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JOURNAL ARTICLE
Youngho Kwon, Ho Jun Yi, Dong-Seong Shin, Bum-Tae Kim
OBJECTIVE: Emboli commonly occurs in mechanical thrombectomy (MT). The objective of this study was to analyze predicting factors of emboli after MT. METHODS: Patients who underwent MT with successful reperfusion for anterior circulation occlusion were enrolled. Emboli included distal emboli at digital subtraction angiography (DSA) and unexpected embolic infarct on diffusion-weighted image (DWI) without distal emboli at DSA. Baseline characteristics, procedural details, angiographic outcomes, and clinical outcomes were reviewed...
March 1, 2024: Current Neurovascular Research
#22
JOURNAL ARTICLE
Paola Palazzo, Eike I Piechowiak, Mirjam R Heldner
BACKGROUND Acute ischemic stroke in the posterior cerebral artery (PCA) territory can lead to persistent disabling deficits. The PCA is divided into 4 segments. The P2 segment begins at the posterior communicating artery and curves around the midbrain and above the tentorium cerebelli. This report is of a 61-year-old man with acute ischemic stroke involving the left hippocampus treated with direct thrombectomy of the P2 segment of the PCA. CASE REPORT A 61-year-old white man presented with transient amnesia, aphasia, right-sided hemianopia, dizziness, and persistent acute memory deficits...
March 5, 2024: American Journal of Case Reports
#23
Kiyonori Kuwahara, Ichiro Nakahara, Shoji Matsumoto, Yoshio Suyama, Jun Morioka, Akiko Hasebe, Jun Tanabe, Sadayoshi Watanabe, Kenichiro Suyama, Yuichi Hirose
It is impossible to predict underlying anomalies in acute large vessel occlusion and it could be a problem when performing mechanical thrombectomy (MT). We report a case of MT for occlusion of the fenestrated middle cerebral artery (MCA) M1 segment. A 49-year-old woman presented to our hospital with dysarthria and left hemiparesis. Acute ischemic stroke due to right occluded MCA was diagnosed. During performing emergent MT, a part of the M1 segment was revealed to be slit-shaped by digital subtraction angiography, suggesting a fenestrated MCA...
May 2024: Radiology Case Reports
#24
JOURNAL ARTICLE
Maud Wang, Hans Henkes, Sherief Ghozy, James E Siegler, Hamza Shaikh, Jane Khalife, Mohamad Abdalkader, Piers Klein, Thanh N Nguyen, Jeremy J Heit, Ahmad Sweid, Kareem El Naamani, Robert W Regenhardt, Jose Danilo Bengzon Diestro, Nicole M Cancelliere, Abdelaziz Amllay, Lukas Meyer, Anne Dusart, Flavio Bellante, Géraud Forestier, Aymeric Rouchaud, Suzana Saleme, Charbel Mounayer, Jens Fiehler, Anna Luisa Kühn, Ajit S Puri, Christian Dyzmann, Peter T Kan, Marco Colasurdo, Gaultier Marnat, Jérôme Berge, Xavier Barreau, Igor Sibon, Simona Nedelcu, Nils Henninger, Charlotte Weyland, Thomas R Marotta, Christopher J Stapleton, James D Rabinov, Takahiro Ota, Shogo Dofuku, Leonard Ll Yeo, Benjamin Y Q Tan, Juan Carlos Martinez-Gutierrez, Sergio Salazar-Marioni, Sunil Sheth, Leonardo Renieri, Carolina Capirossi, Ashkan Mowla, Stavropoula I Tjoumakaris, Pascal Jabbour, Priyank Khandelwal, Arundhati Biswas, Frédéric Clarençon, Mahmoud Elhorany, Kevin Premat, Iacopo Valente, Alessandro Pedicelli, João Pedro Filipe, Ricardo Varela, Miguel Quintero-Consuegra, Nestor R Gonzalez, Markus A Möhlenbruch, Jessica Jesser, Vincent Costalat, Adrien Ter Schiphorst, Vivek Yedavalli, Pablo Harker, Lina M Chervak, Yasmin Aziz, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Monika Killer-Oberpfalzer, Christoph J Griessenauer, Ajith J Thomas, Cheng-Yang Hsieh, David S Liebeskind, Răzvan Alexandru Radu, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Aman B Patel, Vitor Mendes Pereira, Robert Fahed, Boris Lubicz, Adam A Dmytriw, Adrien Guenego
PURPOSE: Our purpose was to assess the efficacy and safety of the pRESET LITE stent retriever (Phenox, Bochum, Germany), designed for medium vessel occlusion (MeVO) in acute ischemic stroke (AIS) patients with a primary MeVO. METHODS: We performed a retrospective analysis of the MAD MT Consortium, an integration of prospectively maintained databases at 37 academic institutions in Europe, North America, and Asia, of AIS patients who underwent mechanical thrombectomy with the pRESET LITE stent retriever for a primary MeVO...
February 21, 2024: Neuroradiology
#25
JOURNAL ARTICLE
John B Quealy
BACKGROUND: Cerebral venous sinus thrombosis (CVST) follows a severe clinical course in 13.5% of cases. Practice guidelines recommend endovascular therapy (EVT); no randomised control trials (RCTs) exist comparing EVTs. PURPOSE: To determine whether specific EVTs are superior to alternatives. DATA SOURCES: CENTRAL, Medline, Embase, five other databases and four clinical trials registers. Grey literature searches, reference checking, citation searching, and author contact...
February 8, 2024: Clinical Neuroradiology
#26
Koji Yoshida, Yosuke Akamatsu, Yoshiyasu Matsumoto, Yasushi Ogasawara, Toshinari Misaki, Hiromu Konno, Kuniaki Ogasawara
The authors present a patient with carotid dissection in a tortuous arterial segment who successfully underwent carotid artery stenting (CAS) by straightening the tortuosity using an inflated balloon guiding catheter (BGC) and a stent retriever (SR). A 56-year-old man was transferred to our institute with right hemiparesis and a National Institutes of Health Stroke Scale score of 9. Magnetic resonance imaging showed left internal carotid artery (ICA) occlusion and ischemic change in the parietal lobe. Emergent angiography revealed tapered extracranial ICA occlusion sugg carotid artery dissection (CAD)...
April 2024: Radiology Case Reports
#27
JOURNAL ARTICLE
Omar N Elkhayyat, Michael T Froehler, Bryan C Good
Acute ischemic stroke (AIS) and mechanical thrombectomy (MT) are commonly studied in vitro using cerebral artery models made of nonbiological materials. However, these models often report higher recanalization rates than those observed clinically, suggesting a discrepancy between experimental models and clinical settings. We believe this may be partly due to the frictional interactions between blood clots, stent retrievers (SRs), and the vessel walls. Experiments were performed to measure the coefficients of static and kinetic friction between blood clots, common nonbiological model materials, and bovine carotid arteries (CAs)...
February 2024: Journal of Biomechanics
#28
REVIEW
John M Pederson, Nicole Hardy, Hannah Lyons, Erin Sheffels, Jillienne C Touchette, Waleed Brinjikji, David F Kallmes, Kevin M Kallmes
OBJECTIVE: The objective of this study was to update our 2021 systematic review and meta-analysis which reported that balloon guide catheters (BGC) are associated with superior clinical and angiographic outcomes compared to standard guide catheters for treatment of acute ischemic stroke. METHODS: We conducted a systematic review of 7 electronic databases to identify literature published between January 2010 and September 2023 reporting BGC versus non-BGC approaches...
January 29, 2024: World Neurosurgery
#29
JOURNAL ARTICLE
Momodou G Bah, Daniel Vollhaber, Leanne Lin, Zachary Wilseck, Joseph J Gemmete, Frank G Conyers, Joseph F Carrera, Neeraj Chaudhary
A woman in her 60s with a history of prior ischaemic stroke developed acute onset slurring of speech, left-sided facial droop and left-sided weakness and was found on CT angiography to have a subocclusive thrombus multiple days after undergoing mitral and tricuspid valve repair surgery. A stent retriever and aspiration catheter were used to successfully remove the subocclusive material which was identified as 'foreign material' on histology. Ultimately, the patient demonstrated clinical improvement.Foreign material embolism is a rare but serious complication that can occur during or after mitral and tricuspid valve repair surgery...
January 30, 2024: BMJ Case Reports
#30
JOURNAL ARTICLE
Monami Dai, Yukihiro Imaoka, Shinichiro Yoshikawa, Shinya Kohyama
Following the implantation of a carotid artery stent (CAS), the aetiology of in-stent occlusion typically shifts from embolic events in the acute phase to intimal hyperplasia in the chronic phase. A man in his 70s with a history of CAS implantation (performed 5 years ago) for left internal carotid artery (ICA) stenosis was admitted to our hospital with a chief complaint of left-sided transient scotoma. MRI revealed an acute occlusion of the left ICA, and an urgent digital subtraction angiography (DSA) was performed...
January 23, 2024: BMJ Case Reports
#31
JOURNAL ARTICLE
Eun-Oh Jeong, Hyon-Jo Kwon, Heewon Jeong, Han-Joo Lee, Kyung Hwan Kim, Hyeon-Song Koh
While mechanical thrombectomy is known to be effective for distal medium vessel occlusion (DMVO) as well as large vessel occlusion, tortuous DMVO are predisposed to vessel injury during stent retriever thrombectomy. Furthermore, getting access to the thrombus may be difficult during suction thrombectomy using a dedicated suction catheter. Most studies describe DMVO treatment using stent retrievers and dedicated suction catheters, but there are limited studies reporting DMVO treated with suction thrombectomy using a microcatheter...
January 12, 2024: Journal of Cerebrovascular and Endovascular Neurosurgery
#32
JOURNAL ARTICLE
Cem Bilgin, Marisabel L Bolsegui, Sherief Ghozy, Amir Hassankhani, Hassan Kobeissi, Mohamed Sobhi Jabal, Rishabh Gupta, Gianluca De Rubeis, Ramanathan Kadirvel, Waleed Brinjikji, Luca Saba, David F Kallmes
BACKGROUND: Distal medium vessel occlusions (DMVOs) and minor strokes represent emerging frontiers in mechanical thrombectomy (MT). Although several randomized clinical trials (RCTs) are underway, the design characteristics of these trials and the specific questions they aim to address have not been extensively explored. This current study sought to investigate the design and data elements reported in active prospective DMVO and minor stroke studies. METHODS: The ClinicalTrials...
January 11, 2024: Journal of Neurointerventional Surgery
#33
JOURNAL ARTICLE
Rishi Gupta, Salvador Miralbés, Angel Calleja Bonilla, Bharath Naravetla, Aniel Q Majjhoo, Mahmoud Rayes, Alejandro M Spiotta, Christian Loehr, Andreea Cioltan, Dominik F Vollherbst, Mario Martínez-Galdámez, Jorge Galván-Fernandez, Ahmad Khaldi, Ryan A McTaggart, Mahesh V Jayaraman, Luc Defreyne, Elisabeth Dhondt, Pedro Vega, Eduardo Murias, Eugene Lin, Varun Chaubal, Lori Lyn Price, David S Liebeskind, Markus A Möhlenbruch
BACKGROUND: Patients treated with mechanical thrombectomy (MT) for acute ischemic strokes from large vessel occlusion (LVO) have better outcomes with effective reperfusion. However, it is unknown which technique leads to better technical and clinical success. We aimed to determine which technique yields the most effective first pass reperfusion during MT. METHODS: In a prospective, multicenter global registry we enrolled patients treated with operator preferred MT technique at 71 hospitals from January 2019 to January 2022...
January 9, 2024: Journal of Neurointerventional Surgery
#34
JOURNAL ARTICLE
Sanjeev Sreenivasan, Gaurav Gupta, Robert Wu, Emad Nourollah-Zadeh, Hai Sun, Anil Nanda, Srihari Sundararajan, Sudipta Roychowdhury
INTRODUCTION: Evidence for improved first-pass effect with the novel radially adjustable radio-opaque stent retriever Tigertriever is lacking. OBJECTIVE: To compare improvement in first pass success with Tigertriever using two different techniques-rapid inflation deflation (RID) and suction thrombectomy (ST). METHODS: Retrospective analysis of patients with acute ischemic stroke who underwent mechanical thrombectomy with Tigertriever at a single comprehensive stroke center...
January 8, 2024: Interventional Neuroradiology
#35
REVIEW
Cem Bilgin, Mohamed Ibrahim, Sherief Ghozy, Mohamed Sobhi Jabal, Mostafa Shehata, Hassan Kobeissi, Ramanathan Kadirvel, Waleed Brinjikji, Alejandro A Rabinstein, David F Kallmes
BACKGROUND: The modified Rankin Scale (mRS) score of ≤2 (functional independence) has been the most common primary endpoint of modern mechanical thrombectomy (MT) trials. However, unlike mRS 0-1, mRS score of 2 indicates disability. An important proportion of the mRS 2 patients are home dependent and report a significant decrease in their quality of life. PURPOSE: To investigate excellent outcome (mRS 0-1) rates after MT. METHODS: We systematically searched Ovid MEDLINE, Ovid EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases...
January 5, 2024: Interventional Neuroradiology
#36
Use of a stent-retriever for treatment of iatrogenic vasospasm secondary to mechanical thrombectomy.
Satoshi Hori, Ryutaro Furudate, Izumi Kumagai, Chikashi Aoyagi, Nobuo Hirota, Tetsuya Yamamoto
The treatment strategy for iatrogenic intracranial vasospasm has not been established. We reported a rare case of stent-retriever use for the treatment of iatrogenic vasospasm after mechanical thrombectomy. The patient presented acute ischemic stroke due to the occlusion of the left middle cerebral artery (MCA). The patient underwent a successfully mechanical thrombectomy, however, severe stenosis was visualized in MCA, which was considered to be an iatrogenic mechanical vasospasm. This vasospasm was successfully treated with the Solitaire stent device, and the patient recovered from ischemic symptoms...
December 30, 2023: Clinical Neurology and Neurosurgery
#37
JOURNAL ARTICLE
Shuntaro Kuwahara, Kazutaka Uchida, Nobuyuki Sakai, Hiroshi Yamagami, Hirotoshi Imamura, Masataka Takeuchi, Manabu Shirakawa, Fumihiro Sakakibara, Koichi Haraguchi, Naoto Kimura, Kentaro Suzuki, Shinichi Yoshimura
BACKGROUND: The safety and effectiveness of stent retriever use for patients with acute large vessel occlusion (LVO) due to intracranial atherosclerotic disease (ICAD) is not well established. We investigated the differences in clinical outcomes in patients with and without ICAD. METHODS: We analyzed the Japan Trevo Registry, a nationwide registry which enrolled patients with acute LVO who underwent endovascular therapy (EVT) using the Trevo retriever alone or in combination with an aspiration catheter...
January 3, 2024: Journal of Neurointerventional Surgery
#38
JOURNAL ARTICLE
Raul G Nogueira, Donald Lobsien, Joachim Klisch, Daniel Pielenz, Elmar Lobsien, Eric Sauvageau, Nima Aghaebrahim, Markus Möhlenbruch, Dominik Vollherbst, Christian Ulfert, Hormozd Bozorgchami, Wayne Clark, Ryan Priest, Edgar A Samaniego, Santiago Ortega-Gutierrez, Malik Ghannam, Demetrius Lopes, Joshua Billingsley, Kiffon Keigher, Diogo C Haussen, Alhamza R Al-Bayati, Adnan Siddiqui, Elad Levy, Michael Chen, Stephan Munich, Peter Schramm, Tobias Boppel, Sandra Narayanan, Bradley A Gross, Christian Roth, Tobias Boeckh-Behrens, Ameer Hassan, Johanna Fifi, Ron F Budzik, Jason Tarpley, Robert M Starke, Eytan Raz, Gary Brogan, David S Liebeskind, Ricardo A Hanel
IMPORTANCE: Stent retriever-based thrombectomy is highly beneficial in large vessel occlusion (LVO) strokes. Many stent retriever designs are currently available, but comparison of these technologies in well-conducted studies is lacking. OBJECTIVE: To determine whether thrombectomy for LVO stroke with the pRESET stent retriever is noninferior to treatment with the Solitaire stent retriever. DESIGN, SETTING, AND PARTICIPANTS: This study was a multicenter, prospective, randomized, controlled, open-label, adaptive, noninferiority trial with blinded primary end point evaluation...
January 2, 2024: JAMA Neurology
#39
JOURNAL ARTICLE
Wuyang Yang, Ryan P Lee, Alice L Hung, Christopher C Young, Shahab Aldin Sattari, Victor Urrutia, Philipe E Gailloud, Risheng Xu, Justin Caplan, L Fernando Gonzalez
OBJECTIVE: A direct-aspiration first-pass technique (ADAPT) in mechanical thrombectomy has been described in recent studies as an efficacious strategy compared with using a stent retriever (SR). We sought to evaluate for cost differences of ADAPT technique versus SR as an initial approach. METHODS: We conducted a retrospective analysis of consecutive patients with mechanical thrombectomy at our institution between 2022 and 2023. Patients were grouped into ADAPT with/without SR as a rescue strategy and SR as an initial approach with allowance of concomitant aspiration...
March 2024: World Neurosurgery
#40
JOURNAL ARTICLE
Chu-Ming Huang, Yi-Fan Hong, Wen-Cheng He, Feng-Li Li, Chu-Kai Xu, Chao Wen, Yu-Dong Ye, Chu-Wei Cai
BACKGROUND: This study sought to scrutinize the clinical outcomes associated with first-pass mechanical thrombectomy (MT) strategies in the management of intracranial atherosclerosis (ICAS)-related large vessel occlusion (LVO). METHODS: Within this post-hoc analysis of the RESCUE BT trial, we compared data pertaining to ICAS-LVO patients situated in the anterior circulation who underwent initial therapeutic interventions utilising either aspiration thrombectomy or stent-retriever thrombectomy...
December 25, 2023: World Neurosurgery
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