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endovascular stroke

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https://www.readbyqxmd.com/read/29222393/protect-proximal-balloon-occlusion-together-with-direct-thrombus-aspiration-during-stent-retriever-thrombectomy-evaluation-of-a-double-embolic-protection-approach-in-endovascular-stroke-treatment
#1
Christian Maegerlein, Sebastian Moench, Tobias Boeckh-Behrens, Manuel Lehm, Dennis M Hedderich, Maria Teresa Berndt, Silke Wunderlich, Claus Zimmer, Johannes Kaesmacher, Benjamin Friedrich
PURPOSE: Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique...
December 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29222229/visual-aids-for-patient-family-and-physician-decision-making-about-endovascular-thrombectomy-for-acute-ischemic-stroke
#2
Ivie Tokunboh, Marta Vales Montero, Matheus Fellipe Zopelaro Almeida, Latisha Sharma, Sidney Starkman, Viktor Szeder, Reza Jahan, David Liebeskind, Nestor Gonzalez, Andrew Demchuk, Michael T Froehler, Mayank Goyal, Maarten G Lansberg, Helmi Lutsep, Lee Schwamm, Jeffrey L Saver
BACKGROUND AND PURPOSE: Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential outcomes and can accelerate decision processes. METHODS: From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of endovascular thrombectomy for patients with acute cerebral ischemia and large vessel occlusion using (1) automated (algorithmic) and (2) expert-guided joint outcome table specification...
December 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29217747/mr-perfusion-to-determine-the-status-of-collaterals-in-patients-with-acute-ischemic-stroke-a-look-beyond-time-maps
#3
K Nael, A Doshi, R De Leacy, J Puig, M Castellanos, J Bederson, T P Naidich, J Mocco, M Wintermark
BACKGROUND AND PURPOSE: Patients with acute stroke with robust collateral flow have better clinical outcomes and may benefit from endovascular treatment throughout an extended time window. Using a multiparametric approach, we aimed to identify MR perfusion parameters that can represent the extent of collaterals, approximating DSA. MATERIALS AND METHODS: Patients with anterior circulation proximal arterial occlusion who had baseline MR perfusion and DSA were evaluated...
December 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29217365/alberta-stroke-program-early-ct-score-time-score-predicts-outcome-after-endovascular-therapy-in-patients-with-acute-ischemic-stroke-a-retrospective-single-center-study
#4
Kenichi Todo, Nobuyuki Sakai, Tomoyuki Kono, Taku Hoshi, Hirotoshi Imamura, Hidemitsu Adachi, Hiroshi Yamagami, Nobuo Kohara
BACKGROUND: Clinical outcomes after successful endovascular therapy in patients with acute ischemic stroke are associated with several factors including onset-to-reperfusion time (ORT), the National Institute of Health Stroke Scale (NIHSS) score, and the Alberta Stroke Program Early CT Score (ASPECTS). The NIHSS-time score, calculated as follows: [NIHSS score] × [onset-to-treatment time (h)] or [NIHSS score] × [ORT (h)], has been reported to predict clinical outcomes after intravenous recombinant tissue plasminogen activator therapy and endovascular therapy for acute stroke...
December 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29217008/endovascular-versus-surgical%C3%A2-revascularization-for-chronic%C3%A2-mesenteric%C3%A2-ischemia-insights-from-the-national-inpatient-sample-database
#5
Fabio V Lima, Dhaval Kolte, Kevin F Kennedy, David W Louis, J Dawn Abbott, Peter A Soukas, Omar N Hyder, Shafiq T Mamdani, Herbert D Aronow
OBJECTIVES: This study sought to compare in-hospital major adverse cardiac and cerebrovascular events (MACCE) following endovascular therapy with open surgery for chronic mesenteric ischemia (CMI). BACKGROUND: There are limited contemporary data on in-hospital cardiovascular outcomes among patients with CMI undergoing revascularization via endovascular therapy versus open surgery in the United States. METHODS: Patients with CMI undergoing endovascular or surgical (mesenteric bypass or endarterectomy) revascularization between 2007 and 2014 were identified from the National Inpatient Sample...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29212743/successful-reperfusion-with-intravenous-thrombolysis-preceding-mechanical-thrombectomy-in-large-vessel-occlusions
#6
Georgios Tsivgoulis, Aristeidis H Katsanos, Peter D Schellinger, Martin Köhrmann, Panayiotis Varelas, Georgios Magoufis, Maurizio Paciaroni, Valeria Caso, Anne W Alexandrov, Edip Gurol, Andrei V Alexandrov
BACKGROUND AND PURPOSE: Although current guidelines advocate pretreatment with intravenous thrombolysis (IVT) in all eligible patients with acute ischemic stroke with large-vessel occlusion before mechanical thrombectomy, there are observational data questioning the efficacy of this approach. One of the main arguments in favor of IVT pretreatment is the potential for tissue-type plasminogen activator-induced successful reperfusion (SR) before the onset of endovascular procedure. METHODS: We performed a systematic review and meta-analysis of randomized controlled clinical trials and observational cohorts providing rates of SR with IVT in patients with large-vessel occlusion before the initiation of mechanical thrombectomy...
December 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29212462/pharmacological-targeting-of-secondary-brain-damage-following-ischemic-or-hemorrhagic-stroke-traumatic-brain-injury-and-bacterial-meningitis-a-systematic-review-and-meta-analysis
#7
Thomas Beez, Hans-Jakob Steiger, Nima Etminan
BACKGROUND: The effectiveness of pharmacological strategies exclusively targeting secondary brain damage (SBD) following ischemic stroke, aneurysmal subarachnoid hemorrhage, aSAH, intracerebral hemorrhage (ICH), traumatic brain injury (TBI) and bacterial meningitis is unclear. This meta-analysis studied the effect of SBD targeted treatment on clinical outcome across the pathological entities. METHODS: Randomized, controlled, double-blinded trials on aforementioned entities with 'death' as endpoint were identified...
December 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29209269/if-time-is-brain-where-is-the-improvement-in-prehospital-time-after-stroke
#8
REVIEW
Jeremy N Pulvers, John D G Watson
Despite the availability of thrombolytic and endovascular therapy for acute ischemic stroke, many patients are ineligible due to delayed hospital arrival. The identification of factors related to either early or delayed hospital arrival may reveal potential targets of intervention to reduce prehospital delay and improve access to time-critical thrombolysis and clot retrieval therapy. Here, we have reviewed studies reporting on factors associated with either early or delayed hospital arrival after stroke, together with an analysis of stroke onset to hospital arrival times...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29205798/carotid-cavernous-fistula-after-endovascular-intervention-for-chronic-carotid-artery-total-occlusion
#9
Chih-Fan Yeh, Yin-Hsien Chen, Mao-Shin Lin, Ching-Chang Huang, Chi-Sheng Hung, Shih-Wei Meng, Chih-Kuo Lee, Hsien-Li Kao
BACKGROUND AND PURPOSE: In addition to head trauma and cranial surgery, endovascular intervention for chronic carotid artery occlusion (CAO) may also result in carotid-cavernous fistula (CCF). The management and prognosis of iatrogenic CCF during CAO recanalization have never been well described and discussed in the literature. MATERIALS AND METHODS: We conducted a retrospective analysis for CAO recanalization attempts in National Taiwan University Hospital and affiliated hospitals...
December 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29203731/mechanical-thrombectomy-and-rescue-therapy-for-intracranial-large-artery-occlusion-with-underlying-atherosclerosis
#10
BaiXue Jia, Lei Feng, David S Liebeskind, Xiaochuan Huo, Feng Gao, Ning Ma, Dapeng Mo, Xiaoling Liao, Chunjuan Wang, Xingquan Zhao, Yuesong Pan, Hao Li, Liping Liu, Yilong Wang, Yongjun Wang, Zhong-Rong Miao
OBJECTIVE: To investigate the safety and efficacy of mechanical thrombectomy plus rescue therapy for intracranial large artery occlusion (ILAO) with underlying intracranial atherosclerosis (ICAS). METHODS: Patients enrolled in the intervention group of EAST (Endovascular Therapy for Acute ischemic Stroke Trial) were analyzed. For underlying ICAS identified during the stent retrieval procedure, rescue treatment was required for those with (1) a degree of arterial stenosis >70% or (2) any degree of arterial with blood flow impairment or (3) evidence of re-occlusion...
December 4, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29203689/novel-interactive-data-visualization-exploration-of-the-escape-trial-endovascular-treatment-for-small-core-and-anterior-circulation-proximal-occlusion-with-emphasis-on-minimizing-ct-to-recanalization-times-data
#11
Matthew Brigdan, Michael D Hill, Abhijeet Jagdev, Noreen Kamal
BACKGROUND AND PURPOSE: The ESCAPE (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) randomized clinical trial collected a large diverse data set. However, it is difficult to fully understand the effects of the study on certain patient groups and disease progression. We developed and evaluated an interactive visualization of the ESCAPE trial data. METHODS: We iteratively designed an interactive visualization using Python's Bokeh software library...
December 4, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29199136/cerebral-venous-collaterals-a-new-fort-for-fighting-ischemic-stroke
#12
REVIEW
Lu-Sha Tong, Zhen-Ni Guo, Yi-Bo Ou, Yan-Nan Yu, Xiao-Cheng Zhang, Jiping Tang, John H Zhang, Min Lou
Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae...
November 30, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/29198629/aortic-replacement-after-tevar-diameter-correction-with-modified-use-of-the-siena-prosthesis
#13
Arminder Jassar, Maximilian Kreibich, Julia Morlock, Stoyan Kondov, Johannes Scheumann, Fabian A Kari, Bartosz Rylski, Matthias Siepe, Alexander Jonaszik, Cornelius Keyl, Frank Humburger, Friedhelm Beyersdorf, Martin Czerny
BACKGROUND: To report a new technique for diameter correction in patients after thoracic endovascular aortic repair (TEVAR) with large stent-grafts using the Vascutek Siena 4-branch collared prosthesis (Vascutek Terumo, Inchinnan, Scotland, UK) in patients undergoing thoracoabdominal (TA) aortic replacement. METHODS: Within a 24-month period, 39 patients underwent TA replacement at our center. Of these, 6 patients had undergone previous TEVAR with large stent-grafts (42 to 48 mm diameter)...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29191873/time-for-a-time-window-extension-insights-from-late-presenters-in-the-escape-trial
#14
J W Evans, B R Graham, P Pordeli, F S Al-Ajlan, R Willinsky, W J Montanera, J L Rempel, A Shuaib, P Brennan, D Williams, D Roy, A Y Poppe, T G Jovin, T Devlin, B W Baxter, T Krings, F L Silver, D F Frei, C Fanale, D Tampieri, J Teitelbaum, D Iancu, J Shankar, P A Barber, A M Demchuk, M Goyal, M D Hill, B K Menon
BACKGROUND AND PURPOSE: The safety and efficacy of endovascular therapy for large-artery stroke in the extended time window is not yet well-established. We performed a subgroup analysis on subjects enrolled within an extended time window in the Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial. MATERIALS AND METHODS: Fifty-nine of 315 subjects (33 in the intervention group and 26 in the control group) were randomized in the ESCAPE trial between 5...
November 30, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29191869/john-nash-and-the-organization-of-stroke-care
#15
M Goyal, A T Wilson, D Mayank, N Kamal, D H Robinson, D Turkel-Parrella, J A Hirsch
The concept of Nash equilibrium, developed by John Forbes Nash Jr, states that an equilibrium in noncooperative games is reached when each player takes the best action for himself or herself, taking into account the actions of the other players. We apply this concept to the provision of endovascular thrombectomy in the treatment of acute ischemic stroke and suggest that collaboration among hospitals in a health care jurisdiction could result in practices such as shared call pools for neurointervention teams, leading to better patient care through streamlined systems...
November 30, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29191548/evaluation-of-enterprise-stent-assisted-coiling-and-telescoping-stents-technique-as-treatment-of-supraclinoid-blister-aneurysms-of-internal-carotid-artery
#16
Ding Xu, Changwei Zhang, Ting Wang, Chaohua Wang, David F Kallmes, Giuseppe Lanzino, Chao You, Xiaodong Xie
BACKGROUND: and Purpose: Supraclinoid blister aneurysms (BAs) of the internal carotid artery (ICA) are uncommon and deadly, and appropriate treatment is controversial. Endovascular reconstruction may allow treatment through aneurysm isolation. We report a single institution experience of Enterprise stent assisted coiling (ESAC) in the treatment of BAs to appraise safety and efficacy. MATERIALS AND METHODS: Patients treated with ESAC for a BA at our institution from 2013-16 were retrospectively included in this study...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29191539/prognostic-role-of-microembolic-signals-after-endovascular-treatment-in-anterior-circulation-ischemic-stroke-patients
#17
Filippo Farina, Anna Palmieri, Silvia Favaretto, Federica Viaro, Giacomo Cester, Francesco Causin, Claudio Baracchini
BACKGROUND: Endovascular treatment (EVT) is an effective therapy for acute ischemic stroke due to large artery occlusion (LAO) of the anterior circulation. Yet, some patients do not experience clinical improvement regardless of successful recanalization and reperfusion. The reasons are unknown but one possible explanation is micro-vessel obstruction downstream. OBJECTIVES: To assess the presence of microembolic signals (MES) with transcranial Doppler (TCD), and define their role as predictors of clinical outcome in EVT-treated stroke patients...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29191528/web-vessels-literature-review-and-neurointerventional-management
#18
Benedito J A Pereira, Ulysses Caus Batista, Renato Tavares Tosello, Igor Neia Stro Her, Alex Machado Baeta, Ronie Leo Piske
OBJECTIVES: The aim of this study is to describe twenty-seven patients with thirty-two WVs from our practice as well as provide a review of the literature regarding imaging diagnostics, clinical presentation and treatment of these lesions. METHODS: A Medline search was performed using combinations of the following words: stroke in young adults, web, recurrent stroke, diaphragm-like, atypical fibromuscular hyperplasia, atypical fibromuscular dysplasia, septal fibromuscular dysplasia, septa, diaphragms, pseudo-valvular folds and carotid diaphragm...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29183174/limit-of-intraoperative-near-infrared-spectroscopy-monitoring-during-endovascular-thrombectomy-in-acute-ischemic-stroke
#19
Ryo Hiramatsu, Motomasa Furuse, Ryokichi Yagi, Hiroyuki Ohnishi, Naokado Ikeda, Naosuke Nonoguchi, Shinji Kawabata, Shigeru Miyachi, Toshihiko Kuroiwa
Endovascular thrombectomy is recommended for a persistent ischemic penumbra if recanalization cannot be achieved by the intravenous (IV) administration of recombinant tissue-plasminogen activator (rt-PA) alone. Although endovascular thrombectomy is a powerful treatment for major cerebral artery occlusion, the monitoring of recanalization and reperfusion during acute ischemic stroke presents a therapeutic challenge, and a previous study reported the usefulness of near-infrared spectroscopy (NIRS) for intraoperative monitoring during emergency endovascular thrombectomy for acute large ischemic stroke...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29180587/correction-to-letter-by-tang-et-al-regarding-article-general-anesthesia-versus-conscious-sedation-for-endovascular-treatment-of-acute-ischemic-stroke-the-anstroke-trial-anesthesia-during-stroke
#20
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Stroke; a Journal of Cerebral Circulation
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