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Mechanical thrombectomy

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https://www.readbyqxmd.com/read/28645588/long-term-outcomes-of-mechanical-thrombectomy-for-the-treatment-of-acute-ischemic-stroke
#1
David McCarthy, Christian Theodotou, Samir Sur, Brian Snelling, Stephanie Chen, Eric C Peterson, Robert M Starke
No abstract text is available yet for this article.
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645587/dawn-of-an-even-newer-era-mechanical-thrombectomy-for-acute-ischemic-stroke-beyond-6-to-8-hours
#2
Christoph J Griessenauer, Clemens M Schirmer
No abstract text is available yet for this article.
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644924/intravenous-thrombolysis-for-acute-ischemic-stroke-a-bridge-between-two-centuries
#3
Georgios Tsivgoulis, Odysseas Kargiotis, Andrei Alexandrov
Intravenous tissue-plasminogen activator (tPA) remains the only approved systemic reperfusion therapy suitable for most patients presenting timely with acute ischemic stroke. Accumulating real-word experience for over 20 years regarding tPA safety and effectiveness lead to re-appraisal of original contraindications for intravenous thrombolysis (IVT). Areas covered: This narrative review focuses on fast yet appropriate selection of patients for safe administration of tPA per recently expanded indications. Novel strategies for rapid patient assessment will be discussed...
June 23, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#4
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28617387/-pharmacological-neuroprotection-in-stroke-in-clinical-practice-new-perspectives
#5
D V Sergeev, M A Domashenko, M A Piradov
Despite recent advances in acute stroke care, clinical armamentarium against stroke remains limited. Furthermore, highly effective approaches to stroke treatment, such as systemic reperfusion and mechanical thrombectomy, cannot be performed in the majority of patients. Neuroprotective strategies, i.e. prevention of irreversible cell damage due to the ischemia, may improve stroke outcomes. However, only few pharmacological agents demonstrated clinical efficacy. Citicoline is an endogenous mononucleotide with neuroprotective effect and established clinical safety and tolerability, which effectiveness in acute stroke was studied in several large, well-controlled trials...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28615906/direct-mechanical-thrombectomy-with-thromboaspiration-in-cerebral-venous-sinus-thrombosis
#6
Vikram Bohra, Romnesh deSouza, Vivek Karan, Vikram Huded
No abstract text is available yet for this article.
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28611834/mechanical-thrombectomy-in-pregnancy-report-of-2-cases-and-review-of-the-literature
#7
REVIEW
Pervinder Bhogal, Marta Aguilar, Muhammad AlMatter, Ulrich Karck, Hansjörg Bäzner, Hans Henkes
BACKGROUND: Mechanical thrombectomy has recently proved extremely effective in improving the outcome of patients with large vessel occlusion. Despite this, questions still remain over certain cohorts of patients that were excluded from the large randomised controlled trials. One such cohort includes pregnant patients. Although thromboembolic stroke is uncommon in pregnancy, the outcome from this pathology can be devastating. SUMMARY: We present 2 cases of mechanical thrombectomy in pregnancy both of which underwent successful flow restoration without complications...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611827/repeated-mechanical-thrombectomy-in-recurrent-large-vessel-occlusion-acute-ischemic-stroke
#8
Mehdi Bouslama, Diogo C Haussen, Leticia C Rebello, Jonathan A Grossberg, Michael R Frankel, Raul G Nogueira
BACKGROUND: Endovascular therapy has been proven effective for the treatment of large vessel occlusion strokes (LVOS). However, the feasibility and potential benefits of repeat thrombectomy for recurrent stroke is unclear. We aim to report our experience with repeat thrombectomy for recurrent LVOS. METHODS: We reviewed our prospectively collected endovascular database for patients who underwent repeated mechanical thrombectomy. Baseline characteristics, procedural data and outcomes were evaluated...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28605743/incomplete-large-vessel-occlusions-in-mechanical-thrombectomy-an-independent-predictor-of-favorable-outcome-in-ischemic-stroke
#9
Volker Maus, Seunghwa You, Alev Kalkan, Jan Borggrefe, Christoph Kabbasch, Utako Birgit Barnikol, Henning Stetefeld, Christian Dohmen, Thomas Liebig, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND AND PURPOSE: Cerebral large vessel occlusion (LVO) in acute ischemic stroke (AIS) may be complete (CLVO) or incomplete (ILVO). The influence of ILVO on clinical outcome after mechanical thrombectomy (MT) remains unclear. We investigated primarily the clinical outcome in patients with AIS due to ILVO or CLVO. METHODS: Five hundred three consecutive AIS patients with LVO treated with stent-retriever or direct aspiration-based MT between 2010 and 2016 were analyzed...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28604186/mechanical-removal-of-a-refluxed-onyx-piece-from-the-middle-cerebral-artery-using-the-solitaire-stent-technical-report
#10
Dilara Gungor, Şükrü Oğuz, Hasan Dinc
Onyx reflux into the parent artery is a rare and sometimes significant complication in the treatment of cerebral arteriovenous malformations (AVMs). We report a patient who presented with Onyx reflux into the M1 segment of the middle cerebral artery (MCA) during embolization of a right temporal AVM. The refluxed Onyx cast was successfully removed by a mechanical thrombectomy device using a self-expandable and fully retrievable Solitaire AB stent.
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28600482/a-multicenter-study-evaluating-the-frequency-and-time-requirement-of-mechanical-thrombectomy
#11
Taylor A Wilson, Thabele Leslie-Mazwi, Joshua A Hirsch, Casey Frey, Teddy E Kim, Alejandro M Spiotta, Reade de Leacy, J Mocco, Felipe C Albuquerque, Andrew F Ducruet, Ahmed Cheema, Adam Arthur, Visish M Srinivasan, Peter Kan, Maxim Mokin, Travis Dumont, Ansaar Rai, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
INTRODUCTION: There are few published data evaluating the incidence of mechanical thrombectomy among stroke centers or the times at which they occur. METHODS: A multicenter retrospective study was performed to identify all patients undergoing emergent thrombectomy for acute ischemic stroke during a 3-month period (June through August 2016). Consultations that did not undergo thrombectomy were not included. RESULTS: Ten institutions participated in the study...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28600481/optimal-thresholds-for-ischemic-penumbra-predicted-by-computed-tomography-perfusion-in-patients-with-acute-ischemic-stroke-treated-with-mechanical-thrombectomy
#12
Katsuharu Kameda, Junji Uno, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND AND PURPOSE: Optimal thresholds for ischemic penumbra detected by CT perfusion (CTP) in patients with acute ischemic stroke (AIS) have not been elucidated. In this study we investigated optimal thresholds for salvageable ischemic penumbra and the risk of hemorrhagic transformation (HT). METHODS: A total of 156 consecutive patients with AIS treated with mechanical thrombectomy (MT) at our hospital were enrolled. Absolute (a) and relative (r) CTP parameters including cerebral blood flow (aCBF and rCBF), cerebral blood volume (aCBV and rCBV), and mean transit time (aMTT and rMTT) were evaluated for their value in detecting ischemic penumbra in each of seven arbitrary regions of interest defined by the major supplying blood vessel...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28596469/-a-case-of-takayasu-arteritis-with-acute-bilateral-occlusion-of-the-internal-carotid-arteries
#13
Takuya Ebata, Junichi Uemura, Hidekazu Yamazaki, Keisuke Imai, Yoshiki Yagita
A 38-year-old woman developed disturbance of consciousness and quadriplegia. Magnetic resonance images showed scattered acute infarcts in both hemispheres and bilateral occlusion of the intracranial artery (ICA). Immediate mechanical thrombectomy restored the patency of the ICA. Contrast-enhanced computed tomography revealed bilateral wall thickening of the abdominal aorta and the iliac arteries. This finding and an elevated erythrocyte sedimentation rate supported the diagnosis of Takayasu arteritis. Here, we thus report a rare case of Takayasu arteritis with acute bilateral occlusion of the internal carotid arteries...
June 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28596195/e-aspects-correlates-with-and-is-predictive-of-outcome-after-mechanical-thrombectomy
#14
J Pfaff, C Herweh, S Schieber, S Schönenberger, J Bösel, P A Ringleb, M Möhlenbruch, M Bendszus, S Nagel
BACKGROUND AND PURPOSE: The e-ASPECTS software is a tool for the automated use of ASPECTS. Our aim was to analyze whether baseline e-ASPECT scores correlate with outcome after mechanical thrombectomy. MATERIALS AND METHODS: Patients with ischemic strokes in the anterior circulation who were admitted between 2010 and 2015, diagnosed by CT, and received mechanical thrombectomy were included. The ASPECTS on baseline CT was scored by e-ASPECTS and 3 expert raters, and interclass correlation coefficients were calculated...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28592218/first-line-use-of-contact-aspiration-for-thrombectomy-versus-a-stent-retriever-for-recanalization-in-acute-cerebral-infarction-the-randomized-aster-study-protocol
#15
Bertrand Lapergue, Julien Labreuche, Raphael Blanc, Xavier Barreau, Jérome Berge, Arturo Consoli, Georges Rodesch, Susanna Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Alain Duhamel, Sandrine Baffert, Mikael Mazighi, Benjamin Gory, Francis Turjman, Michel Piotin
Rationale Mechanical thrombectomy with a stent retriever is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion. New techniques for mechanical thrombectomy, such as contact aspiration, appear promising to increase reperfusion status and improve clinical outcome. Aim We aim at ascertaining whether contact aspiration is more efficient than the stent retriever as a first-line endovascular procedure. Sample size estimates With a two-sided test (alpha = 5%, power = 90%) and an anticipated rate of spontaneous recanalization and catheterization failures of 15%, we estimate that a sample size of 380 patients will be necessary to detect an absolute difference of 15% in primary outcome (superiority design)...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28589250/histopathological-and-bacteriological-analysis-of-thrombus-material-extracted-during-mechanical-thrombectomy-in-acute-stroke-patients
#16
Francisco Hernández-Fernández, Laura Rojas-Bartolomé, Jorge García-García, Óscar Ayo-Martín, Juan David Molina-Nuevo, Rosa Angélica Barbella-Aponte, Gemma Serrano-Heras, Enrique Juliá-Molla, María José Pedrosa-Jiménez, Tomás Segura
PURPOSE: Management of stroke secondary to septic emboli (SE) remains challenging, due to both the lack of specific recommendations and the gravity of the underlying pathology.The aim of this study is to describe the presence of SE in a series of mechanical thrombectomies (MT), analyzing technical complexity and outcomes with respect to the patients by means of histological analysis and microbiological study of the clot. METHODS: All the retrieved clots were studied under an established protocol, including histopathological and bacteriological study with hematoxylin-eosin, Gram and Gomori trichrome staining...
June 6, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28579511/streamlining-workflow-for-endovascular-mechanical-thrombectomy-lessons-learned-from-a-comprehensive-stroke-center
#17
REVIEW
Hongjin Wang, Arthur Thevathasan, Richard Dowling, Steven Bush, Peter Mitchell, Bernard Yan
BACKGROUND: Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays...
June 1, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28579039/total-mismatch-of-diffusion-weighted-imaging-and-susceptibility-weighted-imaging-in-patients-with-acute-cerebral-ischemia
#18
Min-Gyu Park, Jeong A Yeom, Seung Kug Baik, Kyung-Pil Park
BACKGROUND AND PURPOSE: Multiple hypointense vessels (MHV) on susceptibility-weighted imaging (SWI) is associated with an increased oxygen demand in acute cerebral ischemia. Occasionally, some patients exhibit extensive MHV on SWI despite of negative diffusion-weighted imaging (DWI), which is a phenomenon called total mismatch DWI-SWI. We analyzed the clinical characteristics and imaging findings in patients with the total DWI-SWI mismatch. MATERIALS AND METHODS: We selected patients with total DWI-SWI mismatch who underwent MRI within 12hours from onset...
May 31, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28569123/diffusion-weighted-imaging-or-computerized-tomography-perfusion-assessment-with-clinical-mismatch-in-the-triage-of-wake-up-and-late-presenting-strokes-undergoing-neurointervention-with-trevo-dawn-trial-methods
#19
Tudor G Jovin, Jeffrey L Saver, Marc Ribo, Vitor Pereira, Anthony Furlan, Alain Bonafe, Blaise Baxter, Rishi Gupta, Demetrius Lopes, Olav Jansen, Wade Smith, Daryl Gress, Steven Hetts, Roger J Lewis, Ryan Shields, Scott M Berry, Todd L Graves, Tim Malisch, Ansaar Rai, Kevin N Sheth, David S Liebeskind, Raul G Nogueira
Rationale Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h of time last seen well has not been demonstrated in randomized trials. Aim To establish whether subjects considered to have substantial areas of salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6-24 h from time last seen (TLSW) well have better outcomes at three months compared to subjects treated with standard medical therapy alone...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28569122/rationale-and-design-of-combination-of-an-immune-modulator-fingolimod-with-alteplase-bridging-with-mechanical-thrombectomy-in-acute-ischemic-stroke-famtais-trial
#20
Sheng Zhang, Ying Zhou, Ruiting Zhang, Meixia Zhang, Bruce Campbell, Longting Lin, Fu-Dong Shi, Min Lou
Rationale In acute ischemic stroke patients with large vessel occlusion, although reperfusion within 6 h after stroke onset using combined intravenous alteplase and mechanical thrombectomy (bridging therapy) can improve functional outcome, still approximately 50% patients suffer disability which may result from reperfusion injury. Proof-of-concept clinical trials have indicated that the sphingosine-1-phosphate receptor modulator fingolimod may be efficacious in attenuating brain inflammation and improving clinical outcomes in acute ischemic stroke patients as a single therapy beyond 4...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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