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https://www.readbyqxmd.com/read/29127194/dump-the-pump-manual-aspiration-thrombectomy-mat-with-a-syringe-is-technically-effective-expeditious-and-cost-efficient
#1
Bradley A Gross, Ashutosh P Jadhav, Tudor G Jovin, Brian Thomas Jankowitz
INTRODUCTION: Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. OBJECTIVE: To present in vitro and clinical results of MAT with a syringe. METHODS: An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29122459/resolution-of-anton-babinski-syndrome-after-systemic-thrombolysis-and-mechanical-thrombectomy-with-a-stentriever
#2
Giuseppe Leone, Sergio Nappini, Andrea Wlderk, Antonio Laiso, Maria Lamassa, Patrizia Nencini, Salvatore Mangiafico, Nicola Limbucci
Anton-Babinski syndrome is a rare neuropsychiatric syndrome characterized by bilateral cortical blindness and anosognosia with visual confabulation. We present the case of a patient presenting with occlusion of both posterior cerebral arteries (PCA), with Anton-Babinski syndrome, completely solved after combined systemic thrombolysis and mechanical thrombectomy with a stent-retriever.
November 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29113900/dwell-time-of-stentriever-influences-complete-revascularisation-and-first-pass-tici3-revascularisation-in-acute-large-vessel-occlusive-stroke
#3
Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sylaja Padmavathy N, Sankara Sarma P, Sajith Sukumaran, Sapna Erat Sreedharan, Tirur Raman Kapilamoorthy
BACKGROUND AND OBJECTIVE: In acute ischemic stroke with large vessel occlusion, the interaction between the clot retriever and the stent is critical for achieving successful recanalization. The ideal time of stent deployment (dwell time, DT) to improve revascularization is currently unknown., We systematically analysed the effect of different DT on final angiographic and clinical outcome of of patients who underwent mechanical thrombectomy. METHODS: The DT was progressively increased from 3 minutes to 5 minutes and later, 8 minutes during the study period...
November 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29106636/endovascular-coil-retrieval-using-dual-synchronous-solitaire-revascularization-devices
#4
John D Nerva, Ryan P Morton, Cory M Kelly, Danial K Hallam, Michael R Levitt
BACKGROUND AND IMPORTANCE: Coil migration is a potential complication of endovascular aneurysm treatment. Dislodged coils into the parent artery require retrieval to prevent thromboembolic complications. A variety of techniques for coil retrieval have been described, including the use of single stentrievers and aspiration catheters. CLINICAL PRESENTATION: The use of 2 stentrievers, as opposed to a single device, was thought to be advantageous in coil removal by the additional point of friction due to the extensive length of coil stretching and earlier failure of a single device...
November 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28982494/techniques-for-endovascular-treatment-of-acute-ischemic-stroke
#5
REVIEW
L Pierot, M Gawlitza, S Soize
Early recanalization of occluded vessels in patients with acute ischemic stroke (AIS) by either intravenous thrombolysis (IVT) or endovascular revascularization has been shown to be associated with improved clinical outcomes and reduced mortality. Since the initial report regarding endovascular treatment (EVT) of AIS in 1983, endovascular techniques have been tremendously improved, advancing from intra-arterial administration of thrombolytic drugs to stent retrievers. IVT has been evaluated in several large randomized trials and has been shown to improve clinical outcomes at 90 days if treatment was initiated within 3h of stroke onset, while its benefit at 3-4...
November 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28887393/white-matter-hyperintensity-volume-and-outcome-of-mechanical-thrombectomy-with-stentriever-in-acute-ischemic-stroke
#6
Kunakorn Atchaneeyasakul, Thabele Leslie-Mazwi, Kathleen Donahue, Anne-Katrin Giese, Natalia S Rost
BACKGROUND AND PURPOSE: Finding of white matter hyperintensity (WMH) has been associated with an increased risk of parenchymal hematoma and poor clinical outcomes after mechanical thrombectomy using old-generation endovascular devices. Currently, no data exist with regard to the risk of mechanical thrombectomy using stentriever devices in patients with significant WMH. We hypothesized that WMH volume will not affect the hemorrhagic and clinical outcome in patients with acute ischemic stroke undergoing thrombectomy using new-generation devices...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28674985/stroke-basic-and-clinical
#7
Tarvinder P Singh, Jonathan R Weinstein, Sean P Murphy
Tissue plasminogen activator (tPA) was first approved in the USA 25 years ago for those who had experienced a recent occlusion (<3 h) of a cerebral vessel. Now, advances in clot retrieval (stentriever), in concert with tPA, heralds new optimism for ischemic stroke victims, but adds more pressure to identify therapies that will minimize hypoxic damage, protect compromised cells, and promote rehabilitation. In the past preclinical investigations have been poor at predicting potential clinical therapy, but they have contributed enormously to understanding post-stroke pathology...
2017: Advances in Neurobiology
https://www.readbyqxmd.com/read/28465460/efficacy-of-stent-retriever-thrombectomy-in-magnetic-resonance-imaging-versus-computed-tomographic-perfusion-selected-patients-in-swift-prime-trial-solitaire-fr-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment-for-acute-ischemic-stroke
#8
RANDOMIZED CONTROLLED TRIAL
Nicolas Menjot de Champfleur, Jeffrey L Saver, Mayank Goyal, Reza Jahan, Hans-Christoph Diener, Alain Bonafe, Elad I Levy, Vitor M Pereira, Christophe Cognard, Dileep R Yavagal, Gregory W Albers
BACKGROUND AND PURPOSE: The majority of patients enrolled in SWIFT PRIME trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke) had computed tomographic perfusion (CTP) imaging before randomization; 34 patients were randomized after magnetic resonance imaging (MRI). METHODS: Patients with middle cerebral artery and distal carotid occlusions were randomized to treatment with tPA (tissue-type plasminogen activator) alone or tPA+stentriever thrombectomy...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28409731/a-direct-aspiration-first-pass-technique-vs-stentriever-thrombectomy-in-emergent-large-vessel-intracranial-occlusions
#9
Christopher J Stapleton, Thabele M Leslie-Mazwi, Collin M Torok, Reza Hakimelahi, Joshua A Hirsch, Albert J Yoo, James D Rabinov, Aman B Patel
OBJECTIVE Endovascular thrombectomy in patients with acute ischemic stroke caused by occlusion of the proximal anterior circulation arteries is superior to standard medical therapy. Stentriever thrombectomy with or without aspiration assistance was the predominant technique used in the 5 randomized controlled trials that demonstrated the superiority of endovascular thrombectomy. Other studies have highlighted the efficacy of a direct aspiration first-pass technique (ADAPT). METHODS To compare the angiographic and clinical outcomes of ADAPT versus stentriever thrombectomy in patients with emergent large vessel occlusions (ELVO) of the anterior intracranial circulation, the records of 134 patients who were treated between June 2012 and October 2015 were reviewed...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28374677/the-first-reported-stentriever-based-thrombectomy-in-acute-st-elevation-myocardial-infarction-due-to-paradoxical-coronary-embolism
#10
Vladimir Manchurov, Kirill Anisimov, Valentina Khokhlova, Dmitry Skrypnik
No abstract text is available yet for this article.
August 4, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28366064/utility-of-a-y-configured-stentriever-technique-as-a-rescue-method-of-thrombectomy-for-an-intractable-rooted-thrombus-located-on-the-middle-cerebral-artery-bifurcation-technical-note
#11
Hideo Okada, Yoshikazu Matsuda, Joonho Chung, R Webster Crowley, Demetrius K Lopes
Mechanical thrombectomy with stentriever and/or aspiration is the new gold standard for the treatment of acute strokes with large-vessel occlusion. As many as 20% of cases remain refractory to current stentriever and/or aspiration devices. "Saddle clots" obstructing a bifurcation may be a particular challenge for recanalization with conventional techniques and devices. The authors describe an alternative technique to bifurcation occlusions resistant to the conventional mechanical thrombectomy approach in which they simultaneously deployed 2 stentrievers into both branches of an occluded bifurcation...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28347898/stentriever-thrombectomy-failure-a-challenge-in-stroke-management
#12
Claudio Baracchini, Filippo Farina, Matteo Soso, Federica Viaro, Silvia Favaretto, Anna Palmieri, Caterina Kulyk, Enzo Ballotta, Lorena Nico, Giacomo Cester, Francesco Causin
BACKGROUND AND OBJECTIVE: Stentriever thrombectomy failure in patients with acute ischemic stroke caused by anterior circulation large artery occlusion is not a rare event. The purpose of this study was to investigate whether other procedures (tirofiban, permanent stenting) are able to recanalize the occluded vessel and determine a better outcome without increasing mortality and intracranial hemorrhage rates. METHODS: Among 513 patients consecutively admitted with anterior circulation stroke, 109 underwent stentriever thrombectomy...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28341523/intracranial-stents-in-the-endovascular-treatment-of-acute-ischemic-stroke
#13
F Delgado Acosta, E Jiménez Gómez, I Bravo Rey, F A Bravo Rodríguez, J J Ochoa Sepúlveda, R Oteros Fernández
OBJECTIVE: To evaluate the efficacy and safety of intracranial stenting as a rescue therapy after failed mechanical thrombectomy in patients with acute ischemic stroke. MATERIAL AND METHODS: We retrospectively studied 42 patients treated with intracranial stenting after failed mechanical thrombectomy between December 2008 and January 2016. We compared outcomes before and after the incorporation of stentrievers. We assessed the degree of recanalization in the carotid and basilar territories (modified TIMI score), prognostic factors, and outcome (modified Rankin Score at 3 months)...
May 2017: Radiología
https://www.readbyqxmd.com/read/28270000/retrograde-semi-retrieval-technique-for-combined-stentriever-plus-aspiration-thrombectomy-in-acute-ischemic-stroke
#14
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...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28251328/efficacy-and-safety-of-direct-aspiration-first-pass-technique-versus-stent-retriever-thrombectomy-in-acute-basilar-artery-occlusion-a-retrospective-single-center-experience
#15
Johannes C Gerber, Dirk Daubner, Daniel Kaiser, Kay Engellandt, Kevin Haedrich, Angela Mueller, Volker Puetz, Jennifer Linn, Andrij Abramyuk
INTRODUCTION: The study aimed to compare efficacy and safety of aspiration thrombectomy (AT) to stentriever thrombectomy (SRT) in patients with basilar artery (BA) occlusion (BAO). METHODS: We retrospectively included patients with the following characteristics: acute BAO or occlusion of the intracranial vertebral artery (ICVA) and endovascular therapy (EVT) with stentriever (SRT) or aspiration thrombectomy (AT). Additional extra- but not intracranial EVT and intravenous thrombolysis (IVT) were allowed...
March 2017: Neuroradiology
https://www.readbyqxmd.com/read/28122915/stentriever-thrombectomy-with-distal-protection-device-for-carotid-free-floating-thrombus-a-technical-case-report
#16
Suresh Giragani, Ankit Balani, Vikas Agrawal
We report the clinical details, imaging findings and management of a 45-year-old man who presented with recurrent transient ischemic attacks due to carotid free floating thrombus. Free floating thrombus of the carotid artery is a very rare condition with a high risk of distal embolic shower. The optimal treatment options are debatable and include medical management, surgical thrombectomy and endovascular thrombectomy. We describe the use of a stentriever with filter protection in the management of carotid free floating thrombus as a novel treatment option...
January 25, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28100568/stentriever-thrombectomy-with-distal-protection-device-for-carotid-free-floating-thrombus-a-technical-case-report
#17
Suresh Giragani, Ankit Balani, Vikas Agrawal
We report the clinical details, imaging findings and management of a 45-year-old man who presented with recurrent transient ischemic attacks due to carotid free floating thrombus. Free floating thrombus of the carotid artery is a very rare condition with a high risk of distal embolic shower. The optimal treatment options are debatable and include medical management, surgical thrombectomy and endovascular thrombectomy. We describe the use of a stentriever with filter protection in the management of carotid free floating thrombus as a novel treatment option...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/27629085/importance-of-truncal-type-occlusion-in-stentriever-based-thrombectomy-for-acute-stroke
#18
Jang-Hyun Baek, Byung Moon Kim, Dong Joon Kim, Ji Hoe Heo, Hyo Suk Nam, Dongbeom Song, Oh Young Bang
OBJECTIVE: To investigate whether angiographically defined occlusion type could predict of the etiology of acute intracranial large artery occlusion and the stentriever response. METHODS: We reviewed consecutive patients with acute intracranial large artery occlusion who underwent endovascular treatment and examined their workups for embolic sources. Patient demographics, laboratory findings, hyperdense artery sign, and angiographic occlusion type (truncal-type or branching-site occlusion) were compared between embolic sources (+) and (-) groups...
October 11, 2016: Neurology
https://www.readbyqxmd.com/read/27522497/emergent-revascularization-of-acute-tandem-vertebrobasilar-occlusions-endovascular-approaches-and-technical-considerations-confirming-the-role-of-vertebral-artery-ostium-stenosis-as-a-cause-of-vertebrobasilar-stroke
#19
José E Cohen, Ronen R Leker, J Moshe Gomori, Roni Eichel, Gustavo Rajz, Samuel Moscovici, Eyal Itshayek
Patients suffering from acute atherothrombotic occlusion of the proximal vertebral artery (VA) and concomitant basilar artery (BA) occlusion present a grim prognosis. We describe our experience in the endovascular recanalization of tandem vertebrobasilar occlusions using endovascular techniques. The BA was accessed through the normal VA (clean-road) or the occluded, thrombotic VA (dirty-road), and stentriever-based thrombectomy was performed using antegrade or reverse revascularization variants. Seven patients underwent successful stentriever-assisted mechanical thrombectomy of the BA and five sustained concomitant VA revascularization...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27444259/stenting-as-a-rescue-treatment-after-failure-of-mechanical-thrombectomy-for-anterior-circulation-large-artery-occlusion
#20
Jang-Hyun Baek, Byung Moon Kim, Dong Joon Kim, Ji Hoe Heo, Hyo Suk Nam, Joonsang Yoo
BACKGROUND AND PURPOSE: We hypothesized that permanent stenting may be a rescue treatment for stentriever-failed anterior circulation large artery occlusion. We compared the outcomes among patients with permanent stenting and those without stenting after stentriever failure. METHODS: We retrospectively evaluated 208 patients who underwent stentriever thrombectomy for anterior circulation large artery occlusion between September 2010 and September 2015. Modified thrombolysis in cerebral ischemia 2b-3 recanalization was achieved with stentriever alone or in combination with Penumbra device in 155 patients (74...
September 2016: Stroke; a Journal of Cerebral Circulation
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