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https://www.readbyqxmd.com/read/29055224/primary-suction-thrombectomy-for-acute-ischemic-stroke-a-meta-analysis-of-the-current-literature
#1
Jin Pyeong Jeon, Sung-Eun Kim, Chul Ho Kim
OBJECTIVES: We conducted a meta-analysis to assess the angiographic and clinical outcomes for ischemic stroke patients treated with primary suction thrombectomy and to compare the procedural outcomes based on the treatment strategies (primary suction vs. stent retriever thrombectomy). PATIENTS AND METHODS: We conducted a systemic literature review through an online data base from January 2004 through December 2016. The primary outcomes were rate of successful recanalization on final angiogram and good outcome three months after stroke onset...
October 3, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29053070/relationship-between-patient-safety-indicator-events-and-comprehensive-stroke-center-volume-status-in-the-treatment-of-unruptured-cerebral-aneurysms
#2
Chad W Washington, L Ian Taylor, Robert J Dambrino, Paul R Clark, Gregory J Zipfel
OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification. METHODS Using the 2002-2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29052571/susceptibility-weighted-imaging-in-thrombolytic-therapy-of-acute-ischemic-stroke
#3
REVIEW
Lin Li, Ming-Su Liu, Guang-Qin Li, Yang Zheng, Tong-Li Guo, Xin Kang, Mao-Ting Yuan
OBJECTIVE: To provide a comprehensive and latest overview of susceptibility-weighted imaging (SWI) in the application of thrombolysis in acute ischemic stroke, and to update the decision-making effect and clinical value of SWI on identifying stroke patients suitable for thrombolytic therapy and possible benefits and risks followed. DATA SOURCES: Literatures referred to this review were collected from PubMed, Medline, and EMBASE published till May 2017, using the search terms including susceptibility-weighted imaging, gradient-echo, T2*, thrombolysis, recombinant tissue plasminogen activator (rt-PA), thrombolytic therapy, and stroke...
October 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29049664/acute-type-i-aortic-dissection-a-propensity-matched-comparison-of-elephant-trunk-and-arch-debranching-repairs
#4
Mingjia Ma, Xin Feng, Jing Wang, Yiming Dong, Taiqiang Chen, Ligang Liu, Xiang Wei
OBJECTIVES: Our goal was to compare the performance of the frozen elephant trunk (FET) and the hybrid aortic arch debranching procedures for acute Type I aortic dissection. METHODS: From January 2013 to December 2015, 168 patients with Type I aortic disease underwent ascending aorta and total aortic arch replacement with FET implantation (the FET group, n  = 132) or arch debranching with 1-stage aortic arch exclusion using an endovascular stent in a retrograde manner (the debranching group, n  = 36)...
September 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29044603/comorbid-masticatory-impairment-delays-recovery-from-acute-cerebral-ischemia-and-locomotor-hypoactivity-after-subarachnoid-hemorrhage-in-mice
#5
Ikuho Kojima, Tatsushi Mutoh, Kazumasu Sasaki, Yasuko Tatewaki, Yasuyuki Taki, Tatsuya Ishikawa
Tooth loss and related changes in the functionality may lead to worse outcome of stroke patients, but the link involved in this pathway remains unclear. This study aimed to determine the effect of comorbid masticatory impairment on acute cerebral ischemia and neurobehavioral outcome after experimental subarachnoid hemorrhage (SAH). Thirty C57BL/6 mice with (molar-less) or without (control) prior treatment of cutting off the upper molars (separated by at least one week), were subjected to SAH by endovascular perforation...
October 17, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29040040/prevalence-of-carotid-web-in-patients-with-acute-intracranial-stroke-due-to-intracranial-large-vessel-occlusion
#6
Kars C J Compagne, Ad C G M van Es, Olvert A Berkhemer, Jordi Borst, Yvo B W E M Roos, Robert J van Oostenbrugge, Wim H van Zwam, Charles B L M Majoie, Henk A Marquering, Diederik W J Dippel, Aad van der Lugt, Bart J Emmer
Purpose To investigate the prevalence of symptomatic carotid web in patients with acute ischemic stroke due to intracranial large vessel occlusion, to determine the clinical and imaging profile of patients with carotid web as well as their association with ischemic stroke, and to determine the interobserver agreement in the assessment of carotid webs. Materials and Methods All patients (n = 500) of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) in whom the carotid bifurcation could be assessed (n = 443) were included...
October 16, 2017: Radiology
https://www.readbyqxmd.com/read/29037013/angioplasty-stenting-and-other-potential-treatments-of-atherosclerotic-stenosis-of-the-intracranial-arteries-past-present-and-future
#7
REVIEW
Ashley Wabnitz, Marc Chimowitz
Although there is an intuitive appeal to treat symptomatic stenotic intracranial arteries with endovascular therapies such as angioplasty and stenting, current data from randomized trials show intensive medical therapy is far superior for preventing stroke. This is in large part due to the high risk of peri-procedural stroke from angioplasty and stenting. If angioplasty and stenting is to emerge as a proven treatment for intracranial stenosis, endovascular techniques will need to become much safer, identification of patients with intracranial stenosis who are at particularly high risk of stroke despite intensive medical therapy will need to be targeted, and well-designed randomized trials will be necessary to show endovascular therapy is superior to medical therapy in these high-risk patients...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29037009/early-statins-after-intravenous-or-endovascular-recanalization-is-beneficial-regardless-of-timing-intensity-and-stroke-mechanism
#8
Han-Gil Jeong, Beom Joon Kim, Mi Hwa Yang, Moon-Ku Han, Hee-Joon Bae
No abstract text is available yet for this article.
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29032862/endovascular-treatment-of-acute-tandem-occlusion-strokes-and-stenting-first-experience
#9
Süha Akpınar, Pınar Gelener
This study demonstrates the radiologic and clinical findings, etiologies and intervention strategy in 8 acute ischemic stroke patients with tandem occlusions. The mean age was 57 and mean NIHSS score was 19. Stent-assisted thrombectomy (SAT) was performed on all of the patients. Additionally, 6 patients underwent carotid artery stenting before SAT. Recanalization with TICI≥2b was attained in 7/8 patients. The 90thday median mRS was 2 and mortality was 1/8. The etiologies of the tandem occlusions were either extracranial high grade ICA stenosis/occlusion or cervical ICA dissection...
October 9, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29032219/emergency-extracranial-intracranial-bypass-to-revascularize-salvageable-brain-tissue-in-acute-ischemic-stroke-patients
#10
Jan-Karl Burkhardt, Sebastian Winklhofer, Jorn Fierstra, Susanne Wegener, Giuseppe Esposito, Andreas Luft, Oliver Bozinov, Luca Regli
INTRODUCTION: To present an algorithm based on clinical and radiological factors including MR perfusion/diffusion mismatch (MR-PDM) for the indication of urgent cerebral bypass in patients with acute ischemic stroke METHODS: Analysis of clinical and radiological data on eight consecutive patients undergoing urgent cerebral revascularization for acute ischemic stroke due to occlusion of the internal carotid or middle cerebral artery between 2012 and 2015. All patients were either not eligible or failed first line treatment with emergent endovascular revascularization...
October 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29030498/late-recanalization-of-basilar-artery-occlusion-in-a-previously-healthy-17-month-old-child
#11
D Andrew Wilkinson, Aditya S Pandey, Hugh J Garton, Luis Savastano, Julius Griauzde, Neeraj Chaudhary, Joseph J Gemmete
Endovascular treatment of acute ischemic stroke in children is increasingly being reported, although the time window for intervention is unclear. We describe a previously healthy 17-month-old child who presented with vertebral artery thrombosis and cerebellar stroke requiring posterior fossa decompression. She later progressed to basilar artery thrombosis treated with mechanical thrombectomy 50 hours after clinical decline. At 3 month follow-up, the patient had a modified Rankin Scale score of 0.
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29025724/correlation-between-clinical-outcomes-and-baseline-ct-and-ct-angiographic-findings-in-the-swift-prime-trial
#12
A P Jadhav, H-C Diener, A Bonafe, V M Pereira, E I Levy, B W Baxter, T G Jovin, R G Nogueira, D R Yavagal, C Cognard, D D Purcell, B K Menon, R Jahan, J L Saver, M Goyal
BACKGROUND AND PURPOSE: Patient selection for endovascular therapy remains a great challenge in clinic practice. We sought to determine the effect of baseline CT and angiography on outcomes in the Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke (SWIFT PRIME) trial and to identify patients who would benefit from endovascular stroke therapy. MATERIALS AND METHODS: The primary end point was a 90-day modified Rankin Scale score of 0-2...
October 12, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29022855/association-of-left-subclavian-artery-coverage-without-revascularization-and-spinal-cord-ischemia-in-patients-undergoing-thoracic-endovascular-aortic-repair-a-vascular-quality-initiative%C3%A2-analysis
#13
Pedro Gr Teixeira, Karen Woo, Adam W Beck, Salvatore T Scali, Fred A Weaver
Objectives Investigate the impact of left subclavian artery coverage without revascularization on spinal cord ischemia development in patients undergoing thoracic endovascular aortic repair. Methods The Vascular Quality Initiative thoracic endovascular aortic repair module (April 2011-July 2014) was analyzed. Patients undergoing left subclavian artery coverage were divided into two groups according to revascularization status. The association between left subclavian artery revascularization with the primary outcome of spinal cord ischemia and the secondary outcome of stroke was assessed with multivariable analysis adjusting for between-group baseline differences...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29022854/single-center-mid-term-experience-with-chimney-graft-technique-for-the-preservation-of-flow-to-the-supra-aortic-branches
#14
Robert Shahverdyan, Spyridon Mylonas, Michael Gawenda, Jan Brunkwall
Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#15
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29018023/mortality-and-disability-according-to-baseline-blood-pressure-in-acute-ischemic-stroke-patients-treated-by-thrombectomy-a-collaborative-pooled-analysis
#16
Benjamin Maïer, Benjamin Gory, Guillaume Taylor, Julien Labreuche, Raphaël Blanc, Michael Obadia, Marie Abrivard, Stanislas Smajda, Jean-Philippe Desilles, Hocine Redjem, Gabriele Ciccio, Anne Claire Lukaszewicz, Francis Turjman, Roberto Riva, Paul Emile Labeyrie, Alain Duhamel, Jacques Blacher, Michel Piotin, Bertrand Lapergue, Mikael Mazighi
BACKGROUND: High blood pressure (BP) is associated with worse clinical outcomes in the setting of acute ischemic stroke, but the optimal blood pressure target is still a matter of debate. We aimed to study the association between baseline BP and mortality in acute ischemic stroke patients treated by mechanical thrombectomy. METHODS AND RESULTS: A total of 1332 acute ischemic stroke patients treated by mechanical thrombectomy were enrolled (from January 2012 to June 2016) in the ETIS (Endovascular Treatment in Ischemic Stroke) registry...
October 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#17
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28993035/outcomes-of-hybrid-procedure-for-type-b-aortic-dissection-with-an-aberrant-right-subclavian-artery
#18
Huanyu Ding, Songyuan Luo, Yuan Liu, Wenhui Huang, Minchun Jiang, Jie Li, Nianjin Xie, Xiaoping Fan, Ruixin Fan, Jianfang Luo
OBJECTIVE: To report our single-center experience of the hybrid procedure for type B aortic dissection (TBAD) with an aberrant right subclavian artery (ARSA) and the early to midterm outcomes in these patients. METHODS: From December 2011 to February 2016, 16 patients (12 males; median age, 51 years; range, 40-66 years) underwent thoracic endovascular aortic repair and extraanatomic bypass hybrid procedure for TBAD with an ARSA in our center. Demographics, coexisting medical conditions, imaging features, operation details, and follow-up outcomes of these patients were collected retrospectively and analyzed...
October 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28991720/cerebral-hyperperfusion-syndrome-and-intracranial-hemorrhage-after-carotid-endarterectomy-or-carotid-stenting-a-meta-analysis
#19
REVIEW
George Galyfos, Argiri Sianou, Konstantinos Filis
INTRODUCTION: Cerebral hyperperfusion syndrome (CHS) and intracranial hemorrhage (ICH) after carotid revascularization have been associated with significant morbidity and mortality, although pooled data comparing these outcomes between open and endovascular treatment are lacking. Aim of this meta-analysis is to compare CHS and ICH risk between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS). METHODS: A systematic literature review was conducted conforming to established criteria, in order to identify eligible articles published prior to February 2017...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28991718/improving-treatment-times-for-patients-with-in-hospital-stroke-using-a-standardized-protocol
#20
Junpei Koge, Shoji Matsumoto, Ichiro Nakahara, Akira Ishii, Taketo Hatano, Nobutake Sadamasa, Yasutoshi Kai, Mitsushige Ando, Makoto Saka, Hideo Chihara, Wataru Takita, Keisuke Tokunaga, Takahiko Kamata, Hidehisa Nishi, Tetsuya Hashimoto, Atsushi Tsujimoto, Jun-Ichi Kira, Izumi Nagata
BACKGROUND: Previous reports have shown significant delays in treatment of in-hospital stroke (IHS). We developed and implemented our IHS alert protocol in April 2014. We aimed to determine the influence of implementation of our IHS alert protocol. METHODS: Our implementation processes comprise the following four main steps: IHS protocol development, workshops for hospital staff to learn about the protocol, preparation of standardized IHS treatment kits, and obtaining feedback in a monthly hospital staff conference...
October 15, 2017: Journal of the Neurological Sciences
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