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https://www.readbyqxmd.com/read/29451511/-endovascular-treatment-of-symptomatic-carotid-artery-dissection
#1
Alfredo Fede, Andrea Pacchioni, Carlo Penzo, Riccardo Turri, Giuseppe Marchese, Daniela Benedetto, Salvatore Saccà
Internal carotid artery dissection is one of the possible causes of stroke in young adults. The effectiveness of medical therapy alone is often limited and endovascular strategy should be considered, particularly in the presence of persisting neurological symptoms. Currently, there is no general consensus on the most appropriate therapeutic strategy to follow in symptomatic carotid artery dissection. We here report a case of symptomatic carotid artery dissection treated with an endovascular approach, and we review the recent literature regarding this therapeutic strategy...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29445434/primary-endovascular-treatment-of-acute-ischemic-stroke-using-stent-retrievers-initial-egyptian-experience
#2
Ossama Yassin Mansour, Abdulrahman Mostafa Ibrahim Ali, Mohamed Megahed
Background: Several mechanical thrombectomy (MT) devices have been designed with the goal of improving the recanalization rates of major intracranial artery occlusions. Objective: In this single-center experience, we analyzed the acute ischemic stroke (AIS) treatment with Primary MT; safety and efficacy and clinical results in our patients with large vessel occlusion (LVO). Methods: During a five-year period (from September 2011 to July 2016), out of 996 patients who presented to our center with a diagnosis of AIS, 113 (11...
December 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29444972/usefulness-of-adamts13-to-predict-response-to-recanalization-therapies-in-acute-ischemic-stroke
#3
Alejandro Bustamante, MingMing Ning, Teresa García-Berrocoso, Anna Penalba, Cristina Boada, Alba Simats, Jorge Pagola, Marc Ribó, Carlos Molina, Eng Lo, Joan Montaner
OBJECTIVE: We aimed to analyze ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) in relation to arterial recanalization in patients treated with IV tissue plasminogen activator (tPA) and in relation to futile recanalization in patients treated with mechanical thrombectomy. METHODS: Acute ischemic stroke patients (n = 108) with documented arterial occlusions treated with IV-tPA were selected. ADAMTS13 activity was measured by ELISA in samples collected before treatment...
February 14, 2018: Neurology
https://www.readbyqxmd.com/read/29443076/optimized-management-of-endovascular-treatment-for-acute-ischemic-stroke
#4
Katharina Schregel, Daniel Behme, Ioannis Tsogkas, Michael Knauth, Ilko Maier, André Karch, Rafael Mikolajczyk, Mathias Bähr, Jörn Schäper, José Hinz, Jan Liman, Marios-Nikos Psychogios
This manuscript describes a streamlined protocol for the management of patients with acute ischemic stroke, which aims at the minimization of time from hospital admission to reperfusion. Rapid restoration of cerebral blood flow is essential for the outcomes of patients with acute ischemic stroke. Endovascular treatment (EVT) has become the standard of care to accomplish this in patients with acute stroke due to large vessel occlusion (LVO). To achieve reperfusion of ischemic brain regions as fast as possible, all in-hospital time delays have to be carefully avoided...
January 18, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29439126/mechanical-thrombectomy-of-acute-ischemic-stroke-with-a-new-intermediate-aspiration-catheter-preliminary-results
#5
Fabrizio Sallustio, Enrico Pampana, Alessandro Davoli, Stefano Merolla, Giacomo Koch, Fana Alemseged, Marta Panella, Vittoria Carla D'Agostino, Francesco Mori, Daniele Morosetti, Daniel Konda, Sebastiano Fabiano, Marina Diomedi, Roberto Gandini
BACKGROUND AND PURPOSE: To report clinical and procedural outcomes of acute ischemic stroke patients after endovascular treatment with the new thromboaspiration catheter AXS Catalyst 6. METHODS: Patients with anterior and posterior circulation stroke were selected. Successful reperfusion defined as a Thrombolysis in Cerebral Infarction (TICI) score ≥2 b and 3-month functional independence defined as a modified Rankin Scale (mRS) ≤2 were the main efficacy outcomes...
February 8, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29439123/endovascular-thrombectomy-in-wake-up-stroke-and-stroke-with-unknown-symptom-onset
#6
P Bücke, M Aguilar Pérez, V Hellstern, M AlMatter, H Bäzner, H Henkes
BACKGROUND AND PURPOSE: Mechanical thrombectomy in acute ischemic stroke within 6 hours of symptom onset is effective and safe. However, in many patients, information on the beginning of symptoms is not available. Patients can be divided into those with wake-up stroke and daytime-unwitnessed stroke. Evidence on outcome and complications after mechanical thrombectomy in wake-up stroke and daytime-unwitnessed stroke is rare. A potential beneficial effect of mechanical thrombectomy in selected patients with wake-up stroke or daytime-unwitnessed stroke is suspected...
February 8, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29438080/thrombus-neutrophil-extracellular-traps-content-impair-tpa-induced-thrombolysis-in-acute-ischemic-stroke
#7
Celina Ducroux, Lucas Di Meglio, Stephane Loyau, Sandrine Delbosc, William Boisseau, Catherine Deschildre, Malek Ben Maacha, Raphael Blanc, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Robert Fahed, Jean-Baptiste Michel, Michel Piotin, Laurence Salomon, Mikael Mazighi, Benoit Ho-Tin-Noe, Jean-Philippe Desilles
BACKGROUND AND PURPOSE: Neutrophil Extracellular Traps (NETs) are DNA extracellular networks decorated with histones and granular proteins produced by activated neutrophils. NETs have been identified as major triggers and structural factors of thrombosis. A recent study designated extracellular DNA threads from NETs as a potential therapeutic target for improving tissue-type plasminogen activator (tPA)-induced thrombolysis in acute coronary syndrome. The aim of this study was to assess the presence of NETs in thrombi retrieved during endovascular therapy in patients with acute ischemic stroke (AIS) and their impact on tPA-induced thrombolysis...
February 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29437935/the-barrel-vascular-reconstruction-device-for-endovascular-coiling-of-wide-necked-intracranial-aneurysms-a-multicenter-prospective-post-marketing-study
#8
Benjamin Gory, Raphaël Blanc, Francis Turjman, Jérôme Berge, Michel Piotin
BACKGROUND AND PURPOSE: The Barrel vascular reconstruction device (Barrel VRD) is a novel stent with design features that allow endovascular coiling of wide-necked bifurcation aneurysms while preserving adjacent branches, without necessitating dual stent implantation. This study aimed to assess the safety and effectiveness of the Barrel VRD at 12-month follow-up. MATERIALS AND METHODS: The Barrel VRD trial is a prospective, multicenter, observational post-marketing registry evaluating the use of the Barrel VRD for treatment of wide-necked bifurcation aneurysms...
February 2, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29435828/relevance-of-standard-intravenous-thrombolysis-in-endovascular-stroke-therapy-of-a-tertiary-stroke-center
#9
Annette Heinrichs, Omid Nikoubashman, Kolja Schürmann, Simone C Tauber, Martin Wiesmann, Jörg B Schulz, Arno Reich
The majority of patients undergoing endovascular stroke treatment (EST) in randomized controlled trials received additional systemic thrombolysis ("combination or bridging therapy (C/BT)"). Nevertheless, its usefulness in this subtype of acute ischemic stroke (AIS) is discussed controversially. Of all consecutive AIS patients, who received any kind of reperfusion therapy in a tertiary university stroke center between January 2015 and March 2016, those with large vessel occlusions (LVO) and EST with or without additional C/BT, were compared primarily regarding procedural aspects...
February 12, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29431856/cerebral-embolization-silent-cerebral-infarction-and-neurocognitive-decline-after-thoracic-endovascular-aortic-repair
#10
A H Perera, N Rudarakanchana, L Monzon, C D Bicknell, B Modarai, O Kirmi, T Athanasiou, M Hamady, R G Gibbs
BACKGROUND: Silent cerebral infarction is brain injury detected incidentally on imaging; it can be associated with cognitive decline and future stroke. This study investigated cerebral embolization, silent cerebral infarction and neurocognitive decline following thoracic endovascular aortic repair (TEVAR). METHODS: Patients undergoing elective or emergency TEVAR at Imperial College Healthcare NHS Trust and Guy's and St Thomas' NHS Foundation Trust between January 2012 and April 2015 were recruited...
February 12, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29428538/carotid-access-for-endovascular-repair-of-aortic-pathology-a-systematic-review
#11
Thomas W Stonier, Kirtan Patel, Vamsee Bhrugubanda, Andrew Mtl Choong
BACKGROUND: Endovascular repair is now preferred to open access for the management of aortic diseases. This is typically performed via the femoral artery, however not all patients are eligible for this. This systematic review summaries the current evidence for utilising the carotid artery as an alternative access route. METHODS: A systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using four electronic databases...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29428329/three-year-clinical-results-of-carotid-artery-stenting-in-treating-patients-with-contralateral-carotid-artery-occlusion
#12
Jianming Guo, Lianrui Guo, Zhu Tong, Zhonggao Wang, Alan Dardik, Yongquan Gu
BACKGROUND: Patients presenting a carotid stenosis and contralateral carotid occlusion (CCO) have been historically considered at high risk of carotid surgical treatment, and there are few data regarding short-term recovery after stenting therapy in patients with CCO. The aim of this study is to evaluate the short-term recovery and safety of stenting for patients with CCO and different subgroup population. METHODS: We retrospectively reviewed the records of consecutive patients with CCO who were treated with stenting endovascular methods between 2008 and 2014...
February 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29425544/ranibizumab-and-digital-ischemia
#13
R Attal, I Lazareth, G Angelopoulos, P Priollet
Case report of a patient with age-related macular degeneration whose digital ischemia can most plausibly be attributed to ranibizumab. PURPOSE: To report ranibizumab as the probable cause of digital ischemia in a patient treated for age-related macular degeneration. METHODS: Single-patient case report. RESULTS: An 83-year-old woman with an unremarkable medical history suffered acute ischemia in her left hand with necrosis of the distal phalange of the fifth finger after six intravitreal injections of ranibizumab...
February 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29424346/emergency-thrombectomy-for-acute-ischaemic-stroke-current-evidence-international-guidelines-and-local-clinical-practice
#14
A Co Tsang, R Wl Yeung, M My Tse, R Lee, W M Lui
Acute ischaemic stroke due to large vessel occlusion leads to grave neurological morbidity and mortality. Conventional intravenous thrombolysis is ineffective in achieving timely reperfusion in this group of patients. The publication of five positive randomised controlled trials of emergency thrombectomy for acute ischaemic stroke in 2015 provided strong evidence to support endovascular reperfusion therapy and represented a paradigm shift in acute stroke management. In this article, we review the current evidence and international guidelines, and report on the findings of a survey study of the clinical practice and opinions of local neurologists, neurosurgeons, and interventional radiologists in emergency thrombectomy...
February 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29422380/improvement-in-door-to-needle-time-in-patients-with-acute-ischemic-stroke-via-a-simple-stroke-activation-protocol
#15
Benjamin Y Q Tan, Nicholas J H Ngiam, Sibi Sunny, Wan Yee Kong, Howen Tam, Tiong Beng Sim, Benjamin S H Leong, Chandra Bhartendu, Prakash R Paliwal, Raymond C S Seet, Bernard P L Chan, Hock Luen Teoh, Vijay K Sharma, Leonard L L Yeo
BACKGROUND: In acute ischemic stroke (AIS), treatment with intravenous tissue-type plasminogen activator (IV-tPA) is time-sensitive. All stroke centers make continual efforts to reduce door-to-needle time (DNT) with varying success. We present the impact of modifications to our stroke activation protocol on DNT. METHODS: We included 404 consecutive patients with AIS receiving IV-tPA between January 2014 and December 2016. First changes in stroke activation protocol were made in March 2015 in the form of prenotification by paramedics, direct transfer from ambulance to computed tomography (CT) scanner, and rapid en route neurological assessment by an emergency physician and neurologist...
February 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29417839/mechanical-thrombectomy-is-time-still-brain-the-dawn-of-a-new-era
#16
Naveed Kamal, Neil Majmundar, Nitesh Damadora, Mohammad El-Ghanem, Rolla Nuoman, Irwin A Keller, Steven Schonfeld, Igor Rybinnik, Gaurav Gupta, Sudipta Roychowdry, Fawaz Al-Mufti
PURPOSE: The purpose of this study is to review the history of treatments for acute ischemic stroke, examine developments in endovascular therapy, and discuss the future of the management of acute ischemic stroke. METHODS: A selective review of recent clinical trials for the treatment of acute ischemic stroke was conducted. RESULTS: We reviewed completed trials of the management of acute ischemic stroke including intravenous thrombolytics, intraarterial thrombolytics, and thrombectomy...
February 8, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29414888/mass-spectrometry-based-proteomic-profiling-of-thrombotic-material-obtained-by-endovascular-thrombectomy-in-patients-with-ischemic-stroke
#17
Roberto Muñoz, Enrique Santamaría, Idoya Rubio, Karina Ausín, Aiora Ostolaza, Alberto Labarga, Miren Roldán, Beatriz Zandio, Sergio Mayor, Rebeca Bermejo, Mónica Mendigaña, María Herrera, Nuria Aymerich, Jorge Olier, Jaime Gállego, Maite Mendioroz, Joaquín Fernández-Irigoyen
Thrombotic material retrieved from acute ischemic stroke (AIS) patients represents a valuable source of biological information. In this study, we have developed a clinical proteomics workflow to characterize the protein cargo of thrombi derived from AIS patients. To analyze the thrombus proteome in a large-scale format, we developed a workflow that combines the isolation of thrombus by endovascular thrombectomy and peptide chromatographic fractionation coupled to mass-spectrometry. Using this workflow, we have characterized a specific proteomic expression profile derived from four AIS patients included in this study...
February 7, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29408777/streamlined-triage-and-transfer-protocols-improve-door-to-puncture-time-for-endovascular-thrombectomy-in-acute-ischemic-stroke
#18
Akash P Kansagra, Adam N Wallace, David R Curfman, James D McEachern, Christopher J Moran, DeWitte T Cross, Jin-Moo Lee, Andria L Ford, S Goyal Manu, Peter D Panagos, Colin P Derdeyn
OBJECTIVE: Shorter time from symptom onset to treatment is associated with improved outcomes in patients who undergo mechanical thrombectomy for treatment of acute ischemic stroke due to emergent large vessel occlusion. In this work, we detail pre-thrombectomy process improvements in a multi-hospital network and report the effect on door-to-puncture time in patients undergoing mechanical thrombectomy. PATIENTS AND METHODS: A streamlined workflow was adopted to minimize door-to-puncture time...
January 30, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29408775/value-based-procurement-of-medical-devices-application-to-devices-for-mechanical-thrombectomy-in-ischemic-stroke
#19
Sabrina Trippoli, Erminia Caccese, Claudio Marinai, Andrea Messori
OBJECTIVES: In the acute ischemic stroke, endovascular devices have shown promising clinical results and are also likely to represent value for money, as several modeling studies have shown. Pharmacoeconomic evaluations in this field, however, have little impact on the procurement of these devices. The present study explored how complex pharmacoeconomic models that evaluate effectiveness and cost can be incorporated into the in-hospital procurement of thrombectomy devices. PATIENTS AND METHODS: As regards clinical modeling, we extracted outcomes at three months from randomized trials conducted for four thrombectomy devices, and we projected long-term results using standard Markov modeling...
January 29, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29402064/low-versus-standard-dose-intravenous-alteplase-in-the-context-of-bridging-therapy-for-acute-ischemic-stroke-a-korean-enchanted-study
#20
Jong S Kim, Yeon-Jung Kim, Kyung Bok Lee, Jae Kwan Cha, Jong-Moo Park, Yangha Hwang, Eung-Gyu Kim, Joung-Ho Rha, Jaseong Koo, Jei Kim, Yong-Jae Kim, Woo-Keun Seo, Dong-Eog Kim, Thompson G Robinson, Richard I Lindley, Xia Wang, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Following the positive results from recent trials on endovascular therapy (EVT), bridging therapy (intravenous alteplase plus EVT) is increasingly being used for the treatment of acute ischemic stroke. However, the optimal dose of intravenous alteplase remains unknown in centers where bridging therapy is actively performed. The optimal dose for eventual recanalization and positive clinical outcomes in patients receiving bridging therapy also remains unknown. METHODS: In this prospective Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) sub-study, we explored the outcomes following treatment with two different doses (low- [0...
January 2018: Journal of Stroke
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