2,486 results match your criteria Mechanical Thrombolysis in Acute Stroke

Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report.

Children (Basel) 2022 Jun 12;9(6). Epub 2022 Jun 12.

Department of Pediatric Neurology, Oregon Health & Science University, Portland, OR 97239, USA.

Thoracic outlet syndrome (TOS) is a condition that results from the compression of neurovascular structures as they exit the thorax. Arterial ischemic stroke can occur in TOS due to retrograde embolism from the subclavian artery. We describe a 15-year-old girl who presented with left hemiplegia after 2 weeks of right arm numbness and tingling. Read More

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Visualization of the Anterior Temporal Artery as a Predictor of Outcome in Middle Cerebral Artery Occlusion Patients Achieving Successful Recanalization After Transfer.

Cureus 2022 May 20;14(5):e25173. Epub 2022 May 20.

Neurological Surgery, Carolina Neurosurgery & Spine Associates, Charlotte, USA.

Introduction Anterior temporal artery (ATA) visualization on computed tomography angiography (CTA) has been previously associated with good outcomes in middle cerebral artery (MCA) occlusions, but not in the setting of patients who initially present to non-thrombectomy centers. Methods We retrospectively identified acute MCA (M1) occlusion patients who underwent mechanical thrombectomy after transfer from non-thrombectomy-capable centers. Neuroradiologists confirmed the MCA (M1) as the most proximal site of occlusion on CTA and assessed for visualization of the ATA. Read More

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Recent advances in intra-arterial thrombolysis.

Ann Indian Acad Neurol 2008 Jan;11(Suppl 1):S30-S38

Department of Neurology, Neurocritical Care and Vascular Neurology, Baylor College of Medicine, Houston, TX, USA.

Thrombolytic therapy has revolutionized acute ischemic stroke (AIS) treatment; however it is clear that intravenous (IV) thrombolytic therapy has certain limitations, including a short-time window for use, poor specificity for the site of arterial occlusion, and suboptimal recanalization rates. Some of these problems may be circumvented by using intra-arterial (IA) thrombolysis. In this article, we will discuss the various thrombolytic agents being used in AIS, their mechanisms of actions and doses, and the rationale for use of IA therapy as opposed to IV thrombolysis, and review the clinical trials using IA thrombolysis. Read More

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January 2008

Extracorporeal Membrane Oxygenation-First Strategy for Acute Life-Threatening Pulmonary Embolism.

Front Cardiovasc Med 2022 3;9:875021. Epub 2022 Jun 3.

Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Background: Both venoarterial extracorporeal membrane oxygenation (VA-ECMO) and percutaneous mechanical thrombectomy (PMT) are increasingly used to treat acute life-threatening pulmonary embolism (PE). However, there are little data regarding their effectiveness. This study aimed to present the short-term outcomes after managing nine patients with acute life-threatening massive or submassive PE by VA-ECMO with or without complemented PMT and propose a preliminary treatment algorithm. Read More

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Initial high NIHSS and any intracranial hemorrhage are independent factors for poor outcome in nonagenarians treated with thrombectomy for acute large vessel occlusion: the Tokyo/Tama-REgistry of Acute endovascular Thrombectomy (TREAT) study.

World Neurosurg 2022 Jun 15. Epub 2022 Jun 15.

Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan.

Background: Mechanical thrombectomy (MT) is effective in acute ischemic stroke patients ≥80 years old with large vessel occlusion (LVO). However, data for patients ≥90 years old remain very limited and factors influencing functional outcome are unclear. This study aimed to investigate factors influencing functional outcomes in patients ≥90 years old treated with MT for acute LVO. Read More

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Mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion in Argentina: An economic analysis.

J Stroke Cerebrovasc Dis 2022 Jun 15;31(8):106595. Epub 2022 Jun 15.

Health Economics, Policy and Reimbursement, Medtronic South Latin-America, 532 Rosario Norte Street, Las Condes, Chile. Electronic address:

Objectives: Mechanical thrombectomy (MT) after intravenous thrombolysis (IV-tPA) is an effective and cost-saving treatment for stroke due to large vessel occlusion. However, rates of MT use are low in Argentina. This study was designed to estimate the economic value and the budget impact of incorporating MT after thrombolysis, simulating scenarios from Argentinian compulsory social health insurance (Obras Sociales) and private insurances (Empresas de Medicina Prepaga). Read More

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Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion.

Front Neurol 2022 27;13:894173. Epub 2022 May 27.

Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany.

Introduction: Acute symptomatic seizures (ASz) after ischemic stroke are associated with increased mortality; therefore, identifying predictors of ASz is important. The purpose of this study was to analyze predictors of ASz in a population of patients with ischemic stroke due to large arterial vessel occlusion (LVO).

Materials And Methods: This retrospective study examined patients with acute ischemic stroke caused by LVO between 2016 and 2020. Read More

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Acute Neurointervention for Ischemic Stroke.

Interv Cardiol Clin 2022 Jul;11(3):339-347

Division of Vascular Neurology, Department of Neurology, Harris Comprehensive Stroke Center, Henry Ford Health System, Clara Ford Pavillion, Room 453, 2799 W Grand Boulevard, Detroit, MI 48202, USA. Electronic address:

Acute ischemic stroke (AIS) is one of the major causes of death worldwide and a leading cause of disability. Until recently treatment of AIS was supportive, and in a minority of patients intravenous thrombolysis was available but with marginal clinical benefit. With the advent of stent retrievers, distal aspiration catheters as well as improved patient selection neurologic outcomes have greatly improved. Read More

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Quality of Life in the First Year after Ischemic Stroke Treated with Acute Revascularization Therapy.

J Clin Med 2022 Jun 6;11(11). Epub 2022 Jun 6.

Dijon Stroke Registry, EA7460, University of Burgundy, 21000 Dijon, France.

(1) Background: we aimed to describe the disease-specific quality of life (QoL) of ischemic stroke patients treated with acute revascularization therapy, its evolution from 6 months to 12 months, and associated factors. (2) Methods: QoL was assessed with the SS-QoL in consecutive patients treated with either intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT). Variables associated with QoL scores and its evolution were studied using multivariate mixed models, and interaction with time. Read More

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Pregnancy-Related Stroke: A Review.

Obstet Gynecol Surv 2022 Jun;77(6):367-378

Professor, MFM Director, Vice-Chair Research and Education, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR.

Importance: The maternal risk of strokes in the United States is approximately 30/100,000 pregnancies, and strokes are the eighth leading cause of maternal death. Because of the relationship between stroke and significant neurological disability/maternal death, obstetrical health care providers must be able to identify, evaluate, diagnosis, and treat these women.

Evidence Acquisition: PubMed was searched using the search terms "stroke" OR "cerebrovascular accident" OR "intracranial hemorrhage" AND "pregnancy complications" OR "risk factors" OR "management" OR "outcome. Read More

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Thrombosis origin identification of cardioembolism and large artery atherosclerosis by distinct metabolites.

J Neurointerv Surg 2022 Jun 2. Epub 2022 Jun 2.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China

Background: The diagnosis of cerebral thrombosis origin is challenging and remains unclear. This study aims to identify thrombosis due to cardioembolism (CE) and large artery atherosclerosis (LAA) from a new perspective of distinct metabolites.

Methods: Distinct metabolites between 26 CE and 22 LAA origin thrombi, which were extracted after successful mechanical thrombectomy in patients with acute ischemic stroke in the anterior circulation, were analyzed with a ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) system. Read More

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Mechanical thrombectomy failure in anterior circulation strokes: Outcomes and predictors of favorable outcome.

Eur J Neurol 2022 Jun 1. Epub 2022 Jun 1.

Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nantes, Nantes, France.

Background And Purpose: Despite continuous improvement and growing knowledge in the endovascular therapy of large vessel occlusion stroke (LVOS), mechanical thrombectomy (MT) still fails to obtain satisfying intracranial recanalization in 10% to 15% of cases. However, little is known regarding clinical and radiological outcomes among this singularly underexplored subpopulation undergoing failed MT. We aimed to investigate the outcome after failed MT and identify predictive factors of favorable outcome despite recanalization failure. Read More

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Did the severity of the COVID-19 outbreak affect the quality of acute stroke care? (Data from across the country).

Eur Stroke J 2022 Jun 6;7(2):175-179. Epub 2022 Apr 6.

National Health Information Centre, Bratislava, Slovakia.

Introduction: The aim of our study was to determine whether the severity of the COVID-19 pandemic affected the quality of acute care of stroke.

Methods: Data from the stroke register at the National Health Information Centre were analysed. Clinical data from two time periods (the first wave: March-April 2020; the second wave: October-November 2020) were compared using an independent sample -test and the Wilcoxon-Mann-Whitney two sample rank-sum test. Read More

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Pressor therapy in acute ischaemic stroke: an updated systematic review.

Eur Stroke J 2022 Jun 2;7(2):99-116. Epub 2022 Mar 2.

Stroke, Department of Acute Medicine, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Background: Low blood pressure (BP) in acute ischaemic stroke (AIS) is associated with poor functional outcome, death, or severe disability. Increasing BP might benefit patients with post-stroke hypotension including those with potentially salvageable ischaemic penumbra. This updated systematic review considers the present evidence regarding the use of vasopressors in AIS. Read More

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Changes in nationwide in-hospital stroke care during the first four waves of COVID-19 in Germany.

Eur Stroke J 2022 Jun 7;7(2):166-174. Epub 2022 Apr 7.

Department of Neurosurgery, HELIOS Hospital Erfurt, Erfurt, Germany.

Introduction: In the early stages of the global COVID-19 pandemic hospital admissions for acute ischemic stroke (AIS) decreased substantially. As health systems have become more experienced in dealing with the pandemic, and as the proportion of the population vaccinated rises, it is of interest to determine whether the prevalence of AIS hospitalization and outcomes from hospitalization have returned to normal.

Patients And Methods: In this observational, retrospective cohort study, we compared the prevalence and outcomes of AIS during the first four waves of the pandemic to corresponding pre-pandemic periods in 2019 using administrative data collected from a nationwide network of 76 hospitals that manages 7% of all in-hospital cases in Germany. Read More

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Sex differences in outcome after thrombectomy for acute ischemic stroke. A propensity score-matched study.

Eur Stroke J 2022 Jun 7;7(2):151-157. Epub 2022 Apr 7.

Hospital Fazzi, Lecce, Italy.

Background And Purpose: We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients.

Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set. Read More

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European Stroke Organisation guidelines on stroke in women: Management of menopause, pregnancy and postpartum.

Eur Stroke J 2022 Jun 29;7(2):I-XIX. Epub 2022 Mar 29.

Stroke Unit, Santa Maria della Misericordia Hospital, University of Perugia Perugia, Italy.

Pregnancy, postpartum and menopause are regarded as periods women are more vulnerable to ischaemic events. There are conflicting results regarding stroke risk and hormone replacement therapy (HRT) during menopause. Stroke in pregnancy is generally increasing with serious consequences for mother and child; therefore, recommendations for acute treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) are needed. Read More

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Prognostic Accuracy of CTP Summary Maps in Patients with Large Vessel Occlusive Stroke and Poor Revascularization after Mechanical Thrombectomy-Comparison of Three Automated Perfusion Software Applications.

Tomography 2022 05 17;8(3):1350-1362. Epub 2022 May 17.

Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany.

Background: Innovative automated perfusion software solutions offer support in the management of acute stroke by providing information about the infarct core and penumbra. While the performance of different software solutions has mainly been investigated in patients with successful recanalization, the prognostic accuracy of the hypoperfusion maps in cases of futile recanalization has hardly been validated.

Methods: In 39 patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) in the anterior circulation and poor revascularization (thrombolysis in cerebral infarction (TICI) 0-2a) after mechanical thrombectomy (MT), hypoperfusion analysis was performed using three different automated perfusion software solutions (A: RAPID, B: Brainomix e-CTP, C: Syngo. Read More

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BOBBY balloon guide catheter thrombectomy in large-vessel occlusion stroke: Initial experience.

Interv Neuroradiol 2022 May 30:15910199221104920. Epub 2022 May 30.

Department of Radiology, Neurosurgery and Neurology, 5635University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.

Background And Purpose: Nonrandomized studies have found Balloon Guide Catheter (BGC) use to improve technical and functional outcomes in patients undergoing mechanical thrombectomy (MT).

Materials And Methods: We performed a retrospective analysis on prospectively collected data of consecutive ischemic stroke patients undergoing MT at our institution (December 2020-October 2021). Interventions where BOBBY BGC (BBGC, ) was used were identified. Read More

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Utility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke.

Interv Neuroradiol 2022 May 31:15910199221084483. Epub 2022 May 31.

Department of Neurosurgery, 12306The Ohio State University Medical Center, 410 W 10th Ave., Columbus, Ohio 43210.

Background: A number of large bore guide catheters are currently available for use in neuroendovascular surgery. This study represents a multi-institutional retrospective series of patients undergoing mechanical thrombectomy with the use of a TracStar Large Distal Platform (LDP) guide catheter and assessed its performance in vivo in 107 patients.

Objective: To review a multi-institutional initial experience with the TracStar LDP guide catheter during mechanical thrombectomy for emergent large vessel occlusion (ELVO). Read More

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Thrombectomy aspiration post-market study in acute stroke with the Q aspiration catheter: the TAPAS study.

J Neurointerv Surg 2022 May 31. Epub 2022 May 31.

Department of Interventional Neuroradiology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.

Background: The Q Aspiration Catheter (MIVI Neuro) has demonstrated greater aspiration flow rates and ingestion forces compared with conventional catheters in vitro. The safety and performance of the Q Catheter was assessed using a direct aspiration first pass technique in patients with acute ischemic stroke at four neurointerventional centers in Spain.

Methods: We included adult patients who underwent mechanical thrombectomy between March 2019 and March 2020 using the Q Catheter as first-line therapy. Read More

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Predictors of Radiographic and Symptomatic Hemorrhagic Conversion Following Endovascular Thrombectomy for Acute Ischemic Stroke Due to Large Vessel Occlusion.

Cureus 2022 Apr 24;14(4):e24449. Epub 2022 Apr 24.

Neurological Surgery, Montefiore Medical Center, New York, USA.

Background Endovascular therapy is known to achieve a high rate of recanalization in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) and is currently the standard of care. Hemorrhagic conversion is a severe complication that may occur following AIS in patients undergoing endovascular thrombectomy (EVT). There is a scarcity of data on the risk factors related to HV in post-EVT patients, especially those who develop symptomatic hemorrhagic conversion. Read More

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Higher number of stent-retriever thrombectomy passes significantly increases risk of mass effect, poor functional outcome, and mortality.

Interv Neuroradiol 2022 May 30:15910199221104624. Epub 2022 May 30.

Clinical Research Department, 21755Valley Baptist Medical Center, Harlingen, TX, United States.

Introduction: Endovascular treatment (EVT) is a widely proven method to treat patients diagnosed with intracranial large vessel occlusion (LVO). Through this method of treatment, it has been hypothesized that a lower number of thrombectomy passes is an indicator of higher rates of modified Thrombolysis in Cerebral Infarction 2B-3 (mTICI) reperfusion and favorable outcomes at 90-days defined as modified Rankin Scale 0-2 (mRS).

Methods: Through the utilization of a prospectively collected endovascular database between 2012-2020, variables such as demographics, co-morbid conditions, intracerebral hemorrhage, mass effect, mortality rate, and good/poor outcomes regarding mTICI score and mRS assessment at 90-days were examined. Read More

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The importance of CT perfusion for diagnosis and treatment of ischemic stroke in anterior circulation.

J Integr Neurosci 2022 May;21(3):92

Department of Clinical Neurosciences, Faculty of Medicine, University Ostrava, 70800 Ostrava, Czech Republic.

Computed tomography perfusion (CTP) is a functional examination of brain tissue that characterises the state of cerebral perfusion and provides information about the current status of the circulation. CTP can improve diagnostic accuracy of ischemic stroke. Published studies showed that perfusion imaging improves the prognosis of patients with acute ischemic stroke in anterior circulation and allows patients to be referred for treatment outside the time window for administration of intravenous thrombolysis (IVT) or mechanical thrombectomy (MT). Read More

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The Impact of Diabetes Mellitus and Admission Hyperglycemia on Clinical Outcomes after Recanalization Therapies for Acute Ischemic Stroke: STAY ALIVE National Prospective Registry.

Life (Basel) 2022 Apr 25;12(5). Epub 2022 Apr 25.

Department of Neurology, Medical School, University of Pecs, 7624 Pecs, Hungary.

It was previously reported that diabetes mellitus (DM) and admission hyperglycemia (aHG) were associated with poor clinical outcomes in patients with acute ischemic stroke (AIS) who were treated with intravenous thrombolysis (IVT) or mechanical thrombectomy (MT). Our study aimed to assess the prognostic effect of DM and aHG (≥7.8 mmol/L) on clinical outcomes in patients treated with recanalization therapies (IVT and MT). Read More

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Effect of mechanical thrombectomy with vs. without intravenous thrombolysis in acute ischemic stroke.

Clin Ter 2022 May;173(3):257-264

Radiology Center, Bach Mai Hospital, Hanoi, Vietnam.

Background: The results of mechanical thrombectomy (MT), wi-thout or with intravenous thrombolysis, were evaluated and compared in 178 patients with acute ischemic stroke (AIS) due to large vessel occlusions (LVO) at Bach Mai Hospital.

Methods: A total of 178 patients with AIS due to LVO were assigned to undergo MT alone (MT-alone group) or MT preceded by intravenous alteplase (the combined group), at a dose of 0.9 mg per kilogram, administered within 4. Read More

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Disparities in Stroke Patient-Reported Outcomes Measurement Between Healthcare Systems in Brazil.

Front Neurol 2022 6;13:857094. Epub 2022 May 6.

Hospital Moinhos de Vento, Porto Alegre, Brazil.

Introduction: Acute stroke interventions, such as stroke units and reperfusion therapy, have the potential to improve outcomes. However, there are many disparities in patient characteristics and access to the best stroke care. Thus, we aim to compare patient-reported outcome measures (PROMs) after stroke in two stroke centers representing the public and private healthcare systems in Brazil. Read More

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Magnetic Resonance Imaging or Computed Tomography for Suspected Acute Stroke: Association of Admission Image Modality with Acute Recanalization Therapies, Workflow Metrics, and Outcomes.

Ann Neurol 2022 May 22. Epub 2022 May 22.

Hôpital du Valais, Sion, Switzerland.

Objective: To examine rates of intravenous thrombolysis (IVT), mechanical thrombectomy (MT), door-to-needle (DTN) time, door-to-puncture (DTP) time, and functional outcome between patients with admission magnetic resonance imaging (MRI) versus computed tomography (CT).

Methods: An observational cohort study of consecutive patients using a target trial design within the nationwide Swiss-Stroke-Registry from January 2014 to August 2020 was carried out. Exclusion criteria included MRI contraindications, transferred patients, and unstable or frail patients. Read More

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Direct to Angiosuite Versus Conventional Imaging in Suspected Large Vessel Occlusion: A Systemic Review and Meta-Analysis.

Stroke 2022 May 20:101161STROKEAHA121038221. Epub 2022 May 20.

Department of Neurology, Marcus Stroke & Neuroscience Center, Emory University School of Medicine (M.H.M., A.R.A.-B., A.P., N.R.B., D.C.H., R.G.N.).

Background: There is growing evidence to suggest that the direct transfer to angiography suite (DTAS) approach for patients with suspected large vessel occlusion stroke potentially requiring mechanical thrombectomy shortens treatment times and improves outcomes compared with the direct transfer to conventional imaging (DTCI) model. Therefore, we conducted this meta-analysis to compare both approaches to build more concrete evidence to support this innovative treatment concept.

Methods: All potentially relevant studies published in 4 electronic databases/search engines (PubMed, Web of Science, Cochrane Library, and Scopus) from inception to November 2021 were reviewed. Read More

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