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https://www.readbyqxmd.com/read/28490161/endovascular-stroke-therapy-focused-on-stent-retriever-thrombectomy-and-direct-clot-aspiration-historical-review-and-modern-application
#1
REVIEW
Dong-Hun Kang, Jaechan Park
Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28454482/effects-of-environmental-factors-and-metallic-electrodes-on-ac-electrical-conduction-through-dna-molecule
#2
S Abdalla, A Obaid, F M Al-Marzouki
BACKGROUND: Deoxyribonucleic acid (DNA) is one of the best candidate materials for various device applications such as in electrodes for rechargeable batteries, biosensors, molecular electronics, medical- and biomedical-applications etc. Hence, it is worthwhile to examine the mechanism of charge transport in the DNA molecule, however, still a question without a clear answer is DNA a molecular conducting material (wire), semiconductor, or insulator? The answer, after the published data, is still ambiguous without any confirmed and clear scientific answer...
December 2017: Nanoscale Research Letters
https://www.readbyqxmd.com/read/28392138/evaluation-of-recanalisation-treatment-on-posterior-circulation-ischemic-stroke-by-solitaire-device-a-multicenter-retrospective-study
#3
Jianwu Long, Hao Qin, Hongqi Zhang
OBJECTIVES: Posterior circulation ischemic stroke (PCIS), accounting for approximately 20% of total ischemic stroke, is a sever disease that associated with high rate of morbidity and mortality. Though the effectiveness of endovascular mechanical thrombectomy has been well demonstrated in many types of ischemic stroke, it is still unclear what the outcome is in posterior circulation ischemic stroke. METHODS AND MATERIALS: In current study, data was collected from 139 Chinese patients who received endovascular mechanical thrombectomy treatment with Solitaire device after acute posterior circulation ischemic stroke...
March 24, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28366063/revascularization-of-tandem-occlusions-in-acute-ischemic-stroke-review-of-the-literature-and-illustrative-case
#4
REVIEW
Nnenna Mbabuike, Kelly Gassie, Benjamin Brown, David A Miller, Rabih G Tawk
OBJECTIVE Tandem occlusions continue to represent a major challenge in patients with acute ischemic stroke (AIS). The anterograde approach with proximal to distal revascularization as well as the retrograde approach with distal to proximal revascularization have been reported without clear consensus or standard guidelines. METHODS The authors performed a comprehensive search of the PubMed database for studies including patients with carotid occlusions and tandem distal occlusions treated with endovascular therapy...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28292867/vessel-patency-at-24-hours-and-its-relationship-with-clinical-outcomes-and-infarct-volume-in-revascat-trial-randomized-trial-of-revascularization-with-solitaire-fr-device-versus-best-medical-therapy-in-the-treatment-of-acute-stroke-due-to-anterior-circulation
#5
Mònica Millán, Sebastià Remollo, Helena Quesada, Arturo Renú, Alejandro Tomasello, Priyanka Minhas, Natalia Pérez de la Ossa, Marta Rubiera, Laura Llull, Pedro Cardona, Fahad Al-Ajlan, María Hernández, Zarina Assis, Andrew M Demchuk, Tudor Jovin, Antoni Dávalos
BACKGROUND AND PURPOSE: Higher rates of target vessel patency at 24 hours were noted in the thrombectomy group compared with control group in recent randomized trials. As a prespecified secondary end point, we aimed to assess 24-hour revascularization rates by treatment groups and occlusion site as they related to clinical outcome and 24-hour infarct volume in REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset)...
April 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28118796/mechanical-recanalization-for-acute-embolic-occlusion-at-the-origin-of-the-superior-mesenteric-artery
#6
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...
February 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27940648/endovascular-treatment-improves-cognition-after-stroke-a-secondary-analysis-of-revascat-trial
#7
RANDOMIZED CONTROLLED TRIAL
Elena López-Cancio, Tudor G Jovin, Erik Cobo, Neus Cerdá, Marta Jiménez, Meritxell Gomis, María Hernández-Pérez, Cynthia Cáceres, Pere Cardona, Blanca Lara, Arturo Renú, Laura Llull, Sandra Boned, Marian Muchada, Antoni Dávalos
OBJECTIVE: To investigate the effect of endovascular treatment on cognitive function as a prespecified secondary analysis of the REVASCAT (Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours) trial. METHODS: REVASCAT randomized 206 patients with anterior circulation proximal arterial occlusion stroke to Solitaire thrombectomy or best medical treatment alone. Patients with established dementia were excluded from enrollment...
January 17, 2017: Neurology
https://www.readbyqxmd.com/read/27920715/intra-arterial-mechanical-thrombectomy-an-effective-treatment-for-ischemic-stroke-caused-by-endocarditis
#8
Olafur Sveinsson, Lars Herrman, Staffan Holmin
Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#9
Pervinder Bhogal, Marta Aguilar Pérez, Rosa Martinez Moreno, Marcin Miś, Maciej Miś, Hans Henkes
Objective The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. Methods Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27781037/rescue-thrombectomy-in-large-vessel-occlusion-strokes-leads-to-better-outcomes-than-intravenous-thrombolysis-alone-a-real-world-applicability-of-the-recent-trials
#10
Raul G Nogueira, Osama O Zaidat, Alicia C Castonguay, Diogo C Haussen, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Albert J Yoo, Hashem Shaltoni, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Roberta Novakovic, Ashish Nanda, Ritesh Kaushal, Mohammad A Issa, Michael R Frankel, Rishi Gupta
BACKGROUND: The Interventional Management of Stroke III (IMS-III) trial demonstrated no benefit for intravenous recombinant tissue plasminogen activator (IV rt-PA) followed by endovascular therapy versus IV rt-PA alone. However, IMS-III mostly included earlier generation devices. The recent thrombectomy trials have incorporated the stent-retriever technology, but their generalizability remains unknown. METHODS: The North American Solitaire Acute Stroke (NASA) registry recruited patients treated with the Solitaire FR™ device between March 2012 and February 2013...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27758942/cost-effectiveness-of-endovascular-stroke-therapy-a-patient-subgroup-analysis-from-a-us-healthcare-perspective
#11
Wolfgang G Kunz, M G Myriam Hunink, Wieland H Sommer, Sebastian E Beyer, Felix G Meinel, Franziska Dorn, Stefan Wirth, Maximilian F Reiser, Birgit Ertl-Wagner, Kolja M Thierfelder
BACKGROUND AND PURPOSE: Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients' initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location. METHODS: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with both strategies applied in a US setting...
November 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27717502/single-center-experience-of-stent-retriever-thrombectomy-in-acute-ischemic-stroke
#12
Marcin Wiącek, Rafał Kaczorowski, Jarosław Homa, Edward Filip, Janusz Darocha, Daniel Dudek, Wiesław Guz, Halina Bartosik-Psujek
BACKGROUND AND PURPOSE: Recently, positive data from several randomized controlled trials (RCTs) of endovascular therapy for acute ischemic stroke (AIS) has emerged. The aim of this retrospective study is to present our clinical experience in cerebral vessel occlusion treatment using retrievable intracranial stents. METHODS: Forty-three consecutive patients with ischemic stroke (median age 75, range 22-87) treated by stent retriever thrombectomy (Solitaire™ FR) between January 2013 and December 2015 were identified...
January 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27683226/mechanical-thrombectomy-in-patients-with-tumour-related-ischaemic-stroke
#13
Tobias Zander, Javier Maynar, Fernando López-Zárraga, Rogelio Herrera, Juan José Timiraos-Fernández, Andrea Saraceni, Manuel Maynar
Ischaemic stroke is a common cause of death and incapacity and is related in most cases to vascular disease. Intracranial vessel occlusion due to tumour emboli is a rare entity and adequate treatment for this condition is not defined. The use of mechanical thrombectomy devices is considered the treatment of choice for major intracranial vessel occlusion; however, no recommendation can be made in the case of tumour thrombembolia. This report describes two cases who presented with a middle cerebral artery occlusion due to tumour emboli and that were treated using the Solitaire thrombectomy device...
December 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27651872/treatment-of-the-superior-sagittal-sinus-thrombosis-with-the-mechanical-thrombectomy-using-stent-retriever-device
#14
Hoon Kim, Seong Rim Kim, Ik Seong Park, Young Woo Kim
Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment...
September 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27634952/association-of-clot-burden-score-with-radiographic-and-clinical-outcomes-following-solitaire-stent-retriever-thrombectomy-analysis-of-the-swift-prime-trial
#15
Maxim Mokin, Elad I Levy, Adnan H Siddiqui, Mayank Goyal, Raul G Nogueira, Dileep R Yavagal, Vitor M Pereira, Jeffrey L Saver
BACKGROUND: The clot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. CBS is based on the presence or absence of contrast opacification on CT angiography (CTA). Its value in predicting radiographic and clinical outcomes in patients given endovascular stroke therapy remains unknown. OBJECTIVE: To evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial...
September 15, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27601379/influence-of-device-choice-on-the-effect-of-intra-arterial-treatment-for-acute-ischemic-stroke-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-for-acute-ischemic-stroke-in-the-netherlands
#16
RANDOMIZED CONTROLLED TRIAL
Diederik W Dippel, Charles B Majoie, Yvo B Roos, Aad van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Hester F Lingsma, Peter J Koudstaal, Kilian M Treurniet, Lucie A van den Berg, Debbie Beumer, Puck S Fransen, Olvert A Berkhemer
BACKGROUND AND PURPOSE: Intra-arterial treatment by means of retrievable stents has been proven safe and effective. In MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), the choice of the type of thrombectomy device was left to the discretion of the interventionist. The aim of this study was to explore the differences in functional outcome, neurological recovery, reperfusion, extent of infarction, and adverse events according to stent type and make...
October 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27540091/solitaire-stentectomy-deploy-and-engage-and-loop-and-snare-techniques
#17
Rajsrinivas Parthasarathy, Vipul Gupta, Gaurav Goel, Anshu Mahajan
Solitaire FR stent-based mechanical thrombectomy provides clinical benefit in selected patients with acute ischaemic stroke due to large vessel occlusion. A dreaded device complication that is associated with poor technical and clinical outcome is stent detachment. Retrieval of the detached stent can be technically challenging and has been attempted with variable success. The key benefit of this strategy is the lack of need to administer fibrinolytic/antiplatelet agents that can potentially be catastrophic in the setting of acute stroke...
August 18, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27520994/solitaire-stentectomy-deploy-and-engage-and-loop-and-snare-techniques
#18
Rajsrinivas Parthasarathy, Vipul Gupta, Gaurav Goel, Anshu Mahajan
Solitaire FR stent-based mechanical thrombectomy provides clinical benefit in selected patients with acute ischaemic stroke due to large vessel occlusion. A dreaded device complication that is associated with poor technical and clinical outcome is stent detachment. Retrieval of the detached stent can be technically challenging and has been attempted with variable success. The key benefit of this strategy is the lack of need to administer fibrinolytic/antiplatelet agents that can potentially be catastrophic in the setting of acute stroke...
August 12, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27387708/a-comparison-of-acute-vascular-damage-caused-by-adapt-versus-a-stent-retriever-device-after-thrombectomy-in-acute-ischemic-stroke-a-histological-and-ultrastructural-study-in-an-animal-model
#19
S Peschillo, F Diana, J Berge, P Missori
BACKGROUND: It has been amply demonstrated that endovascular procedures can be successful treatment for stroke, both in terms of revascularization and clinical outcome. There is not, however, a published comparison of any histological or ultrastructural damage to the vessels that may be caused by a direct aspiration first pass technique (ADAPT) or stent retrievers (SR) used in these procedures. This study analyses and compares acute damage to the arterial wall caused by ADAPT or SR. MATERIAL AND METHODS: Damage to the walls of swine extracranial arteries was evaluated after ADAPT with the Penumbra system or thrombectomy with an SR (Solitaire 6×30)...
July 7, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27312281/mechanical-thrombectomy-with-the-solitaire-ab-stent-for-treatment-of-acute-basilar-artery-occlusion-a-single-center-experience
#20
Shiwei Du, Gengsheng Mao, Dongmei Li, Ming Qiu, Qingbin Nie, Haibo Zhu, Yang Yang, Youping Zhang, Youxiang Li, Zhongxue Wu
Basilar artery occlusion (BAO) remains one of the most devastating subtypes of ischemic stroke, and prognosis is poor if early recanalization is not achieved. The purpose of this study was to evaluate the safety and technical feasibility of mechanical thrombectomy with the Solitaire AB stent (Covidien, Irvine, CA, USA) for the treatment of acute BAO through a single-center experience. Twenty-one patients with acute BAO were treated with mechanical thrombectomy with the Solitaire AB stent device between 1st September 2011 and 1st December 2014...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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