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Mechanical thrombectomy

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https://www.readbyqxmd.com/read/28930804/venous-thromboembolism-in-gynecological-malignancy
#1
Abigail Cohen, Chung Sim Lim, Alun Huw Davies
OBJECTIVE: Venous thromboembolism (VTE) is a recognized complication of gynecological malignancy and represents a leading cause of morbidity and mortality in these patients. The review aimed to discuss the incidence, risk factors, and clinical presentation of VTE before examining the literature on the diagnosis, prevention, and management in the context of uterine, cervical, ovarian, and vulval cancers. METHODS/MATERIALS: A literature search was performed using Ovid Medline and Embase with the following words: "gynecological malignancy," "pelvic tumor," "venous thromboembolism," "deep vein thrombosis" and "pulmonary embolism...
September 19, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28923278/can-adjunctive-therapies-augment-the-efficacy-of-endovascular-thrombolysis-a-potential-role-for-activated-protein-c
#2
REVIEW
Arun Paul Amar, Abhay P Sagare, Zhen Zhao, Yaoming Wang, Amy R Nelson, John H Griffin, Berislav V Zlokovic
In the management of acute ischemic stroke, vessel recanalization correlates with functional status, mortality, cost, and other outcome measures. Thrombolysis with intravenous tissue plasminogen activator has many limitations that restrict its applicability, but recent advances in the development of mechanical thrombectomy devices as well as improved systems of stroke care have resulted in greater likelihood of vessel revascularization. Nonetheless, there remains substantial discrepancy between rates of recanalization and rates of favorable outcome...
September 15, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28923277/animal-models-of-ischaemic-stroke-and-characterisation-of-the-ischaemic-penumbra
#3
REVIEW
Christopher McCabe, Mariana M Arroja, Emma Reid, I Mhairi Macrae
Over the past forty years, animal models of focal cerebral ischaemia have allowed us to identify the critical cerebral blood flow thresholds responsible for irreversible cell death, electrical failure, inhibition of protein synthesis, energy depletion and thereby the lifespan of the potentially salvageable penumbra. They have allowed us to understand the intricate biochemical and molecular mechanisms within the 'ischaemic cascade' that initiate cell death in the first minutes, hours and days following stroke...
September 16, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28919314/24-hour-alberta-stroke-program-early-ct-score-assessment-in-post-stroke-spasticity-development-in-patients-with-a-first-documented-anterior-circulation-ischemic-stroke
#4
Ondrej Volny, Maria Justanova, Petra Cimflova, Linda Kasickova, Ivana Svobodova, Jan Muzik, Martin Bares
BACKGROUND: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. METHODS: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry)...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28916667/cost-effectiveness-of-thrombectomy-in-patients-with-acute-ischemic-stroke-the-thrace-randomized-controlled-trial
#5
Hamza Achit, Marc Soudant, Kossar Hosseini, Aurélie Bannay, Jonathan Epstein, Serge Bracard, Francis Guillemin
BACKGROUND AND PURPOSE: The benefit of mechanical thrombectomy added to intravenous thrombolysis (IVT) in patients with acute ischemic stroke has been largely demonstrated. However, evidence of the economic incentive of this strategy is still limited, especially in the context of a randomized controlled trial. We aimed to analyze whether mechanical thrombectomy combined with IVT (IVMT) is cost-effective when compared with IVT alone. METHODS: Individual-level cost and outcome data were collected in the THRACE randomized controlled trial (Thrombectomie des Artères Cerébrales) including patients with acute ischemic stroke...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916305/unusual-causes-of-venous-thrombosis-bladder-distension-and-uterine-mass
#6
Michael L Caparelli, Sepehr Lalezari, Steven Perlman
Thrombosis of the inferior vena cava (IVC) continues to be a rare event and there is a scarcity of evidence with regard to its etiology. One source for IVC thrombosis is external compression from adjacent structures. In this case series we present one case of IVC thrombosis caused by a severely distended bladder and a case of external iliac thrombosis caused by external compression from an abnormally enlarged uterus. The treatment of each case is varied and included novel oral anticoagulation (NOAC), catheter-directed thrombolysis in conjunction with mechanical thrombectomy, or a combination of these...
September 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28913684/-telemedicine-in-stroke-care
#7
REVIEW
L Breuer, S Schwab
Telemedicine is already widely used in many telestroke networks and ensures stroke treatment close to the patient's home in rural and medically underserved areas. This is particularly effective when telemedicine is integrated into a stroke unit concept. While telemedically based thrombolysis therapy has become routine practice for many years, practical implementation of comprehensive mechanical thrombectomy and the related processes remains challenging. The main tasks for the future further include development of a structured stroke aftercare system in neurologically underserved areas and permanent assurance of high-quality stroke care in telemedically connected sites...
September 14, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28912596/complete-reperfusion-is-required-for-maximal-benefits-of-mechanical-thrombectomy-in-stroke-patients
#8
Ángel Chamorro, Jordi Blasco, Antonio López, Sergio Amaro, Luis San Román, Laura Llull, Arturo Renú, Salvatore Rudilosso, Carlos Laredo, Victor Obach, Xabier Urra, Anna M Planas, Enrique C Leira, Juan Macho
A mTICI 2b or a mTICI 3 score are currently considered success following mechanical thrombectomy (MT) in acute stroke but is undetermined whether the two scores translate equivalent outcomes. We present a single-center, retrospective cohort of patients with anterior circulation stroke treated with MT and achieving a final mTICI score 2b or 3. A multimodal CT at baseline and a multimodal MRI at 24 hours assessed the growth of the infarct, and the modified Rankin Scale (mRS) assessed functional outcome at 90 days...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28911996/accessibility-to-tertiary-stroke-centers-in-hokkaido-japan-use-of-novel-metrics-to-assess-acute-stroke-care-quality
#9
Kensuke Fujiwara, Toshiya Osanai, Eiichi Kobayashi, Takumi Tanikawa, Ken Kazumata, Kikutaro Tokairin, Kiyohiro Houkin, Katsuhiko Ogasawara
BACKGROUND: Both the accessibility and availability of stroke specialists are major determinants of patient outcomes following acute ischemic stroke (AIS). The purpose of this study was to implement novel metrics to assess the accessibility of tertiary stroke centers as well as to evaluate regional disparities in stroke specialists. METHODS: Using network analysis in a geographic information system, we calculated areas within 30- and 60-minute travel times to facilities providing intravenous recombinant tissue-type plasminogen activator and mechanical thrombectomy...
September 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28906581/is-there-a-benefit-of-mechanical-thrombectomy-in-patients-with-large-stroke-dwi-aspects%C3%A2-5
#10
Pierre-François Manceau, Sébastien Soize, Matthias Gawlitza, Guillaume Fabre, Serge Bakchine, Carole Durot, Isabelle Serre, Georgios-Emmanouil Metaxas, Laurent Pierot
BACKGROUND: Whether to withhold mechanical thrombectomy when the diffusion-weighted imaging (DWI) lesion exceeds a given volume is undetermined. We aimed to identify markers that will help to select patients with large DWI lesions (DWI-Alberta Stroke Program Early CT Score, DWI-ASPECTS≤5) that may benefit from thrombectomy. METHODS: From May 2010 to November 2016, we studied 82 acute ischemic stroke patients with DWI-ASPECTS≤5 (43 men, 64.6±14.4 years, NIHSS 18...
September 14, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28905995/leptomeningeal-collateral-status-predicts-outcome-after-middle-cerebral-artery-occlusion
#11
C F Madelung, C Ovesen, C Trampedach, A Christensen, I Havsteen, C K Hansen, H Christensen
OBJECTIVES: Perfusion through leptomeningeal collateral vessels is a likely pivotal factor in the outcome of stroke patients. We aimed to investigate the effect of collateral status on outcome in a cohort of unselected, consecutive stroke patients with middle cerebral artery occlusion undergoing reperfusion therapy. MATERIALS AND METHODS: This retrospectively planned analysis was passed on prospectively collected data from 187 consecutive patients with middle cerebral artery occlusion admitted within 4...
September 14, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28904450/acute-ischemic-stroke-treatment-using-mechanical-thrombectomy-a-study-of-137-patients
#12
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#13
Waleed Brinjikji, Jeffrey Pasternak, Mohammad H Murad, Harry J Cloft, Tasha L Welch, David F Kallmes, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28901185/evaluation-of-parametric-response-mapping-to-assess-therapeutic-response-to-human-mesenchymal-stem-cells-after-experimental-stroke
#14
Rui He, Anaïck Moisan, Olivier Detante, Chantal Rémy, Alexandre Krainik, Emmanuel Luc Barbier, Benjamin Lemasson
Stroke is the leading cause of disability in adults. After the very narrow time frame during which treatment by thrombolysis and mechanical thrombectomy is possible, cell therapy has huge potential for enhancing stroke recovery. Accurate analysis of the response to new therapy using imaging biomarkers is needed to assess therapeutic efficacy. The aim of this study was to compare 2 analysis techniques: the parametric response map (PRM), a voxel-based technique, and the standard whole-lesion approach. These 2 analyses were performed on data collected at 4 time points in a transient middle cerebral artery occlusion (MCAo) model, which was treated with human mesenchymal stem cells (hMSCs)...
August 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28895453/extracranial-internal-carotid-artery-vasospasm-during-thrombectomy
#15
Isamu Miura, Akitsugu Kawashima, Masataka Hayashi, Akane Tanda, Tomomi Ishikawa, Takakazu Kawamata
The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient's National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28887393/white-matter-hyperintensity-volume-and-outcome-of-mechanical-thrombectomy-with-stentriever-in-acute-ischemic-stroke
#16
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...
September 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28887391/direct-mechanical-thrombectomy-versus-combined-intravenous-and-mechanical-thrombectomy-in-large-artery-anterior-circulation-stroke-a-topical-review
#17
REVIEW
Urs Fischer, Johannes Kaesmacher, Vitor Mendes Pereira, René Chapot, Adnan H Siddiqui, Michael T Froehler, Christoph Cognard, Anthony J Furlan, Jeffrey L Saver, Jan Gralla
No abstract text is available yet for this article.
September 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28875831/animal-models-of-focal-cerebral-ischaemia-and-haemorrhagic-transformation-considerations-in-experimental-stroke-study-design
#18
Jennifer A Shearer, Andrew S Douglas, Brian P Kirby, Turgut Tatlisumak, Karen M Doyle
Ischaemic stroke is often complicated with haemorrhage within the infarct zone or in a remote location especially when treated with intravenous thrombolysis and/or thrombectomy. While these early recanalisation treatments are highly effective, some of the benefit is lost because of haemorrhagic complications and consequential neurological deterioration of the patients. A number of mechanisms have been described that mediate the haemorrhagic changes and several agents have been tested in experimental models for inhibiting post stroke haemorrhage...
September 5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28867531/-acute-management-of-ischemic-stroke-in-2017
#19
C Blanc-Labarre, B Delpont, M Hervieu-Bègue, G-V Osseby, F Ricolfi, P Thouant, M Giroud, Y Béjot
Acute management of ischemic stroke is a burning topic in 2017 since stroke represents the leading cause of acquired handicap in adults. Over the last past years, major improvement took place, especially with the demonstration of the efficacy of mechanical thrombectomy, thus needing to better organize care pathways, and optimize access to neurologists and interventional neuroradiology platforms. Intensive care stroke units remain the pivotal place of patients' management. A multidisciplinary coordination is required, with continuous teaching of all the actors involved in stroke management, so as to increase the number of patients who could benefit from available active treatments...
August 31, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28867126/early-ventricular-tachycardia-or-fibrillation-in-patients-with-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-and-impact-on-mortality-and-stent-thrombosis-from-the-harmonizing-outcomes-with-revascularization-and-stents
#20
Ioanna Kosmidou, Monica Embacher, Thomas McAndrew, José M Dizon, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
The prevalence and impact of early ventricular arrhythmias (ventricular tachycardia [VT]/ventricular fibrillation [VF]) occurring before mechanical revascularization for acute ST segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention are poorly understood. We sought to investigate the association between early VT/VF and long-term clinical outcomes using data from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial. Among 3,602 patients with STEMI, 108 patients (3...
August 8, 2017: American Journal of Cardiology
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