2,131 results match your criteria Mechanical Thrombolysis in Acute Stroke


Transcranial Doppler to evaluate postreperfusion therapy following acute ischemic stroke: A literature review.

J Neuroimaging 2021 Jun 15. Epub 2021 Jun 15.

UCSD Comprehensive Stroke Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA.

Cerebral vessel recanalization therapy, either intravenous thrombolysis or mechanical thrombectomy, is the main treatment that can significantly improve clinical outcomes after acute ischemic stroke. The degree of recanalization and cerebral reperfusion of the ischemic penumbra are dependent on cerebral hemodynamics. Currently, the main imaging modalities to assess reperfusion are MRI and CT perfusion. Read More

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Endovascular thrombectomy and intra-arterial interventions for acute ischaemic stroke.

Cochrane Database Syst Rev 2021 Jun 14;6:CD007574. Epub 2021 Jun 14.

University Hospital of North Norway, Tromsø, Norway.

Background: Most disabling strokes are due to a blockage of a large artery in the brain by a blood clot. Prompt removal of the clot with intra-arterial thrombolytic drugs or mechanical devices, or both, can restore blood flow before major brain damage has occurred, leading to improved recovery. However, these so-called endovascular interventions can cause bleeding in the brain. Read More

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Atherosclerotic Components in Thrombi Retrieved by Thrombectomy for Internal Carotid Artery Occlusion Due to Large Artery Atherosclerosis: A Case Report.

Front Neurol 2021 28;12:670610. Epub 2021 May 28.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

The correlation between the composition of thrombi retrieved by mechanical thrombectomy (MT) and stroke etiology is inconclusive. We describe a case with atherosclerotic components in thrombi retrieved by MT for acute internal carotid artery (ICA) occlusion. A 69-year-old man with acute onset of global aphasia and right hemiplegia was transferred to our institute. Read More

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Early Hospital Arrival After Acute Ischemic Stroke Is Associated With Family Members' Knowledge About Stroke.

Front Neurol 2021 26;12:652321. Epub 2021 May 26.

Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China.

Prehospital delay is the major factor limiting intravenous thrombolysis and mechanical thrombectomy in acute ischemic stroke (AIS). This study aimed to: (1) identify factors related to prehospital delay and (2) determine the impact of recognition and behavior of family members on patient delay. A cross-sectional, multicenter study was conducted at six teaching hospitals in China between December 1, 2018 and November 30, 2019. Read More

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Interaction between thrombin potential and age on early clinical outcome in patients hospitalized for COVID-19.

J Thromb Thrombolysis 2021 Jun 10. Epub 2021 Jun 10.

Dipartimento Di Medicina Traslazionale, Università del Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore Della Carità, Via Solaroli 17, 28100, Novara, NO, Italy.

Patients with Coronavirus Disease-2019 (COVID-19) have haemostatic dysfunction and are at higher risk of thrombotic complications. Although age is a major risk factor for outcome impairment in COVID-19, its impact on coagulative patterns here is still unclear. We investigated the association of Endogenous Thrombin Potential (ETP) with thrombotic and haemorrhagic events according to different ages in patients admitted for COVID-19. Read More

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Systolic blood pressure variability following endovascular thrombectomy and clinical outcome in acute ischemic stroke: A meta-analysis.

Acta Neurol Scand 2021 Jun 10. Epub 2021 Jun 10.

Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA.

Blood pressure variability (BPV) has been linked with the outcome of acute ischemic stroke (AIS) after endovascular thrombectomy (EVT). However, the association of the stroke outcome with specific short-term BPV parameters is unclear. We did a systematic literature search for studies published from January 2010 to September 2020. Read More

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Clinical imaging factors of excellent outcome after thrombolysis in large-vessel stroke: a THRACE subgroup analysis.

Stroke Vasc Neurol 2021 Jun 8. Epub 2021 Jun 8.

Department of Neurology-Stroke Unit, CIC-P 1433, INSERMU1116, Université de Lorraine, Nancy Regional University Hospital Center, Nancy, France

Background: For patients with stroke with large-vessel occlusion (LVO), study of factors predicting response to intravenous thrombolysis (IVT) would allow identifying subgroups with high expected gain, and those for whom it could be considered as futile, and even detrimental. From patients included in the Mechanical Thrombectomy After Intravenous Alteplase vs Alteplase Alone After Stroke trial, we investigated clinical-imaging factors associated with optimal response to IVT.

Methods: We included patients receiving IVT alone. Read More

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[Border areas of thrombectomy].

Nervenarzt 2021 Jun 7. Epub 2021 Jun 7.

Hirnschlagzentrum, Klinik für Neurologie, Universitätsspital Basel, 4031, Basel, Schweiz.

Mechanical thrombectomy (MT) has become the standard procedure in the treatment of patients with acute ischemic stroke (AIS) due to occlusion of a large proximal cerebral artery of the anterior circulation. Nevertheless, according to the current guidelines large patient collectives are still excluded from this highly effective treatment method. Therefore, this article gives an overview of possible extensions of the indications for treatment with MT. Read More

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Prognostic capacity of hyperdense middle cerebral artery sign in anterior circulation acute ischaemic stroke patients receiving reperfusion therapy: a systematic review and meta-analysis.

Acta Neurol Belg 2021 Jun 6. Epub 2021 Jun 6.

Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, Australia.

Pre-intervention CT imaging-based biomarkers, such as hyperdense middle cerebral artery sign (HMCAS) may have a role in acute ischaemic stroke prognostication. However, the clinical utility of HMCAS in settings of reperfusion therapy and the level of prognostic association is still unclear. This systematic review and meta-analysis investigated the association of HMCAS sign with clinical outcomes and its prognostic capacity in acute ischaemic stroke patients treated with reperfusion therapy. Read More

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Blind Exchange With Mini-Pinning Technique Using the Tron Stent Retriever for Middle Cerebral Artery M2 Occlusion Thrombectomy in Acute Ischemic Stroke.

Front Neurol 2021 19;12:667835. Epub 2021 May 19.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

The usefulness of the blind exchange with mini-pinning (BEMP) technique has recently been reported for mechanical thrombectomy in patients with stroke owing to medium vessel occlusion (MeVO). The Tron stent retriever can be delivered and deployed through a 0.0165-inch microcatheter. Read More

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Recanalisation theraphy for acute ischemic stroke in cancer patients.

Sci Rep 2021 Jun 2;11(1):11634. Epub 2021 Jun 2.

Clinical Neurology, Udine University Hospital, Udine, Italy.

To date, very few studies focused their attention on efficacy and safety of recanalisation therapy in acute ischemic stroke (AIS) patients with cancer, reporting conflicting results. We retrospectively analysed data from our database of consecutive patients admitted to the Udine University Hospital with AIS that were treated with recanalisation therapy, i.e. Read More

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Ten-Year Trend in Age, Sex, and Racial Disparity in tPA (Alteplase) and Thrombectomy Use Following Stroke in the United States.

Stroke 2021 Jun 3:STROKEAHA120032132. Epub 2021 Jun 3.

University of Maryland, Baltimore (S.C.).

Background And Purpose: IV tPA (intravenous thrombolysis with alteplase) and mechanical thrombectomy (MT) utilization increased in acute ischemic stroke hospitalizations in the United States over the last decade. It is uncertain whether this increase occurred equally across all age, sex, and racial groups.

Methods: Adult acute ischemic stroke hospitalizations (weighted n=4 442 657) contained in the 2008 to 2017 National Inpatient Sample were identified using codes. Read More

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Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes: Analysis From the STRATIS Registry.

Stroke 2021 Jun 3:STROKEAHA120032430. Epub 2021 Jun 3.

Advanced Neuroscience Network/Tenet South Florida, Boynton Beach (N.H.M.-K.).

Background And Purpose: This study investigates clinical outcomes after mechanical thrombectomy in adult patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) of 0 to 5.

Methods: We included data from the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) from patients who underwent mechanical thrombectomy within 8 hours of symptom onset and had available ASPECTS data adjudicated by an independent core laboratory. Angiographic and clinical outcomes were collected, including successful reperfusion (modified Thrombolysis in Cerebral Infarction ≥2b), functional independence (modified Rankin Scale score 0-2), 90-day mortality, and symptomatic intracranial hemorrhage at 24 hours. Read More

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Mean Platelet Volume as a Potential Marker of Large Vessel Occlusion and Predictor of Outcome in Acute Ischemic Stroke Patients Treated with Reperfusion Therapy.

Life (Basel) 2021 May 24;11(6). Epub 2021 May 24.

Clinic of Neurology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland.

(1) Background: An early diagnosis of a large vessel occlusion (LVO) is crucial in the management of the acute ischemic stroke (AIS). The laboratory predictors of LVO and a stroke outcome remain unknown. We have hypothesized that high MPV-a surrogate marker of the activated platelet-may be associated with LVO, and it may predict a worse AIS outcome. Read More

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Stroke Patients' Characteristics and Clinical Outcomes: A Pre-Post COVID-19 Comparison Study.

Medicina (Kaunas) 2021 May 19;57(5). Epub 2021 May 19.

Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei.

: The Coronavirus disease 2019 (COVID-19) pandemic caused significant disruption to established medical care systems globally. Thus, this study was aimed to compare the admission and outcome variables such as number of patient and its severity, acute recanalisation therapy given pre-post COVID-19 at a primary stroke centre located in Malaysia. : This cross-sectional hospital-based study included adult ischaemic stroke patients. Read More

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Determinants of in-hospital death in patients with a thrombus straddling a patent foramen ovale: protocol of a systematic review.

F1000Res 2020 10;9:1437. Epub 2020 Dec 10.

Heart & Brain Laboratory, Western University, London, Ontario, N6C1C4, Canada.

Thrombi identified on echocardiography at the time of straddling a patent foramen ovale (PFO) constitute a medical emergency with an associated imminent risk of death.  Ischemic stroke (IS) and myocardial infarction (MI) occurring in patients with a thrombus straddling a PFO (TSPFO) may be associated with increased risk of in-hospital death. Variables associated with increased risk of death in women and men may be different. Read More

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[The criteria for effectiveness of reperfusion therapy and neuroprotective therapy in ischemic stroke].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(4):86-92

Sechenov First Moscow State Medical University, Moscow, Russia.

The narrative review discusses the data on efficacy and safety of reperfusion therapy (RT) and neuroprotective therapy in ischemic stroke. The influence of therapy on mortality, residual neurologic deficit and disability is analyzed. It was shown that RT (thrombolysis or mechanical thromboextraction) leads to significant decrease of residual neurologic deficit or disability. Read More

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WALRUS Balloon Guide Catheter (BGC) for Stroke Intervention: Technical Considerations and Clinical Outcomes.

World Neurosurg 2021 May 22. Epub 2021 May 22.

Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo, New York, USA; Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA. Electronic address:

Introduction: The use of balloon guide catheters (BGCs) for proximal flow arrest during neurointerventional procedures is limited due to incompatibility of these catheters with large-bore aspiration catheters and difficulty in device navigation. The objective of our study was to describe the use of Walrus (Q'Apel Medical, Fremont, CA), a new 8-French (F) BGC, with a variety of aspiration catheters and procedures requiring flow arrest.

Methods: Consecutive cases using Walrus BGCs for proximal flow arrest during mechanical thrombectomy for acute stroke cases were recorded. Read More

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Treatment efficacy of arterial urokinase thrombolysis combined with mechanical thrombectomy for acute cerebral infarction and its influence on neuroprotective factors and factors for neurological injury.

Am J Transl Res 2021 15;13(4):3380-3389. Epub 2021 Apr 15.

Department of Interventional Vascular Surgery, Affiliated Hospital of Hebei University Baoding, Hebei Province, China.

Objective: This study was designed to explore the treatment efficacy of arterial urokinase thrombolysis combined with Solitaire AB stent for acute cerebral infarction (ACI) and its influence on neuroprotective factors and factors for neurological injury.

Methods: We randomly assigned 90 patients with ACI to receive arterial urokinase thrombolysis combined with Solitaire AB stent thrombectomy (observation group, OG) or to receive arterial urokinase thrombolysis (control group, CG). The two groups were compared in the National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living (ADL) score, vascular recanalization rate 1 month after treatment, and serum levels of neuroprotective factors (insulin-like growth factor-I (IGF-1), neurotrophic factor (NTF), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF)) and factors for neurological injury (neuron-specific enolase (NSE), S100B protein (S100B), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), glial fibrillary acidic protein (GFAP)) before treatment and the day after treatment. Read More

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Aspiration Thrombectomy in Patients with Large Vessel Occlusion and Mild Stroke: A Single-Center Experience.

Med Sci Monit 2021 May 21;27:e930014. Epub 2021 May 21.

Department of Radiology, Faculty Hospital Trnava, Trnava, Slovakia.

BACKGROUND The purpose of this study was to evaluate outcomes of patients with mild stroke, defined by National Institutes of Health Stroke Scale (NIHSS) score <6, caused by large vessel occlusion treated with aspiration thrombectomy. MATERIAL AND METHODS Data from the endovascular stroke registry of our center were retrospectively analyzed. Anterior or posterior circulation strokes with NIHSS score <6 upon admission were analyzed. Read More

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The smoking paradox in ischemic stroke patients treated with intra-arterial thrombolysis in combination with mechanical thrombectomy-VISTA-Endovascular.

PLoS One 2021 20;16(5):e0251888. Epub 2021 May 20.

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Background: The smoking-paradox of a better outcome in ischemic stroke patients who smoke may be due to increased efficacy of thrombolysis. We investigated the effect of smoking on outcome following endovascular therapy (EVT) with mechanical thrombectomy alone versus in combination with intra-arterial (IA-) thrombolysis.

Methods: The primary endpoint was defined by three-month modified Rankin Scale (mRS). Read More

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Accuracy and reliability of PBV ASPECTS, CBV ASPECTS and NCCT ASPECTS in acute ischaemic stroke: a matched-pair analysis.

Neuroradiol J 2021 May 20:19714009211015771. Epub 2021 May 20.

Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.

Background And Purpose: To investigate the reliability and accuracy of Alberta Stroke Program Early Computed Tomography Scores (ASPECTS) derived from flatpanel detector computed tomography pooled blood volume maps compared to non-contrast computed tomography and multidetector computed tomography perfusion cerebral blood volume maps.

Methods: ASPECTS from pooled blood volume maps were evaluated retrospectively by two experienced readers for 37 consecutive patients with acute middle cerebral artery (MCA) M1 occlusion who underwent flatpanel detector computed tomography perfusion imaging before mechanical thrombectomy between November 2016 and February 2019. For comparison with ASPECTS from non-contrast computed tomography and cerebral blood volume maps, a matched-pair analysis according to pre-stroke modified Rankin scale, age, stroke severity, site of occlusion, time from stroke onset to imaging and final modified thrombolysis in cerebral infarction (mTICI) was performed in a separate group of patients who underwent multimodal computed tomography prior to mechanical thrombectomy between June 2015 and February 2019. Read More

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Reliability of Field Assessment Stroke Triage for Emergency Destination Scale Use by Paramedics: Mobile Stroke Unit First-Year Experience.

Stroke 2021 May 20:STROKEAHA120033775. Epub 2021 May 20.

Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, and the Department of Neurology, Emory University School of Medicine, Atlanta (N.R.B., M.R.F., R.G.N., N.A.B., S.W.E., N.J., D.N., D.C.H.).

Background And Purpose: Field Assessment Stroke Triage for Emergency Destination (FAST-ED) scale is a helpful tool to triage patients with stroke in the field. However, data on its reliability in the prehospital setting are lacking. We aim to test the reliability of FAST-ED scale when used by paramedics in a mobile stroke unit covering a metropolitan area. Read More

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Structural and Functional Imaging of the Retina in Central Retinal Artery Occlusion - Current Approaches and Future Directions.

J Stroke Cerebrovasc Dis 2021 Jul 17;30(7):105828. Epub 2021 May 17.

Department of Neurology, Duke University School of Medicine, Durham, North Carolina, USA. Electronic address:

Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke which affects the retina. Intravenous thrombolysis is emerging as a compelling therapeutic approach. However, it is not known which patients may benefit from this therapy because there are no imaging modalities that adequately distinguish viable retina from irreversibly infarcted retina. Read More

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Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: A meta-analysis of randomized controlled trials.

Int J Stroke 2021 Jun 2:17474930211021353. Epub 2021 Jun 2.

Stroke, Division of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, UK.

Background: Direct mechanical thrombectomy may result in similar outcomes compared to a bridging approach with intravenous thrombolysis (IVT + MT) in acute ischemic stroke. Recent randomized controlled trials have varied in their design and noninferiority margin.

Aim: We sought to meta-analyze accumulated trial data to assess the difference and non-inferiority in clinical and procedural outcomes between direct mechanical thrombectomy and bridging therapy. Read More

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Functional Outcomes Among Patients With Acute Ischemic Stroke After Mechanical Thrombectomy With or Without Intravenous Thrombolysis.

JAMA 2021 05;325(19):2019-2020

Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.

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Management dilemmas in acute ischemic stroke and concomitant acute pulmonary embolism: Case series and literature review.

eNeurologicalSci 2021 Jun 15;23:100341. Epub 2021 Apr 15.

Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America.

Background: Pulmonary embolism (PE) and acute ischemic stroke (AIS) are common disorders with high morbidity and mortality, rarely presenting simultaneously. There is a paucity of data regarding the management of this uncommon presentation. The treatment of these two entities is complex in the acute phase due to the concomitant need for thrombolysis in AIS and anticoagulation for PE. Read More

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Use of 8Fr angio-seal for closure of femoral arteriotomy following use of 8Fr and 9Fr sheaths in patients undergoing mechanical thrombectomy for acute ischaemic stroke.

J Clin Neurosci 2021 Jun 25;88:277-280. Epub 2021 Apr 25.

Interventional Neuroradiology Department, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.

Background: Little is known about the safety of off-label use of an 8Fr Angio-Seal VIP for large-bore arteriotomies in patients treated with mechanical thrombectomy (MT) and intravenous thrombolysis (IVT) for acute ischaemic stroke (AIS). We aimed to identify differences in the groin complication rate using an 8Fr Angio-Seal VIP for common femoral arteriotomy closures following the use of 8Fr and 9Fr sheaths.

Methods: All AIS patients who underwent MT at our tertiary neuroscience unit between January 2018 and March 2020 were retrospectively reviewed. Read More

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Unknown Onset Stroke: Differences Between Patients with Wake-Up Stroke and Daytime-Unwitnessed Stroke.

J Stroke Cerebrovasc Dis 2021 Jul 10;30(7):105842. Epub 2021 May 10.

Department of Neurology, Mannheim Center for Translational Neurosciences, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address:

Objectives: Patients with unknown onset stroke (UOS) can be categorized as wake-up stroke (WUS) and daytime-unwitnessed stroke (DUS). We sought to determine whether decisions for initial imaging modalities, frequency of mismatch findings, resulting treatment decisions and outcome differ between WUS and DUS patients.

Materials And Methods: In a retrospective analysis, all patients with UOS admitted to our Stroke Unit from January to December 2018 were evaluated and classified as either WUS or DUS. Read More

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