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Intra-arterial thrombolysis

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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
#1
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/28429356/thrombolysis-in-acute-stroke-without-angiographically-documented-occlusion
#2
M-C Shi, F-N Chu, C Li, S-C Wang
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) using urokinase (UK) in acute stroke patients without angiographically-documented occlusion, and to define predictors of clinical outcome. PATIENTS AND METHODS: We analyzed clinical and radiological data of acute ischemic stroke patients whose angiography did not show an arterial occlusion within six hours of symptom onset and who were further treated with IAT using UK...
April 2017: European Review for Medical and Pharmacological Sciences
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
#3
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/28400063/first-case-of-ischemic-stroke-which-happened-during-continuous-intravenous-infusion-of-rt-pa
#4
Anna Zurawska, Jaroslaw Czeczotka, Jacek J Rozniecki
Catheter-directed thrombolysis (CDT) is one of the methods in the treatment of patients with acute lower limb ischemia. It is based on intrathrombus infusion of one of the thrombolytic agents. The most common complication of CDT is bleeding. We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus...
March 18, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28395418/-efficacy-comparison-of-three-vascular-recanalization-in-patients-with-acute-vertebrobasilar-occlusion
#5
G H Ni, C Liang, W D Zhao, X Y Tian, H G Sun, S R Gao, L S Ding
Objectives: To investigate the therapeutic effects of intravenous thrombolysis, intra-artery thrombolysis, mechanical thrombectomy on patients with acute vertebrobasilar occlusion. Methods: Retrospective analysis of clinical data of patients with acute vertebrobasilar occlusion, admitted to Huai'an First People's Hospital and Bingtuan Qishi Hospital from January 2014 to January 2016, was performed. According to different vascular recanalization, these patients were divided into intravenous thrombolysis group, intra-artery thrombolysis group and mechanical thrombectomy group...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28389610/admission-glucose-and-effect-of-intra-arterial-treatment-in-patients-with-acute-ischemic-stroke
#6
Elizabeth Osei, Heleen M den Hertog, Olvert A Berkhemer, Puck S S Fransen, Yvo B W E M Roos, Debbie Beumer, Robert J van Oostenbrugge, Wouter J Schonewille, Jelis Boiten, Adrienne A M Zandbergen, Peter J Koudstaal, Diederik W J Dippel
BACKGROUND AND PURPOSE: Hyperglycemia on admission is common after ischemic stroke. It is associated with unfavorable outcome after treatment with intravenous thrombolysis and after intra-arterial treatment. Whether hyperglycemia influences the effect of reperfusion treatment is unknown. We assessed whether increased admission serum glucose modifies the effect of intra-arterial treatment in patients with acute ischemic stroke. METHODS: We used data from the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular treatment for acute ischemic stroke in the Netherlands)...
April 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28291676/long-term-outcome-after-thrombolysis-for-acute-lower-limb-ischaemia
#7
O Grip, A Wanhainen, S Acosta, M Björck
OBJECTIVES: The purpose was to study long-term outcome after thrombolysis for acute arterial lower limb ischaemia, and to evaluate the results depending on the underlying aetiology of arterial occlusion. METHODS: This was a retrospective study of patients entered into a prospective database. Patients were identified in prospective databases from two vascular centres, including a large number of variables. Case records were analysed retrospectively. Through cross linkage with the Population Registry 100% accurate survival data were obtained...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
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
#8
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/28274514/cerebral-venous-sinus-thrombosis-in-pregnancy-and-puerperium-a-pooled-systematic-review
#9
REVIEW
Ahmed I Kashkoush, Henry Ma, Nitin Agarwal, David Panczykowski, Daniel Tonetti, Gregory M Weiner, William Ares, Cynthia Kenmuir, Ashutosh Jadhav, Tudor Jovin, Brian T Jankowitz, Bradley A Gross
Pregnancy and puerperium are risk factors for cerebral venous sinus thrombosis (CVST); however studies describing diagnosis and management in this population are limited. The objective of this study was to amalgamate published case reports and series regarding diagnosis and management of CVST in pregnancy and puerperium. Searches of PubMed and the Cochrane library were performed using search terms "pregnancy"/"puerperium" and "sinus occlusion"/"sinus thrombosis". Studies were included in our pooled analysis if they included individual patient symptoms, management approach and follow-up condition...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28271663/vascular-complications-following-prophylactic-balloon-occlusion-of-the-internal-iliac-arteries-resolved-by-successful-interventional-thrombolysis-in-a-patient-with-morbidly-adherent-placenta
#10
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jia-Ning Fu, Yun-Yan Chen, Zhi-Guo Zhuang, Jian-Hua Lin
The increasing incidence of morbidly adherent placenta (MAP) is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic iliac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal iliac artery balloons who had external iliac artery thrombosis detected by computed tomography angiography (CTA) 72 h post cesarean section...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28201864/recurrent-contrast-induced-encephalopathy-following-coronary-angiography
#11
Roberto Spina, Neil Simon, Romesh Markus, David W M Muller, Krishna Kathir
Contrast-induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra-arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood-brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24-48 h...
February 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28184347/intra-arterial-thrombolysis-for-central-retinal-artery-occlusion-after-the-coil-embolization-of-paraclinoid-aneurysm
#12
Minwook Yoo, Sung-Chul Jin, Hae Yu Kim, Byeong-Sam Choi
The most common complication of coil embolization for cerebral aneurysms is thrombo-embolic stroke; in rare cases, these strokes, can present with central retinal artery occlusion. At our institution, a 53-year-old woman underwent stent-assisted coiling of the aneurysm. The patient's vision was improved immediately after intra-arterial thrombolysis and had further improved 8 months later. This report describes our experience of a rare case of central retinal artery occlusion after coil embolization that was successfully treated by intra-arterial thrombolysis...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28154103/acute-ischemic-stroke-therapy-overview
#13
Luciana Catanese, Joseph Tarsia, Marc Fisher
The treatment of acute ischemic stroke has undergone dramatic changes recently subsequent to the demonstrated efficacy of intra-arterial (IA) device-based therapy in multiple trials. The selection of patients for both intravenous and IA therapy is based on timely imaging with either computed tomography or magnetic resonance imaging, and if IA therapy is considered noninvasive, angiography with one of these modalities is necessary to document a large-vessel occlusion amenable for intervention. More advanced computed tomography and magnetic resonance imaging studies are available that can be used to identify a small ischemic core and ischemic penumbra, and this information will contribute increasingly in treatment decisions as the therapeutic time window is lengthened...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28130468/leukoaraiosis-intracerebral-hemorrhage-and-functional-outcome-after-acute-stroke-thrombolysis
#14
Kannikar Kongbunkiat, Duncan Wilson, Narongrit Kasemsap, Somsak Tiamkao, Fatima Jichi, Vanessa Palumbo, Michael D Hill, Alastair M Buchan, Simon Jung, Heinrich P Mattle, Nils Henninger, David J Werring
OBJECTIVE: To perform a systematic review and pooled meta-analysis of published studies to assess whether the presence of leukoaraiosis on neuroimaging before treatment with thrombolysis (IV or intra-arterial) is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) or poor functional outcome. METHODS: We included studies of patients with acute ischemic stroke, treated with IV or intra-arterial thrombolysis, which assessed functional outcome (3-month modified Rankin Scale [mRS]) or sICH in relation to leukoaraiosis on pretreatment neuroimaging (CT or MRI)...
February 14, 2017: Neurology
https://www.readbyqxmd.com/read/28120326/thrombolytic-treatment-for-ischaemic-stroke-could-the-crisis-of-confidence-have-been-avoided-by-better-analysis-of-trial-data
#15
REVIEW
David Barer, Eivind Berge
In many countries, thrombolysis with intravenous alteplase has become a central part of acute stroke care in recent years, requiring radical restructuring of services. However, a significant minority of emergency and stroke physicians have always had serious doubts about the safety and efficacy of thrombolytic treatment, and in 2015 these prompted a major review of the licensing status of alteplase by the UK regulatory authorities. Subsequent dramatic headlines and media stories have called into question the integrity of researchers and clinicians and undermined public faith in medical research...
February 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#16
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
January 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27920715/intra-arterial-mechanical-thrombectomy-an-effective-treatment-for-ischemic-stroke-caused-by-endocarditis
#17
Olafur Sveinsson, Lars Herrman, Staffan Holmin
Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27917359/protective-roles-of-intra-arterial-mild-hypothermia-and-arterial-thrombolysis-in-acute-cerebral-infarction
#18
Xiaoxiang Peng, Yue Wan, Wenjun Liu, Bitang Dan, Li Lin, Zhouping Tang
OBJECTIVE: Herein, we evaluated the efficacy and safety of intra-arterial mild hypothermia in combination with arterial thrombolysis to treat acute cerebral infarction due to middle cerebral artery occlusion. METHODS: A total of 26 patients with acute middle cerebral artery occlusion were divided into a normothermia group (n = 15) and a mild hypothermia group (n = 11). The infarct volumes at 24 h and 7 days after the operation were compared between the normothermia group and the mild hypothermia group...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#19
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27848280/intra-arterial-thrombolysis-of-digital-artery-occlusions-in-a-patient-with-polycythemia-vera
#20
Philipp Jud, Franz Hafner, Thomas Gary, Leyla Ghanim, Rainer Lipp, Marianne Brodmann
There are limited therapeutic options for the resolution of digital artery occlusions. Intra-arterial thrombolysis with anticoagulative and thrombolytic drugs successfully restored the blood flow in the affected digital arteries.
January 2017: VASA. Zeitschrift Für Gefässkrankheiten
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