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Mechanical thrombectomy

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https://www.readbyqxmd.com/read/29789214/emergent-carotid-endarterectomy-versus-stenting-in-acute-stroke-patients-with-tandem-occlusion
#1
Diana E Slawski, Mouhammad A Jumaa, Hisham Salahuddin, Julie Shawver, M Junaid Humayun, Todd Russell, Andrew Seiwert, David Paolini, Jihad Abbas, Munier Nazzal, Gretchen E Tietjen, Aixa Espinosa-Morales, Andrea Korsnack, Syed F Zaidi
OBJECTIVE: Acute stroke due to tandem cervical internal carotid artery (ICA) and intracranial large-vessel occlusion (ILVO) has a high rate of morbidity and mortality. The most appropriate treatment strategy for the extracranial culprit lesion remains unclear. In this study, we report our institutional outcomes with two approaches: emergent carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: Patients with tandem ICA-ILVO were identified in a prospective mechanical thrombectomy (MT) database between July 2012 and April 2016...
May 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29786531/mechanical-aspiration-thrombectomy-in-the-treatment-of-acute-intrastent-renal-artery-thrombosis
#2
REVIEW
Umberto G Rossi, Gian Andrea Rollandi, Raffaello Dallatana, Maurizio Cariati
Chimney-and-periscope technique for thoraco-abdominal aneurysm repair is a valuable treatment option in selected patients. Acute renal artery occlusion is a serious complication after this technique. We report a case of acute right renal artery occlusion, consequent to a previous chimney-and-periscope technique that was treated urgently by mechanical aspiration thrombectomy.
May 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29784123/endovascular-interventions-for-venous-disease
#3
REVIEW
Paul O'Connor, Robert Lookstein
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, occur in up to 900,000 people per year in the United States. Current first-line therapy consists of systemic anticoagulation with a goal to prevent additional thrombus formation. Treatment with anticoagulation alone provides less than satisfactory results with some studies showing propagation of thrombus in almost 40% of cases. Current first-line therapy does not include active removal of thrombus and does little to alleviate acute symptoms and the damaging inflammatory response that may result in postthrombotic syndrome...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29783014/comparison-of-micro-clamping-stent-retriever-thrombectomy-with-conventional-stent-retriever-thrombectomy-in-intracranial-large-vessel-embolism
#4
Zhen-Sheng Liu, Gang Deng, Long-Jiang Zhou, Yong Sun, Xin-Jiang Zhang, Xiong-Wei Kuang, Yong-Lin Qin, Jia-Xiang Wang, Qing Shan
OBJECTIVE: To evaluate the effectiveness of micro-clamping stent-retriever thrombectomy (MSRT) in acute ischemic stroke patients with intracranial large vessel embolism (ILVE), and compare the same with conventional stent-retriever thrombectomy (CSRT). MATERIALS AND METHODS: We retrospectively evaluated a total of 108 ILVE patients treated by MSRT (n=52) and CSRT (n=56) from the two participating institutions between January 2016 and November 2017. The rates of successful (mTICI 2b or 3) and complete reperfusion (mTICI 3), time from guide catheter placement to reperfusion, rates of first-pass success, and the number of passes for reperfusion were compared between the MSRT and CSRT groups...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29774056/epigenetic-regulation-of-inflammation-in-stroke
#5
REVIEW
Gavin Yong-Quan Ng, Lim Yun-An, Christopher G Sobey, Thameem Dheen, David Yang-Wei Fann, Thiruma V Arumugam
Despite extensive research, treatments for clinical stroke are still limited only to the administration of tissue plasminogen activator and the recent introduction of mechanical thrombectomy, which can be used in only a limited proportion of patients due to time constraints. A plethora of inflammatory events occur during stroke, arising in part due to the body's immune response to brain injury. Neuroinflammation contributes significantly to neuronal cell death and the development of functional impairment and death in stroke patients...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29774008/repeated-endovascular-treatment-of-early-recurrent-proximal-middle-cerebral-artery-occlusion-case-report-and-brief-review-of-the-literature
#6
Simon Fandler, Hannes Deutschmann, Franz Fazekas, Thomas Gattringer
Mechanical thrombectomy (MT) is the gold standard treatment for large vessel occlusion (LVO) stroke of the anterior circulation. Whether MT can also be effectively and safely performed in early recurrent LVO is largely unclear. We present the case of a middle-aged patient who was successfully treated by MT for right proximal middle cerebral artery (MCA) occlusion with excellent outcome. One day after discharge (9 days after the first MT), the patient was readmitted with wake-up stroke. MRI again revealed right proximal MCA occlusion with severe diffusion-perfusion mismatch...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29773715/embolus-retriever-with-interlinked-cages-versus-other-stent-retrievers-in-acute-ischemic-stroke-an-observational-comparative-study
#7
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#8
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29768962/successful-thrombectomy-in-endocarditis-related-stroke-case-report-and-review-of-the-literature
#9
Manuel Bolognese, Alexander von Hessling, Martin Müller
Neurological complications of infective endocarditis are frequent, especially ischaemic strokes. As intravenous thrombolysis in infective endocarditis-related ischaemic stroke has a controversial benefit/risk ratio, alternative treatment regimens have to be considered. We present the case of a young patient with septic embolism of the middle cerebral artery who was successfully treated with mechanical thrombectomy, and give a short review of the existing literature.
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29768352/effectiveness-of-trevo-stent-retriever-in-acute-ischemic-stroke-comparison-with-solitaire-stent
#10
Ho Jun Yi, Dong Hoon Lee, Sang Uk Kim
Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29765394/mechanical-thrombectomy-in-elderly-stroke-patients-with-mild-to-moderate-baseline-disability
#11
Diana E Slawski, Hisham Salahuddin, Julie Shawver, Cynthia L Kenmuir, Gretchen E Tietjen, Andrea Korsnack, Syed F Zaidi, Mouhammad A Jumaa
Background: The number of elderly patients suffering from ischemic stroke is rising. Randomized trials of mechanical thrombectomy (MT) generally exclude patients over the age of 80 years with baseline disability. The aim of this study was to understand the efficacy and safety of MT in elderly patients, many of whom may have baseline impairment. Methods: Between January 2015 and April 2017, 96 patients ≥80 years old who underwent MT for stroke were selected for a chart review...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29761220/transcriptomic-analysis-of-the-harvested-endothelial-cells-in-a-swine-model-of-mechanical-thrombectomy
#12
Nasren Jaff, Rikard Grankvist, Lars Muhl, Arvin Chireh, Mikael Sandell, Stefan Jonsson, Fabian Arnberg, Ulf Eriksson, Staffan Holmin
PURPOSE: In mechanical thrombectomy (MT) for ischemic stroke, endothelial cells (ECs) from intracranial blood vessels adhere to the stent retriever device and can be harvested. However, understanding the molecular biology and the role of the endothelium in different pathological conditions remains insufficient. The purpose of the study was to characterize and analyze the molecular aspect of harvested ECs using cell culture and transcriptomic techniques in an MT swine model relevant to clinical ischemic stroke...
May 14, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29760275/targeting-reperfusion-injury-in-the-age-of-mechanical-thrombectomy
#13
REVIEW
Atsushi Mizuma, Je Sung You, Midori A Yenari
No abstract text is available yet for this article.
May 14, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29758114/time-well-spent-in-recanalizing-complex-cerebrovascular-occlusions
#14
Perttu J Lindsberg
After publication of several randomized, controlled trials demonstrating the efficacy of mechanical thrombectomy (MT) following intravenous t-PA (IV t-PA) the current guidelines of acute management of cerebrovascular have been revised (1,2). In addition to IV t-PA within 4,5 hours applied in a wide spectrum of ischemic stroke subtypes, MT has been proven as the second therapeutic target in a longer time window in much more selected cases of large vessel occlusions (LVO). This article is protected by copyright...
May 14, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29755897/improving-door-to-groin-puncture-time-for-mechanical-thrombectomy-via-iterative-quality-protocol-interventions
#15
Vincent J Cheung, Arvin R Wali, David R Santiago-Dieppa, Robert C Rennert, Michael G Brandel, Jeffrey A Steinberg, Brian R Hirshman, Kevin Porras, Peter Abraham, Julie Jurf, Emily Botts, Scott Olson, J Scott Pannell, Alexander A Khalessi
INTRODUCTION: Delays in door to groin puncture time (DGPT) for patients with ischemic stroke caused by acute large vessel occlusions (LVO) are associated with worse clinical outcomes. We present the results of a quality improvement protocol for endovascular stroke treatment at the University of California, San Diego (UCSD) that aimed to minimize DGPT. MATERIALS AND METHODS: Our stroke team implemented a series of quality improvement measures to decrease DGPT, with a target of 90 minutes or less...
March 10, 2018: Curēus
https://www.readbyqxmd.com/read/29752489/cerebral-venous-thrombosis-state-of-the-art-diagnosis-and-management
#16
REVIEW
Adam A Dmytriw, Jin Soo A Song, Eugene Yu, Colin S Poon
PURPOSE: This review article aims to discuss the pathophysiology, clinical presentation, and neuroimaging of cerebral venous thrombosis (CVT). Different approaches for diagnosis of CVT, including CT/CTV, MRI/MRV, and US will be discussed and the reader will become acquainted with imaging findings as well as limitations of each modality. Lastly, this exhibit will review the standard of care for CVT treatment and emerging endovascular options. METHODS: A literature search using PubMed and the MEDLINE subengine was completed using the terms "cerebral venous thrombosis," "stroke," and "imaging...
May 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29748424/intravenous-recombinant-tissue-type-plasminogen-activator-influence-on-outcome-in-anterior-circulation-ischemic-stroke-treated-by-mechanical-thrombectomy
#17
Marc Ferrigno, Nicolas Bricout, Didier Leys, Laurent Estrade, Charlotte Cordonnier, Thomas Personnic, Maeva Kyheng, Hilde Henon
BACKGROUND AND PURPOSE: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) improves functional outcome in patients with ischemic stroke related to proximal-vessel occlusion in the anterior circulation. Whether MT alone is as effective as IVT/MT remains controversial. We aimed at evaluating the influence of IVT in patients with large anterior circulation artery occlusion treated with MT. METHODS: We did a prospective observational cohort study in patients with stroke related to large anterior circulation artery occlusion treated by MT who were admitted to Lille University Hospital, Lille, France...
May 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29746644/relationships-between-selective-neuronal-loss-and-microglial-activation-after-ischaemic-stroke-in-man
#18
Rhiannon S Morris, P Simon Jones, Josef A Alawneh, Young T Hong, Tim D Fryer, Franklin I Aigbirhio, Elizabeth A Warburton, Jean-Claude Baron
Modern ischaemic stroke management involves intravenous thrombolysis followed by mechanical thrombectomy, which allows markedly higher rates of recanalization and penumbral salvage than thrombolysis alone. However, <50% of treated patients eventually enjoy independent life. It is therefore important to identify complementary therapeutic targets. In rodent models, the salvaged penumbra is consistently affected by selective neuronal loss, which may hinder recovery by interfering with plastic processes, as well as by microglial activation, which may exacerbate neuronal death...
May 9, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29745451/electronic-cardiac-arrest-triage-score-best-predicts-mortality-after-intervention-in-patients-with-massive-and-submassive-pulmonary-embolism
#19
Taishi Hirai, Steven Tate, Kathryn Dryer, Deshon Jones, Jonathan Rosenberg, Sandeep Nathan, Atman P Shah, Kyle Carey, Matthew Churpek, Dana Edelson, Janet Friant, Jonathan Paul, John E A Blair
OBJECTIVE: To determine if the cardiac arrest triage (CART) Score would better predict poor outcomes after pharmacomechanical therapy (PMT) for massive and submassive pulmonary embolism (PE) than traditional risk scores BACKGROUND: PMT for massive and submassive PE allows for clot lysis with minimal doses of fibrinolytics. Although PMT results in improved right ventricular function, and reduced pulmonary pressures and thrombus burden, predictors of poor outcome are not well-studied. METHODS: We conducted a retrospective analysis of all patients who underwent PMT for massive or submassive PE at a single institution from 2010 to 2016...
May 10, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29744519/mechanical-thrombectomy-a-brief-review-of-a-revolutionary-new-treatment-for-thromboembolic-stroke
#20
REVIEW
Pervinder Bhogal, Tommy Andersson, Volker Maus, Anastasios Mpotsaris, Leonard Yeo
The recent success of endovascular stroke treatment has heralded a new era in the management of acute ischemic stroke (AIS) with significantly improved outcome for patients. A large number of patients may be amenable to this new treatment and as the evidence expands the number of patients eligible for mechanical thrombectomy continues to increase. Recent evidence suggests that the time window for treatment can be extended up to 24 h after symptom onset for patients with anterior circulation strokes; however, many clinicians and medical professionals may not be aware of these recent changes and it is important that they are kept up-to-date with this rapidly evolving treatment...
May 9, 2018: Clinical Neuroradiology
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