacy and adverse events using the contact aspiration technique vs the standard stent retriever technique as a first-line endovascular treatment for successful revascularization among patients with acute ischemic stroke and large vessel occlusion...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28754806/impact-of-balloon-guide-catheter-on-technical-and-clinical-outcomes-a-systematic-review-and-meta-analysis
#16
Waleed Brinjikji, Robert M Starke, M Hassan Murad, David Fiorella, Vitor M Pereira, Mayank Goyal, David F Kallmes
BACKGROUND AND PURPOSE: Flow arrest with balloon guide catheters (BGCs) is becoming increasingly recognized as critical to optimizing patient outcomes for mechanical thrombectomy. We performed a systematic review and meta-analysis of the literature for studies that compared angiographic and clinical outcomes for patients who underwent mechanical thrombectomy with and without BGCs. MATERIALS AND METHODS: In April 2017 a literature search on BGC and mechanical thrombectomy for stroke was performed...
July 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28754235/mechanical-thrombectomy-for-acute-ischemic-stroke-patients-aged-80-years-or-older
#17
Taichiro Imahori, Kazuhiro Tanaka, Atsushi Arai, Ryoji Shiomi, Daigo Fujiwara, Tatsuya Mori, Akiyoshi Yokote, Kazushi Matsushima, Daisaku Matsui, Makoto Kobayashi, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
BACKGROUND: There are limited data about the prognostic factors predicting outcomes after mechanical thrombectomy with stent retrievers for the elderly. Here, we evaluated outcomes in elderly patients in a real-world setting. METHODS: Between April 2015 and January 2017, 80 patients with anterior intracranial acute large vessel occlusion, who had lived independently before ictus, were treated with mechanical thrombectomy using a stent retriever at our institute...
July 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28751516/the-use-and-utility-of-aspiration-thrombectomy-in-acute-ischemic-stroke-a-systematic-review-and-meta-analysis
#18
D Wei, J R Mascitelli, D A Nistal, C P Kellner, J T Fifi, J D Mocco, R A De Leacy
BACKGROUND: Thrombectomy trials are often specifically interpreted as evidence for the effectiveness of stent retrievers. The effectiveness of other thrombectomy techniques such as aspiration thrombectomy should be validated through further investigation and review. PURPOSE: To evaluate published treatment times and clinical outcomes in patients treated with aspiration thrombectomy or ADAPT (A Direct Aspiration, First Pass Technique) for acute ischemic stroke. DATA SOURCES: A systematic literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28730457/efficacy-safety-and-clinical-outcome-of-modern-mechanical-thrombectomy-in-elderly-patients-with-acute-ischemic-stroke
#19
Seungnam Son, Dong-Hun Kang, Yang-Ha Hwang, Yong-Sun Kim, Yong-Won Kim
BACKGROUND: The average life expectancy is increasing worldwide, surpassing 80 years in some countries. Recently, mechanical thrombectomy (MT) using modern devices and techniques has led to improved clinical outcomes following acute ischemic stroke. However, thus far, it remains uncertain whether MT is effective in elderly patients aged over 80 years. METHODS: Between July 2013 and June 2016, 207 patients with acute ischemic stroke in the anterior circulation received MT at our center...
July 20, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28709707/endovascular-treatment-of-acute-ischemic-stroke-with-eric-device
#20
Laurent Pierot, Jean-Yves Gauvrit, Vincent Costalat, Michel Piotin, Charbel Mounayer, Denis Herbreteau, Sophie Gallas, René Anxionnat, Hubert Desal
BACKGROUND AND PURPOSE: After 6 positive randomized trials, mechanical thrombectomy with stent-retriever is now recommended as a first-line treatment for acute ischemic stroke (AIS). The ERIC device is a device with several interlinked cage-like spheres fixed on a pusher wire. Neurothrombectomy France (NTF) is a registry conducted in France to analyze the results of mechanical thrombectomy. In order to analyze its performances, the subgroup of patients treated with the ERIC device was analyzed...
July 11, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
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