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Mechanical thrombectomy

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https://www.readbyqxmd.com/read/28429604/intra-arterial-verapamil-post-thrombectomy-is-feasible-safe-and-neuroprotective-in-stroke
#1
Justin F Fraser, Michael Maniskas, Amanda Trout, Doug Lukins, Lindsey Parker, W Lane Stafford, Abdulnasser Alhajeri, Jill Roberts, Gregory J Bix
Large vessel ischemic stroke represents the most disabling subtype. While t-PA and endovascular thrombectomy can recanalize the occluded vessel, good clinical outcomes are not uniformly achieved. We propose that supplementing endovascular thrombectomy with superselective intra-arterial (IA) verapamil immediately following recanalization could be safe and effective. Verapamil, a calcium channel blocker, has been shown to be an effective IA adjunct in a pre-clinical mouse focal ischemia model. To demonstrate translational efficacy, mechanism, feasibility, and safety, we conducted a group of translational experiments...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#2
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28428348/predictors-of-the-aspiration-component-success-of-a-direct-aspiration-first-pass-technique-adapt-for-the-endovascular-treatment-of-stroke-reperfusion-strategy-in-anterior-circulation-acute-stroke
#3
Raphaël Blanc, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Jean-Philippes Desilles, Eliane Orng, Guillaume Taylor, Elodie Drumez, Robert Fahed, Julien Labreuche, Mikael Mazighi, Bertrand Lapergue, Michel Piotin
BACKGROUND AND PURPOSE: The technique of a direct aspiration first pass technique (ADAPT) for the endovascular treatment of stroke has been reported to be fast, safe, and effective for the treatment of acute ischemic stroke. The aim of this study is to determine the preoperative factors that affect success of the aspiration component of the technique in ischemic stroke patients with large vessel occlusion in the anterior circulation. METHODS: We enrolled all 347 consecutive patients with anterior circulation acute ischemic stroke admitted for mechanical thrombectomy at our institution from August 2013 to October 2015 and treated by ADAPT for the endovascular treatment of stroke...
April 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28424039/endovascular-treatment-of-ischemic-stroke-an-updated-meta-analysis-of-efficacy-and-safety
#4
Simone Vidale, Elio Agostoni
BACKGROUND: Recent randomized trials demonstrated the superiority of the mechanical thrombectomy over the best medical treatment in patients with acute ischemic stroke due to an occlusion of arteries of proximal anterior circulation. In this updated meta-analysis, we aimed to summarize the total clinical effects of the treatment, including the last trials. METHODS: We performed literature search of Randomized Crontrolled Trials (RCTs) published between 2010 and October 2016, comparing endovenous thrombolysis plus mechanical thrombectomy (intervention group) with best medical care alone (control group)...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#5
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28422279/efficacy-and-safety-of-mechanical-thrombectomy-in-older-adults-with-acute-ischemic-stoke
#6
Fabrizio Sallustio, Giacomo Koch, Caterina Motta, Marina Diomedi, Fana Alemseged, Vittoria C D'Agostino, Simone Napolitano, Domenico Samà, Alessandro Davoli, Daniel Konda, Daniele Morosetti, Enrico Pampana, Roberto Floris, Roberto Gandini
OBJECTIVES: To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke. DESIGN: Retrospective cohort study. SETTING: Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy. PARTICIPANTS: Elderly adults treated for acute ischemic stroke (N = 219). MEASUREMENTS: Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, <80)...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28412100/risk-of-acute-kidney-injury-after-percutaneous-pharmacomechanical-thrombectomy-using-angiojet-in-venous-and-arterial-thrombosis
#7
Guillermo A Escobar, Dillon Burks, Matthew R Abate, Mohammed F Faramawi, Ahsan T Ali, Lewis C Lyons, Mohammed M Moursi, Matthew R Smeds
BACKGROUND: Percutaneous mechanical thrombectomy (PMT) is commonly used to treat acute thrombotic syndromes. Angiojet (AJ) forcibly sprays fibrinolytics to fragment and aspirate thrombus. It's known to cause hemolysis and gross hematuria, yet potential consequences to renal function after AJ remain unstudied. We sought to determine the risk of acute kidney injury (AKI) after AJ when compared to other lysis techniques. METHODS AND RESULTS: We retrospectively reviewed patients treated with thrombolysis over 5 years...
April 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28408627/minor-stroke-syndromes-in-large-vessel-occlusions-mechanical-thrombectomy-or-thrombolysis-only
#8
M P Messer, S Schönenberger, M A Möhlenbruch, J Pfaff, C Herweh, P A Ringleb, S Nagel
While mechanical thrombectomy for large-vessel occlusions is now an evidence-based treatment, its efficacy and safety in minor stroke syndromes (NIHSS ≤ 5) is not proved. We identified, in our prospective data base, 378 patients with minor strokes in the anterior circulation; 54 (14.2%) of these had proved large-vessel occlusions. Eight of 54 (14.8%) were immediately treated with mechanical thrombectomy, 6/54 (11.1%) after early neurologic deterioration, and the rest were treated with standard thrombolysis only...
April 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28400981/new-developments-in-the-pathophysiology-workup-and-diagnosis-of-dural-venous-sinus-thrombosis-dvst-and-a-systematic-review-of-endovascular-treatments
#9
REVIEW
Sanjay Konakondla, Clemens M Schirmer, Fengwu Li, Xiaogun Geng, Yuchuan Ding
Dural venous sinus thrombosis (DVST) is a rare cause of stroke, which typically affects young women. The importance of identifying pre-disposing factors that lead to venous stasis lies in the foundation of understanding the etiology, pathophysiology and clinical presentation. The precise therapeutic role of interventional therapies is not fully understood though the current data do suggest potential applications. The aim of the study was to perform a systematic review and meta-analysis to evaluate the utility of and short-term 30-day survival after endovascular therapy for patients with DVST...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28395418/-efficacy-comparison-of-three-vascular-recanalization-in-patients-with-acute-vertebrobasilar-occlusion
#10
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/28395416/-application-of-percutaneous-angiojet-thrombectomy-in-patients-with-acute-symptomatic-portal-and-superior-mesenteric-venous-thrombosis
#11
J H Song, X He, W S Lou, L Chen, G P Chen, H B Su, W Y Shi, T Wang, B X Zhao, J P Gu
Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV)...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28392138/evaluation-of-recanalisation-treatment-on-posterior-circulation-ischemic-stroke-by-solitaire-device-a-multicenter-retrospective-study
#12
Jianwu Long, Hao Qin, Hongqi Zhang
OBJECTIVES: Posterior circulation ischemic stroke (PCIS), accounting for approximately 20% of total ischemic stroke, is a sever disease that associated with high rate of morbidity and mortality. Though the effectiveness of endovascular mechanical thrombectomy has been well demonstrated in many types of ischemic stroke, it is still unclear what the outcome is in posterior circulation ischemic stroke. METHODS AND MATERIALS: In current study, data was collected from 139 Chinese patients who received endovascular mechanical thrombectomy treatment with Solitaire device after acute posterior circulation ischemic stroke...
March 24, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28389294/comparison-of-aspire-mechanical-thrombectomy-versus-angiojet-thrombectomy-system-in-a-porcine-iliac-vein-thrombosis-model
#13
Roy J Weinberg, Tamuru Okada, Aaron Chen, Walter Kim, Changyi Chen, Peter H Lin
PURPOSE: To compare the efficacy and safety profile of the AngioJet thrombectomy device and ASPIRE thrombectomy system in a porcine venous thrombosis model. MATERIALS AND METHODS: Twelve adult pigs underwent bilateral iliac venous thrombosis created by using a stent-graft thrombosis model, and subsequently underwent either AngioJet (n = 6) or ASPIRE mechanical thrombectomy (n = 6) one week later. Intravascular ultrasound (IVUS) was used to assess thrombectomy efficacy, and computed tomography was used to evaluate pulmonary embolism (PE)...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28384632/is-reperfusion-useful-in-ischaemic-stroke-patients-presenting-with-a-low-national-institutes-of-health-stroke-scale-and-a-proximal-large-vessel-occlusion-of-the-anterior-circulation
#14
Cyril Dargazanli, Arturo Consoli, Benjamin Gory, Raphaël Blanc, Julien Labreuche, Cristian Preda, Frédéric Bourdain, Jean-Pierre Decroix, Hocine Redjem, Gabriele Ciccio, Mikael Mazighi, Stanislas Smajda, Jean-Philippe Desilles, Roberto Riva, Paul-Emile Labeyrie, Oguzhan Coskun, Georges Rodesch, Francis Turjman, Michel Piotin, Bertrand Lapergue
BACKGROUND: In population-based studies, patients presenting with minor or mild stroke symptoms represent about two-thirds of stroke patients, and almost one-third of these patients are unable to ambulate independently at the time of discharge. Although mechanical thrombectomy (MT) has become the standard of care for acute ischaemic stroke with proximal large vessel occlusion (LVO) in the anterior circulation, the management of patients harbouring proximal occlusion and minor-to-mild stroke symptoms has not yet been determined by recent trials...
April 7, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28382485/-availability-of-mechanical-thrombectomy-for-acute-stroke-analysis-of-the-health-care-reality-in-germany
#15
C Krogias, D Bartig, M Kitzrow, F Brassel, E W Busch, M Nolden-Koch, G Reimann, C Weimar, R Weber, J Eyding
BACKGROUND: Mechanical thrombectomy (MT) has become an evidence-based therapy for stroke patients with proximal vessel occlusion of the anterior cerebral circulation. Nationwide availability of MT for all eligible patients within the shortest possible time window is a major challenge. AIM OF THE STUDY: Nationwide analysis of the rates of systemic thrombolysis (STL) and MT in Germany according to region and hospital-based evaluation. METHODS: The evaluation involved data analysis of the diagnosis-related groups (DRG) statistics and structured quality reports of hospitals for 2010 and 2014...
April 5, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28377257/special-endovascular-treatment-for-acute-large-artery-occlusion-resulting-from-atherosclerotic-disease
#16
Ting-Yu Yi, Wen-Huo Chen, Yan-Min Wu, Mei-Fang Zhang, Yue-Hong Chen, Zong-Zhong Wu, Yan-Chuan Shi, Bai-Ling Chen
BACKGROUND: and Purpose: Acute intracranial atherosclerotic disease (IAD)-related large artery occlusion (LAO) is typically refractory to mechanical thrombectomy. We evaluated the feasibility and safety of emergency balloon-assisted or stent-assisted angioplasty performed with tirofiban administration for acute IAD-related LAO. METHODS: We identified, from among 55 consecutive patients who underwent endovascular treatment for LAO, 12 patients with acute IAD-related LAO who underwent balloon-assisted or stent-assisted angioplasty with (n = 3) or without passage of a stent retriever...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28377089/patient-eligibility-for-thrombectomy-after-acute-stroke-northern-french-alps-database-analysis
#17
J Papassin, I M Favre-Wiki, T Atroun, F Tahon, K Boubagra, G Rodier, F Bing, S Marcel, C Vallot, L Belle, M Hommel, O Detante
BACKGROUND: Since 2015, the emergence of mechanical thrombectomy as standard care in acute stroke has involved organizational changes not only for stroke centers, but also for entire emergency regional networks. The aim of our study was to assess the proportion of ischemic stroke patients, admitted to stroke units in the Northern French Alps within the first 6h of onset, eligible for thrombectomy. METHODS: This study retrospectively analyzed the clinical and radiological data of all acute stroke patients hospitalized at three stroke units of the Northern French Alps Emergency Network (RENAU) in 2014...
April 1, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28375045/thrombectomy-accessibility-after-transfer-from-a-primary-stroke-center-analysis-of-a-three-year-prospective-registry
#18
Denis Sablot, Nicolas Gaillard, Philippe Smadja, Jean-Marie Bonnec, Alain Bonafe
Background No comprehensive study exists about mechanical thrombectomy accessibility for patients admitted to a primary stroke center without onsite interventional neuroradiology service. Aims To evaluate mechanical thrombectomy accessibility within 6 h after transfer from a primary stroke center to a distant (156 km apart; 1.5 h by car) comprehensive stroke center. Methods Analysis of data collected in a three-year prospective registry on patients admitted to a primary stroke center within 4.5 h after symptom onset and selected for transfer to a comprehensive stroke center for mechanical thrombectomy...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28369771/intervention-radiology-for-venous-thrombosis-early-thrombus-removal-using-invasive-methods
#19
REVIEW
Ana I Casanegra, Robert D McBane, Haraldur Bjarnason
The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Anticoagulation alone does not reduce the likelihood of this outcome. Compression therapy may be effective but garment discomfort limits its implementation...
April 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28366071/vessel-wall-signal-enhancement-on-3-t-mri-in-acute-stroke-patients-after-stent-retriever-thrombectomy
#20
Peter Abraham, J Scott Pannell, David R Santiago-Dieppa, Vincent Cheung, Jeffrey Steinberg, Arvin Wali, Mihir Gupta, Robert C Rennert, Roland R Lee, Alexander A Khalessi
OBJECTIVE In vivo and in vitro studies have demonstrated histological evidence of iatrogenic endothelial injury after stent retriever thrombectomy. However, noncontrast vessel wall (VW)-MRI is insufficient to demonstrate vessel injury. Authors of this study prospectively evaluated iatrogenic endothelial damage after stent retriever thrombectomy in humans by utilizing high-resolution contrast-enhanced VW-MRI. Characterization of VW-MRI changes in vessels subject to mechanical injury from thrombectomy may allow better understanding of the biological effects of this intervention...
April 2017: Neurosurgical Focus
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