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https://www.readbyqxmd.com/read/28938644/intravascular-ultrasound-guidance-in-drug-eluting-stents-implantation-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#1
Cheng Qian, Hong Feng, Jianlei Cao, Guangyu Zhang, Yanggan Wang
OBJECTIVE: Previous evidence suggested that intravascular ultrasound (IVUS) guidance could improve outcomes after drug-eluting stents (DES) placement, largely driven by data from observational studies. We, therefore, performed a meta-analysis and trial sequential analysis of randomized controlled trials to overcome this limitation. RESULTS: The retrieval process yielded 7 RCTs with 3,192 patients. Compared to the angiography guidance, IVUS-guided DES implantation was associated with a significant reduction in the major adverse cardiac events (MACE) (OR 0...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28904450/acute-ischemic-stroke-treatment-using-mechanical-thrombectomy-a-study-of-137-patients
#2
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#3
Waleed Brinjikji, Jeffrey Pasternak, Mohammad H Murad, Harry J Cloft, Tasha L Welch, David F Kallmes, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28895453/extracranial-internal-carotid-artery-vasospasm-during-thrombectomy
#4
Isamu Miura, Akitsugu Kawashima, Masataka Hayashi, Akane Tanda, Tomomi Ishikawa, Takakazu Kawamata
The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient's National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28893465/recurrent-benign-urethral-strictures-treated-with-covered-retrievable-self-expandable-metallic-stents-long-term-outcomes-over-an-18-year-period
#5
Min Tae Kim, Kun Yung Kim, Ho-Young Song, Jung-Hoon Park, Jiaywei Tsauo, Zhe Wang, Pyeong Hwa Kim
PURPOSE: To assess the long-term outcomes of covered retrievable self-expandable metallic stent (REMS) placement for recurrent benign urethral stricture and to compare the outcomes associated with 3 types of covered REMSs. MATERIALS AND METHODS: A retrospective study was performed in 54 male patients in whom 114 REMSs were placed between November 1998 and December 2016. These included 26 polyurethane-covered REMSs in 13 patients (group A), 47 internally polytetrafluoroethylene (PTFE)-covered REMSs in 21 patients (group B), and 41 externally PTFE-covered REMSs in 20 patients (group C)...
September 8, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28881894/outcomes-following-the-main-treatment-options-in-patients-with-a-leaking-esophagus-a-systematic-literature-review
#6
S Persson, I Rouvelas, T Irino, L Lundell
Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28878444/experimental-evaluation-and-training-of-stent-clot-retrieval-the-confront-clot-scrambling-method
#7
Tomotaka Ohshima, Shunsaku Goto, Taiki Yamamoto, Kojiro Ishikawa
The introduction of stent retrievers has changed the methods used for acute intracranial thrombectomy, but the training approach has not been discussed enough. We, therefore, aimed to establish a simple skill up method which can be used to train anytime and anywhere with low costs. Also, we introduce our experimental confront clot scrambling method (CCSM) which makes a profitable visualization in how the stent retriever works. The CCSM involved a sham clot set in the middle of a polyvinyl chloride tube, after which two stent retrievers were navigated from each side before being simultaneously withdrawn with the same force...
August 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28864867/safety-of-the-solitaire-4%C3%A2-%C3%A3-%C3%A2-40%C3%A2-mm-stent-retriever-in-the-treatment-of-ischemic-stroke
#8
Felix Zibold, Pasquale Mordasini, Pascal Mosimann, Eike Piechowiak, Tomas Dobrocky, Urs Fischer, Marcel Arnold, Sebastian Bellwald, Jan Gralla
PURPOSE: Stent retrievers apply mechanical force to the intracranial vasculature. Our aim was to evaluate the safety and efficacy of the long Solitaire 4 × 40 mm stent retriever for large vessel occlusion in stroke patients. METHODS: We conducted a retrospective analysis of all patients treated for acute ischemic large vessel occlusion stroke with the Solitaire 2 FR 4 × 40 device between May and October 2016 at our institution. Patient-specific data at baseline and at discharge were documented...
September 1, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28864601/predictive-value-of-computed-tomography-angiography-determined-occlusion-type-in-stent-retriever-thrombectomy
#9
Jang-Hyun Baek, Byung Moon Kim, Joonsang Yoo, Hyo Suk Nam, Young Dae Kim, Dong Joon Kim, Ji Hoe Heo, Oh Young Bang
BACKGROUND AND PURPOSE: We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. METHODS: Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment...
September 1, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28863285/endovascular-treatment-of-acute-ischemic-stroke-in-octogenarians-a-meta-analysis-of-observational-studies
#10
Jin Pyeong Jeon, Sung-Eun Kim, Chul Ho Kim
OBJECTIVES: The aim of this study is to compare procedural outcomes after endovascular treatment (EVT) according to age (≥80 years vs. <80 years) and to examine treatment outcomes after mechanical thrombectomy using a stent retriever between the different age groups. PATIENTS AND METHODS: A systemic literature review of an online database of articles published from January 2004 to February 2017 was conducted. The primary outcome was successful recanalization in the final angiogram and symptomatic intracranial hemorrhage (S-ICH) after EVT...
August 29, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28860909/anatomical-and-functional-outcomes-of-canalicular-laceration-repair-with-self-retaining-mini-monoka-stent
#11
Md Shahid Alam, Neha Shrirao Mehta, Bipasha Mukherjee
AIM: To evaluate the anatomical and functional outcomes of canalicular laceration repair with self retaining monocanalicular intubation system (Mini-MONOKA). MATERIALS AND METHODS: The data of 29 patients undergoing canalicular laceration repair from 2010 to 2014 were retrospectively analyzed. Operative details and complications were noted. The stent was removed earliest at 3 months. Anatomical and functional success was defined by a patent syringing and the absence of epiphora respectively...
July 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28845749/patterns-of-acute-ischemic-strokes-after-carotid-endarterectomy-and-therapeutic-implications
#12
Fabien Lareyre, Juliette Raffort, Caroline Weill, Claire Marsé, Laurent Suissa, Julien Chikande, Réda Hassen-Khodja, Elixène Jean-Baptiste
AIM: Acute ischemic strokes following surgical treatment of carotid stenosis lead to substantial disability and mortality, and vascular mechanisms underlying their development are not fully elucidated. The goal of this study was to analyze the topographic patterns of acute ischemic stroke following carotid endarterectomy (CEA) on diffusion-weighted and perfusion-weighted magnetic resonance imaging (MRI). MATERIAL AND METHODS: Data were retrospectively collected from consecutive patients who underwent CEA and developed postoperative acute ischemic stroke...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28844911/endovascular-mechanical-thrombectomy-for-acute-middle-cerebral-artery-m2-segment-occlusion-a-systematic-review
#13
REVIEW
Ching-Jen Chen, Connor Wang, Thomas J Buell, Dale Ding, Daniel M Raper, Natasha Ironside, Gabriella M Paisan, Robert M Starke, Andrew M Southerland, Kenneth Liu, Bradford B Worrall
INTRODUCTION: The benefit of endovascular mechanical thrombectomy (EMT) for acute distal occlusions of the middle cerebral artery M2 segment is incompletely defined. The aim of this systematic review is to analyze the recent literature regarding EMT for acute M2 occlusions. METHODS: We reviewed the literature to identify all studies of patients with acute M2 occlusions who underwent EMT which were published after January 1, 2015. Excellent and good outcomes were defined as modified Rankin Scale of 0-1 and 0-2 at 3 months, respectively...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28844524/mechanical-thrombectomy-for-pediatric-acute-stroke-and-ventricular-assist-device
#14
Robert Clinton Stowe, Peter Kan, Day Burruss Breen, Sonika Agarwal
BACKGROUND: Certain pediatric populations have increased risk of ischemic strokes, including those with cardiac disease and those dependent on mechanical circulatory devices such as ventricular assist devices. Due to their need for chronic anticoagulation, patients with mechanical circulatory devices are not candidates for systemic thrombolysis and thus treatment of acute ischemic stroke is limited. CASE: A 9-year-old boy with a ventricular assist device presented with acute onset of dense right hemiparesis, global aphasia, and a pediatric NIHSS score of 23...
August 24, 2017: Brain & Development
https://www.readbyqxmd.com/read/28843804/intra-arterial-alteplase-thrombolysis-during-mechanical-thrombectomy-for-acute-ischemic-stroke
#15
Daniel M Heiferman, Daphne D Li, Nathan C Pecoraro, Angela M Smolenski, Asterios Tsimpas, William W Ashley
BACKGROUND: Intra-arterial alteplase (IA tPA) is commonly used during mechanical thrombectomy for acute ischemic stroke in patients with large-vessel occlusion, but specific indications and applications for its use remain undefined. METHODS: We analyzed 40 patients who underwent stent-retriever mechanical thrombectomy, 28 of whom received adjunctive IA tPA. To our knowledge, this is the largest cohort with this concomitant treatment reported in the literature in the post-mechanical thrombectomy trial era...
August 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28843801/endovascular-stroke-treatment-of-patients-over-80-years-old-cumulative-evidence-from-the-real-world
#16
Sofia Figueiredo, Andreia Carvalho, Marta Rodrigues, André Cunha, Ludovina Paredes, Henrique Costa, Pedro Barros, Tiago Gregório, Manuel Ribeiro, Sérgio Castro, Miguel Veloso
BACKGROUND: Evidence on stent retriever-based thrombectomy (SRT) efficacy in elderly patients is controversial. This study aimed to analyze safety and efficacy outcomes in octogenarians submitted to SRT. METHODS: Analysis was based on a prospective observational registry of patients with stroke because of anterior circulation large-vessel occlusion treated with SRT at our center between January 2015 and September 2016. Patients were dichotomized into 2 age groups: ≤80 and >80 years old...
August 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28833513/application-of-an-enhanced-device-to-transluminal-retrieval-of-malappositioned-coronary-stents-an-experimental-study
#17
Masayuki Mori, Kenji Sakata, Junichiro Yokawa, Chiaki Nakanishi, Hirofumi Okada, Masaya Shimojima, Shohei Yoshida, Tsuyoshi Yoshimuta, Kenshi Hayashi, Masakazu Yamagishi, Masa-Aki Kawashiri
OBJECTIVES: This study investigated the application of a novel enhanced device to retrieval of deployed stents in a porcine coronary model. BACKGROUND: Recurrence of in-stent restenosis and stent thrombosis still remains to be resolved. Under these conditions, it is sometimes necessary to retrieve malfunctional stents responsible for thrombosis. However, few data exist regarding the feasibility and safety of retrieval device use in previously deployed coronary stents...
August 21, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28830971/systematic-evaluation-of-patients-treated-with-neurothrombectomy-devices-for-acute-ischemic-stroke-primary-results-of-the-stratis-registry
#18
Nils H Mueller-Kronast, Osama O Zaidat, Michael T Froehler, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P Klucznik, Jeffrey L Saver, Frank R Hellinger, Dileep R Yavagal, Tom L Yao, David S Liebeskind, Ashutosh P Jadhav, Rishi Gupta, Ameer E Hassan, Coleman O Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G Nogueira, Ravi H Gandhi, Eric C Peterson, Shervin R Dashti, Curtis A Given, Brijesh P Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H McPherson, Peter Kvamme, Thomas J Grobelny, Muhammad S Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J Monteith, Robert D Ecker, Clemens M Schirmer, Eric Sauvageau, Alex Abou-Chebl, Colin P Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H Siddiqui, Travis M Dumont, Abdulnasser Alhajeri, M Asif Taqi, Khaled Asi, Jeffrey Carpenter, Alan Boulos, Gaurav Jindal, Ajit S Puri, Rohan Chitale, Eric M Deshaies, David H Robinson, David F Kallmes, Blaise W Baxter, Mouhammad A Jumaa, Peter Sunenshine, Aniel Majjhoo, Joey D English, Shuichi Suzuki, Richard D Fessler, Josser E Delgado Almandoz, Jerry C Martin, Diogo C Haussen
BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. METHODS: STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset...
August 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28828203/misaligned-pconus-device-case-report-of-a-unique-complication
#19
Krishna Prasad Bellam Premnath, Gigy Kuruttukulam, Anil Kumar Shivan
pCONus is a stent-like endovascular device which aids in retention of coils within wide-necked bifurcation aneurysms. It is retrievable even after complete deployment and is detached electrolytically. The pCONus aided coiling of wide-necked bifurcation aneurysms has a high technical success rate and a good safety profile. Different complications have been described in literature with the usage of pCONus. This case report describes a unreported complication of inappropriately deployed pCONus device.
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28826861/single-center-experience-of-mechanical-thrombectomy-with-the-trevo-xp-provue-6%C3%A3-25-mm-stent-retriever-in-mca-occlusion-comparison-with-trevo-xp-provue-4%C3%A3-20-mm
#20
Ho Jun Yi, Jae Hoon Sung, Dong Hoon Lee, Jae Taek Hong, Sang Won Lee
BACKGROUND: There are a few studies assessing the suitable stent size for mechanical thrombectomy in MCA occlusion. So, the authors attempted to determine what size of a stent is suitable for thrombectomy in MCA occlusion through a comparison of Trevo XP 6×25 mm and 4×20 mm stents. METHODS: The authors changed Trevo XP 4×20 mm stent to Trevo XP 6×25 mm stents for thrombectomy in MCA occlusion with the hypothesis that larger size stent would make better outcomes...
August 18, 2017: World Neurosurgery
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