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Mechanical thrombectomy

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https://www.readbyqxmd.com/read/28226511/characterization-of-thrombus-stiffening-in-radio-frequency-rf-mechanical-thrombectomy
#1
Chris C H Chon, Jack Z Qin, John C K Kwok, David C C Lam, Chris C H Chon, Jack Z Qin, John C K Kwok, David C C Lam, David Cc Lam, Chris Ch Chon, John Ck Kwok, Jack Z Qin
Intra-arterial mechanical thrombectomy (IAMT) for ischemic stroke has high recanalization rate, long treatment time window and low risk of symptomatic intracerebral haemorrhage (sICH), but thrombus fragments produced during treatment can lead to distal embolization. Fragmentation can be reduced if the thrombus is strengthened by increasing the thrombus's crosslink density. Radio frequency (rf) electric current commonly used in surgery to cut and coagulate tissue can induce crosslinking in thrombus. The increase in thrombus stiffness as a result of the increase in crosslinking from rf treatment is characterized in this study...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28219908/a-case-of-right-middle-cerebral-artery-tendonectomy-following-mitral-valve-replacement-surgery
#2
Mary C Thomas, Josser E Delgado Almandoz, Adam J Todd, Mark L Young, Jennifer L Fease, Jill Marie Scholz, Anna M Milner, Maximilian Mulder, Yasha Kayan
Following mechanical mitral valve replacement surgery, a 69-year-old woman had an ischemic stroke in the right middle cerebral artery territory. Mechanical thrombectomy showed the embolus to be a piece of chordae tendineae excised during the valve replacement surgery.
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28213758/influence-of-a-combined-ct-c-arm-system-on-periprocedural-workflow-and-procedure-times-in-mechanical-thrombectomy
#3
Johannes Pfaff, Silvia Schönenberger, Christian Herweh, Mirko Pham, Simon Nagel, Peter Arthur Ringleb, Sabine Heiland, Martin Bendszus, Markus Alfred Möhlenbruch
OBJECTIVE: To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. METHODS: This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device...
February 17, 2017: European Radiology
https://www.readbyqxmd.com/read/28213478/endovascular-mechanical-thrombectomy-for-cerebral-venous-sinus-thrombosis-a-systematic-review
#4
REVIEW
Adeel Ilyas, Ching-Jen Chen, Daniel M Raper, Dale Ding, Thomas Buell, Panogiotis Mastorakos, Kenneth C Liu
BACKGROUND: Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke that, when severe, can be a therapeutic challenge. Endovascular mechanical thrombectomy (EMT) techniques have significantly evolved over the past decade, but data regarding the efficacy and safety of EMT for CVST are poorly defined. OBJECTIVE: To summarize the large number of case series on this relatively rare condition and establish trends in the outcomes of EMT for CVST. METHODS: A literature review was performed using PubMed and Medline to identify reports of three or more patients with CVST treated with EMT...
February 17, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28194477/maximizing-first-pass-complete-reperfusion-with-save
#5
Volker Maus, Daniel Behme, Christoph Kabbasch, Jan Borggrefe, Ioannis Tsogkas, Omid Nikoubashman, Martin Wiesmann, Michael Knauth, Anastasios Mpotsaris, Marios Nikos Psychogios
BACKGROUND: Endovascular techniques for treatment of large vessel occlusions (LVO) in patients with acute ischemic stroke (AIS) have advanced in recent years. We report a multicenter experience using a combined aspiration and stent retriever technique for mechanical thrombectomy (MT). METHODS: We retrospectively analyzed 32 consecutive MT patients using a novel, combined approach of Stent retriever Assisted Vacuum-locked Extraction (SAVE) by 3 operators at 3 stroke centers...
February 13, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28188400/-juvenile-stroke-what-is-important
#6
M Fischer, B Eckert, J Röther
Stroke in young adults is a diagnostic and therapeutic challenge for all persons involved. Approximately 15% of ischemic strokes occur in young adults. Lack of awareness of the symptoms in emergency departments often results in delayed diagnosis and access to specific therapeutic options, such as revascularization. The causes are often heterogeneous and necessitate specific investigations. The etiology of juvenile stroke includes drug abuse, vasculitis and arteriopathies, such as reversible vasoconstriction syndrome and posterior reversible encephalopathy syndrome, although the prevalence of classical vascular risk factors is high...
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28187798/critical-care-in-acute-ischemic-stroke
#7
M McDermott, T Jacobs, L Morgenstern
Most ischemic strokes are managed on the ward or on designated stroke units. A significant proportion of patients with ischemic stroke require more specialized care. Several studies have shown improved outcomes for patients with acute ischemic stroke when neurocritical care services are available. Features of acute ischemic stroke patients requiring intensive care unit-level care include airway or respiratory compromise; large cerebral or cerebellar hemisphere infarction with swelling; infarction with symptomatic hemorrhagic transformation; infarction complicated by seizures; and a large proportion of patients require close management of blood pressure after thrombolytics...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28183712/mechanical-thrombectomy-of-embolised-native-aortic-valve-post-tavi
#8
John Joseph Coughlan, Rob Fleck, Cormac O'Connor, Peter Crean
No abstract text is available yet for this article.
February 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28175353/116%C3%A2-effect-of-annual-hospital-procedure-volume-on-outcomes-after-mechanical-thrombectomy-in-acute-ischemic-stroke-patients-an-analysis-of-13%C3%A2-502-procedures
#9
Vishal B Jani, Chiu Yuen To, Achint Patel, Prashant S Kelkar, Boyd Richards, Richard D Fessler
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28174330/vessel-wall-enhancement-and-blood-cerebrospinal-fluid-barrier-disruption-after-mechanical-thrombectomy-in-acute-ischemic-stroke
#10
Arturo Renú, Carlos Laredo, Antonio Lopez-Rueda, Laura Llull, Raúl Tudela, Luis San-Roman, Xabier Urra, Jordi Blasco, Juan Macho, Laura Oleaga, Angel Chamorro, Sergio Amaro
BACKGROUND AND PURPOSE: Less than half of acute ischemic stroke patients treated with mechanical thrombectomy obtain permanent clinical benefits. Consequently, there is an urgent need to identify mechanisms implicated in the limited efficacy of early reperfusion. We evaluated the predictors and prognostic significance of vessel wall permeability impairment and its association with blood-cerebrospinal fluid barrier (BCSFB) disruption after acute stroke treated with thrombectomy. METHODS: A prospective cohort of acute stroke patients treated with stent retrievers was analyzed...
February 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28170316/medical-university-of-south-carolina-telestroke-a-telemedicine-facilitated-network-for-stroke-treatment-in-south-carolina-a-progress-report
#11
Sami Al Kasab, Robert J Adams, Ellen Debenham, David J Jones, Christine Ann Holmstedt
BACKGROUND: Patients in rural communities lack access to acute stroke therapies. Rapid administration of lytic therapy increases the likelihood of favorable functional outcome in acute ischemic stroke (AIS). At the Medical University of South Carolina (MUSC), we implemented a Web-based telestroke program that allows patients presenting with AIS at a rural hospital to receive expert stroke consultation within minutes. This increases their chances of receiving lytic therapy, and therefore increases the likelihood of good functional outcome...
February 7, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28157744/treatment-of-acute-ischemic-stroke
#12
Alejandro A Rabinstein
PURPOSE OF REVIEW: This article provides an update on the state of the art of the emergency treatment of acute ischemic stroke with particular emphasis on the alternatives for reperfusion therapy. RECENT FINDINGS: The results of several randomized controlled trials consistently and conclusively demonstrating that previously functional patients with disabling strokes from a proximal intracranial artery occlusion benefit from prompt recanalization with mechanical thrombectomy using a retrievable stent have changed the landscape of acute stroke therapy...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28151414/basilar-stroke-from-a-persistent-hypoglossal-artery
#13
Alfred P See, Jacob F Baranoski, Bruno C Flores, Andrew Ducruet, Felipe C Albuquerque
Occlusion of the basilar artery can be treated with endovascular thrombectomy, although the results have not been well studied. Persistent fetal cerebrovascular anatomy can lead to unusual presentation of carotid atherosclerotic disease and can be a barrier to successful mechanical thrombectomy if not recognized. This case presents a rare persistent carotico-basilar anastomosis which resulted in basilar occlusion via the persistent hypoglossal artery and coincident absence of contralateral vertebral arterial access due to a left vertebral artery terminating in the left posterior inferior cerebellar artery...
February 1, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28144702/endovascular-thrombectomy-in-acute-ischemic-stroke-outcome-in-referred-versus-directly-admitted-patients
#14
Philipp Bücke, Marta Aguilar Pérez, Elisabeth Schmid, Christian H Nolte, Hansjörg Bäzner, Hans Henkes
PURPOSE: Endovascular mechanical thrombectomy (mTE) in acute ischemic stroke due to large cerebral artery occlusion is effective and safe. The procedure is currently offered by specialized hospitals. Physicians from smaller hospitals need to refer patients to stroke centers. Secondary referrals involve delays for transportation. Little is known about effects of distant referrals on outcome and complications as compared to direct admittance. METHODS: To evaluate the effects of referral patterns on outcome and safety, we analyzed 941 patients with anterior circulation stroke receiving mTE between January 2010 and December 2015...
January 31, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28143898/a-multicenter-study-of-the-safety-and-effectiveness-of-mechanical-thrombectomy-for-patients-with-acute-ischemic-stroke-not-meeting-top-tier-evidence-criteria
#15
Nitin Goyal, Georgios Tsivgoulis, Donald Frei, Aquilla Turk, Blaise Baxter, Michael T Froehler, J Mocco, Jay Vachhani, Daniel Hoit, Lucas Elijovich, David Loy, Raymond D Turner, Justin Mascitelli, Kiersten Espaillat, Andrei V Alexandrov, Anne W Alexandrov, Adam S Arthur
BACKGROUND: While mechanical thrombectomy (MT) has become the standard of care for patients with acute ischemic stroke (AIS) with emergent large-vessel occlusions (ELVO), recently published guidelines appropriately award top-tier evidence to the same selective criteria that were employed in completed clinical trials. We sought to evaluate the safety and effectiveness of MT in patients with AIS with ELVO who do not meet top-tier evidence criteria (TTEC). METHODS: We conducted an observational study on consecutive patients with AIS with ELVO who underwent MT at six high-volume endovascular centers...
January 31, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28132961/does-reducing-the-duration-from-symptom-onset-to-recanalization-improve-the-results-of-intracranial-mechanical-thrombectomy-in-the-elderly
#16
Koichiro Komatsubara, Tomohisa Dembo, Eishi Sato, Hiroki Sasamori, Masataka Torii, Yoshiaki Shiokawa, Teruyuki Hirano
Endovascular recanalization for acute major cerebral artery occlusion is effective within a short time after symptom onset. However, its efficacy in the elderly remains unknown. We assessed the efficacy of our comprehensive stroke center's reduction of this time in 28 consecutive patients for elderly patients (defined as patients aged ≥75 years) with acute major cerebral artery occlusion treated with intravenous injection of tissue plasminogen activator, followed by thrombus retrieval by endovascular therapy...
January 27, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28131432/dominant-vertebral-artery-status-and-functional-outcome-after-endovascular-therapy-of-symptomatic-basilar-artery-occlusion
#17
Jun Young Chang, Seunguk Jung, Cheolkyu Jung, Hee-Joon Bae, Oki Kwon, Moon-Ku Han
BACKGROUND AND PURPOSE: To determine whether status of dominant vertebral artery could affect clinical outcome in patients with symptomatic basilar artery occlusion (BAO). METHODS: We reviewed patients with symptomatic BAO who underwent endovascular treatment at the institute between January 2007 and July 2014. Patients were categorized into 2 groups according to functional outcome and baseline characteristics, treatment related factors were compared. Variables including clinical and imaging parameters were also compared according to the dominant V1 lesion...
January 25, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28130280/basilar-stroke-from-a-persistent-hypoglossal-artery
#18
Alfred P See, Jacob F Baranoski, Bruno C Flores, Andrew Ducruet, Felipe C Albuquerque
Occlusion of the basilar artery can be treated with endovascular thrombectomy, although the results have not been well studied. Persistent fetal cerebrovascular anatomy can lead to unusual presentation of carotid atherosclerotic disease and can be a barrier to successful mechanical thrombectomy if not recognized. This case presents a rare persistent carotico-basilar anastomosis which resulted in basilar occlusion via the persistent hypoglossal artery and coincident absence of contralateral vertebral arterial access due to a left vertebral artery terminating in the left posterior inferior cerebellar artery...
January 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28118796/mechanical-recanalization-for-acute-embolic-occlusion-at-the-origin-of-the-superior-mesenteric-artery
#19
Yoichi Miura, Tomohiro Araki, Mio Terashima, Junya Tsuboi, Yasuhiro Saito, Kenji Kanamaru, Hidenori Suzuki
PURPOSE: We report a combined technique consisting of thrombectomy and thromboaspiration for the treatment of acute embolic occlusion of the superior mesenteric artery (SMA) at the origin. CASE: A 90-year-old female with chronic atrial fibrillation had a sudden onset of abdominal pain and hematochezia due to acute embolic occlusion at the origin of the SMA. Computed tomographic findings showed reversible bowel wall ischemia. We performed mechanical thrombectomy using the Solitaire FR revascularization device, a self-expanding and fully retrievable stent-based thrombectomy system for acute intracranial large artery occlusion, combined with manual aspiration through a 6F guiding sheath placed at the SMA origin via a right brachial approach...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28118025/inter-rater-variability-for-ct-angiography-evaluation-between-neurologists-and-neuroradiologist-in-acute-stroke-patients
#20
Michal Bar, Jir Kra, Tomas Jonszta, Vaclav Marcian, Martin Kuliha, Robert Mikulík
OBJECTIVES: The diagnosis of arterial occlusion has a considerable impact on the indication of mechanical thrombectomy, and computed tomography angiography (CTA) is recommended in management of acute stroke. The goal of present study is to assess the inter-rater agreement in the diagnosis of occlusion of intracranial arteries on CTA between a neuroradiologist and neurologists. METHODS: CTA images of 75 acute-stroke patients were evaluated for occlusion of intracranial arteries by an experienced interventional neuroradiologist, stroke and general neurologist...
January 24, 2017: British Journal of Radiology
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