1,440 results match your criteria Mechanical Thrombolysis in Acute Stroke


Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry.

Stroke 2019 Feb 19:STROKEAHA118021126. Epub 2019 Feb 19.

University of California, Los Angeles, CA (R.J., J.L.S., S.S., D.S.L.).

Background and Purpose- Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established. Methods- STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever as first-line therapy. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021126DOI Listing
February 2019
1 Read

Institutional and provider variations for mechanical thrombectomy in the treatment of acute ischemic stroke: a survey analysis.

J Neurointerv Surg 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurology, Neurosurgery and Radiology, University of Minnesota, Minneapolis, MN, USA.

Introduction: Stent retriever combined with aspiration, or the 'Solumbra technique', has recently emerged as one of the popular methods of mechanical thrombectomy (MT). However, the variations in understanding and implementation of the Solumbra technique have not been reported.

Methods: An 18 part anonymous survey questionnaire was designed to extract information regarding technical variations of MT with a focus on the Solumbra technique. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014614DOI Listing
February 2019

Rapid Alteplase Administration Improves Functional Outcomes in Patients With Stroke due to Large Vessel Occlusions.

Stroke 2019 Feb 14:STROKEAHA118021840. Epub 2019 Feb 14.

Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, Health Science Centre, University of Calgary, Alberta, Canada (M.D.H.).

Background and Purpose- We report the relation of onset-to-treatment time and door-to-needle time with functional outcomes and mortality among patients with ischemic stroke with imaging-proven large vessel occlusion treated with intravenous alteplase. Methods- Individual patient-level data from the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration were pooled from 7 trials that randomized patients to mechanical thrombectomy added to best medical therapy versus best medical therapy alone. Analysis was restricted to patients who received alteplase directly at the endovascular hospital. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021840DOI Listing
February 2019

Cost-utility analysis of mechanical thrombectomy between 6 and 24 hours in acute ischemic stroke.

Int J Stroke 2019 Feb 13:1747493019830587. Epub 2019 Feb 13.

2 Imaging Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.

Background: Recently, two randomized controlled trials demonstrated the benefit of mechanical thrombectomy performed between 6 and 24 h in acute ischemic stroke. The current economic evidence is supporting the intervention only within 6 h, but extended thrombectomy treatment times may result in better long-term outcomes for a larger cohort of patients.

Aims: We compared the cost-utility of mechanical thrombectomy in addition to medical treatment versus medical treatment alone performed beyond 6 h from stroke onset in the UK National Health Service (NHS). Read More

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http://dx.doi.org/10.1177/1747493019830587DOI Listing
February 2019

Neurological Complications of Cardiological Interventions.

Curr Neurol Neurosci Rep 2019 Feb 9;19(2). Epub 2019 Feb 9.

Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins drive, Iowa City, IA, 52242, USA.

Purpose Of Review: Neurological complications are common during cardiac procedures. The type of procedure influences the profile of neurological complications and their management. In this article, we review the different neurological complications encountered following cardiac procedures, and treatment strategies for managing those complications. Read More

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http://link.springer.com/10.1007/s11910-019-0923-1
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http://dx.doi.org/10.1007/s11910-019-0923-1DOI Listing
February 2019
8 Reads

Does Clot Burden Score on Baseline T2*-MRI Impact Clinical Outcome in Acute Ischemic Stroke Treated with Mechanical Thrombectomy?

J Stroke 2019 Jan 31;21(1):91-100. Epub 2019 Jan 31.

Paris Descartes University, INSERM UMR 894 and Department of Neuroradiology, Sainte-Anne Hospital Center, Paris, France.

Background And Purpose: A long clot, defined by a low (0-6) clot burden score (CBS) assessed by T2*-MR sequence, is associated with worse clinical outcome after intravenous thrombolysis (IVT) for acute ischemic stroke than is a small clot (CBS, 7-10). The added benefit of mechanical thrombectomy (MT) might be higher in patients with long clot. The aim of this pre-specified post hoc analysis of the THRombectomie des Artères CErebrales (THRACE) trial was to assess the association between T2*-CBS, successful recanalization and clinical outcome. Read More

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http://dx.doi.org/10.5853/jos.2018.01921DOI Listing
January 2019
1 Read

Post-Thrombolysis Recanalization in Stroke Referrals for Thrombectomy: Incidence, Predictors, and Prediction Scores.

Stroke 2018 12;49(12):2975–2982

From the Neurology Department (P.S., G.T., J.-L.M., J.-C.B.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France.

Background and Purpose—Whether all acute stroke patients with large vessel occlusion need to undergo intravenous thrombolysis before mechanical thrombectomy (MT) is debated as (1) the incidence of post-thrombolysis early recanalization (ER) is still unclear; (2) thrombolysis may be harmful in patients unlikely to recanalize; and, conversely, (3) transfer for MT may be unnecessary in patients highly likely to recanalize. Here, we determined the incidence and predictors of post-thrombolysis ER in patients referred for MT and derive ER prediction scores for trial design. Methods—Registries from 4 MT-capable centers gathering patients referred for MT and thrombolyzed either on site (mothership) or in a non MT-capable center (drip-and-ship) after magnetic resonance– or computed tomography–based imaging between 2015 and 2017. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.022335DOI Listing
December 2018

Effectiveness of Low-Dose Intravenous Tissue Plasminogen Activator before Stent Retriever or Aspiration Mechanical Thrombectomy.

J Vasc Interv Radiol 2019 Feb;30(2):134-140

Department of Neurosurgery, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu 4-9-1 292-8535, Japan.

Purpose: To determine whether thrombolysis with a lower dose of intravenous recombinant tissue plasminogen activator before mechanical thrombectomy is beneficial for functional outcomes compared with mechanical thrombectomy alone.

Materials And Methods: Data for 100 Japanese patients who underwent mechanical thrombectomy between July 2014 and November 2017 were retrospectively reviewed. These patients were divided into groups according to whether they received intravenous thrombolysis before mechanical thrombectomy, and outcomes were compared. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443183168
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http://dx.doi.org/10.1016/j.jvir.2018.11.005DOI Listing
February 2019
4 Reads

Ideal sedation for stroke thrombectomy: a prospective pilot single-center observational study.

Neurosurg Focus 2019 Feb;46(2):E16

1National Skull Base Foundation, Thousand Oaks.

OBJECTIVESeveral retrospective studies have supported the use of conscious sedation (CS) over general anesthesia (GA) as the preferred methods of sedation for stroke thrombectomy, but a recent randomized controlled trial showed no difference in outcomes after CS or GA. The purpose of the Ideal Sedation for Stroke Thrombectomy (ISST) study was to evaluate the difference in time and outcomes in the reperfusion of anterior circulation in ischemic stroke using GA and monitored anesthesia care (MAC).METHODSThe ISST study was a prospective, open-label registry. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18522DOI Listing
February 2019
2 Reads

Urgent Middle Cerebral Artery Embolectomy of Calcified Embolus After Intravenous Thrombolysis: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2019 Feb 4. Epub 2019 Feb 4.

Department of Neurosurgery, Hospital Ceske Budejovice, Czech Republic.

This video shows an urgent microsurgical embolectomy of the inferior division of the left middle cerebral artery in a patient treated by intravenous thrombolysis (IVT). Patient was eligible for endovascular mechanical thrombectomy1; however, the interventional radiologist was not comfortable performing the procedure given prior unsuccessful attempts to remove a calcified cerebral embolus.2 A 75-yr-old female presented with an acute ischemic stroke with isolated aphasia (NIHSS 9). Read More

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https://academic.oup.com/ons/advance-article/doi/10.1093/ons
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http://dx.doi.org/10.1093/ons/opy404DOI Listing
February 2019
5 Reads

Initial experience with the novel EmboTrap II clot-retrieving device for the treatment of ischaemic stroke.

Interv Neuroradiol 2019 Feb 4:1591019918819709. Epub 2019 Feb 4.

2 Interventional Neurovascular Unit, Careggi University Hospital, Firenze, Italy.

Introduction: We report our experience with the novel stent-type clot-retrieval device EmboTrap II for the revascularization of large artery occlusions in acute ischaemic stroke.

Materials And Methods: Twenty-nine patients with acute ischaemic stroke due to large artery occlusion underwent mechanical thrombectomy with the new EmboTrap II in two Italian centres. Clinical, procedural and radiological data were collected. Read More

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http://dx.doi.org/10.1177/1591019918819709DOI Listing
February 2019
1 Read

Thrombus perviousness is not associated with first-pass revascularization using stent retrievers.

Interv Neuroradiol 2019 Feb 4:1591019918825444. Epub 2019 Feb 4.

Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada.

Background And Purpose: Recent studies suggest that thrombus imaging characteristics such as Hounsfield unit (HU) and perviousness assessed on noncontrast computed tomography (NCCT) and CT angiography (CTA) can predict successful recanalization. We assessed whether these thrombus imaging characteristics could predict successful first-pass recanalization.

Methods: We retrospectively reviewed cases of mechanical thrombectomy over a three-year period in which patients received a multiphase CTA and were treated with a stent retriever on first pass. Read More

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http://journals.sagepub.com/doi/10.1177/1591019918825444
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http://dx.doi.org/10.1177/1591019918825444DOI Listing
February 2019
3 Reads
0.730 Impact Factor

[Reperfusion therapy in patients with minor or mild ischemic stroke].

Authors:
Junpei Koge

Rinsho Shinkeigaku 2019 Jan 31. Epub 2019 Jan 31.

Division of Neurology, Saiseikai Fukuoka General Hospital.

A significant number of patients with minor or mild stroke symptoms on initial presentation subsequently develop neurological deterioration and poor clinical outcomes at hospital discharge. The presence of an underlying large vessel occlusion is a strong predictor of both clinical worsening and poor outcome. Although patients with a low baseline National Institutes of Health Stroke Scale (NIHSS) could have been included in some randomized controlled trials, the benefits of the mechanical thrombectomy for patients with a low NIHSS score are unknown. Read More

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http://dx.doi.org/10.5692/clinicalneurol.cn-001255DOI Listing
January 2019

[Implementation of Penumbra-assisted Half-Stent Thrombectomy for Patients with Acute M2 Occlusion:Results of Initial Experiences].

No Shinkei Geka 2019 Jan;47(1):71-78

Department of Neurosurgery, Shinsuma General Hospital.

The benefits of mechanical thrombectomy(MT)for acute M2 occlusion have remained unclear because of unavoidable device-related complications due to vascular morphological characteristics. We developed a Penumbra-assisted half-stent thrombectomy for achieving secure retrieval of thrombus with minimal damage to the small-caliber vessel. In total, 6 patients were treated with MT for acute M2 occlusion using this technique between November 2016 and May 2017, including 3 men and 3 women, mean age 74. Read More

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http://dx.doi.org/10.11477/mf.1436203898DOI Listing
January 2019
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Innovations in Acute Stroke Reperfusion Strategies.

Ann Indian Acad Neurol 2019 Jan-Mar;22(1):6-12

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Vascular neurology is witnessing unprecedented innovations in the management of acute ischemic stroke, especially in reperfusion strategies. The emergence of mechanical thrombectomy with new generation devices has revolutionized the treatment of acute ischemic stroke with large vessel occlusion. The reperfusion strategies are evolving with the extension of the window period for thrombolysis and endovascular therapy through the concept of "tissue clock" in addition to the established "time clock. Read More

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http://dx.doi.org/10.4103/aian.AIAN_263_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327700PMC
January 2019
3 Reads

Efficacy of Sonothrombolysis Using Microbubbles Produced by a Catheter-Based Microfluidic Device in a Rat Model of Ischemic Stroke.

Ann Biomed Eng 2019 Jan 28. Epub 2019 Jan 28.

Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.

Limitations of existing thrombolytic therapies for acute ischemic stroke have motivated the development of catheter-based approaches that utilize no or low doses of thrombolytic drugs combined with a mechanical action to either dissolve or extract the thrombus. Sonothrombolysis accelerates thrombus dissolution via the application of ultrasound combined with microbubble contrast agents and low doses of thrombolytics to mechanically disrupt the fibrin mesh. In this work, we studied the efficacy of catheter-directed sonothrombolysis in a rat model of ischemic stroke. Read More

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http://dx.doi.org/10.1007/s10439-019-02209-0DOI Listing
January 2019
2 Reads
3.195 Impact Factor

Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: comparison of technical and clinical outcomes.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.

Background: A transradial approach (TRA) is associated with fewer access site complications than a transfemoral technique (TFA).However, there is concern that performing mechanical thrombectomy (MT) via TRA may lead to longer revascularization times and thus worse outcomes. Nonetheless, TRA may confer added benefits in MT since navigation of challenging aortic arch and carotid anatomy is often facilitated by a right radial artery trajectory. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0144
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http://dx.doi.org/10.1136/neurintsurg-2018-014485DOI Listing
January 2019
5 Reads

Association of Time From Stroke Onset to Groin Puncture With Quality of Reperfusion After Mechanical Thrombectomy: A Meta-analysis of Individual Patient Data From 7 Randomized Clinical Trials.

JAMA Neurol 2019 Jan 22. Epub 2019 Jan 22.

University of Lorraine, and University Hospital of Nancy, Nancy, France.

Importance: Reperfusion is a key factor for clinical outcome in patients with acute ischemic stroke (AIS) treated with endovascular thrombectomy (EVT) for large-vessel intracranial occlusion. However, data are scarce on the association between the time from onset and reperfusion results.

Objective: To analyze the rate of reperfusion after EVT started at different intervals after symptom onset in patients with AIS. Read More

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http://dx.doi.org/10.1001/jamaneurol.2018.4510DOI Listing
January 2019

Solitaire Stent Permanent Implantation as an Effective Rescue Treatment for Emergency Large Artery Occlusion.

World Neurosurg 2019 Jan 19. Epub 2019 Jan 19.

Department of Neurosurgery, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China. Electronic address:

Background: In this study, we present our experiences on the feasibility of rescue permanent Solitaire stent placement for failed mechanical thrombectomy (MT) and our protocol to avoid ineffective stent placement.

Methods: We retrospectively evaluated the data for consecutive patients admitted into the Second Affiliated Hospital of Wenzhou Medical University and 2 collaboration hospitals from August 2014 to May 2018 for emergency large artery occlusion. The baseline clinical characteristics and radiologic assessment, interventional data, clinical outcome, and angiographic follow-up data were assessed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193000
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http://dx.doi.org/10.1016/j.wneu.2018.12.145DOI Listing
January 2019
5 Reads

A Puzzling Case of Cryptogenic Stroke.

J Stroke Cerebrovasc Dis 2019 Jan 17. Epub 2019 Jan 17.

UOC Neurologia, Dipartimento di scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo; Fondazione Policlinico Universitario A. Gemelli - IRCCS, Roma, Italy. Electronic address:

Background: Stroke is a common neurological complication of infective endocarditis (IE) and it is associated with increased morbidity and mortality but infective endocarditis in acute stroke setting is hard to discover.

Material And Methods: A 75-year-old man referred to hospital for the onset of left hemiparesis and dysarthria. His past medical history included hypertension. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.001DOI Listing
January 2019
3 Reads

Correlation between pre-admission blood pressure and outcome in a large telestroke cohort.

J Clin Neurosci 2019 Jan 16. Epub 2019 Jan 16.

Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA, United States. Electronic address:

Background: Telemedicine rapidly connects patients, with acute ischemic stroke symptoms, with neurovascular specialists for assessment to reduce chemical thrombolysis delivery times. Management of AIS includes maintaining target systolic blood pressures (SBP). In this retrospective study, we assess the efficacy of the telestroke (TS) system at a primary stroke center and the prognostic value of SBP throughout the transportation process. Read More

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http://dx.doi.org/10.1016/j.jocn.2019.01.014DOI Listing
January 2019
2 Reads

Thrombectomy or intravenous thrombolysis in patients with NIHSS of 5 or less?

J Neuroradiol 2019 Jan 16. Epub 2019 Jan 16.

Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France.

Background And Purpose: To compare outcomes of minor stroke patients with intracranial vessel occlusions (IVO) underwent mechanical thrombectomy (MT) versus those treated with intravenous thrombolysis alone (IVT).

Methods: We retrospectively reviewed two large prospective stroke databases from two European centers searching for patients admitted with minor stroke (i.e. Read More

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http://dx.doi.org/10.1016/j.neurad.2019.01.089DOI Listing
January 2019
2 Reads

Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials.

J Stroke Cerebrovasc Dis 2019 Jan 14. Epub 2019 Jan 14.

International Clinical Research Centre, Stroke Research Program, St. Anne´s University Hospital, Brno, Czech Republic; Departments of Clinical Neurosciences, Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Neurology, St. Anne´s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Background: In randomized clinical trials, mechanical thrombectomy (MT) was proved to be a highly effective treatment of acute ischemic stroke which improved clinical outcomes. Some of the trials used automated computed tomography perfusion (CTP) analysis for selection of participants. We present a single-center experience with CTP selection and comparison with CTP trials. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057183074
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.041DOI Listing
January 2019
3 Reads

Bridging Therapy Versus Direct Mechanical Thrombectomy in Patients with Acute Ischemic Stroke due to Middle Cerebral Artery Occlusion: A Clinical-Histological Analysis of Retrieved Thrombi.

Cell Transplant 2019 Jan 18:963689718823206. Epub 2019 Jan 18.

1 Department of Neurology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

Mechanical thrombectomy (MT) is effective in managing patients with acute ischemic stroke (AIS) caused by large-vessel occlusions and allows for valuable histological analysis of thrombi. However, whether bridging therapy (pretreatment with intravenous thrombolysis before MT) provides additional benefits in patients with middle cerebral artery (MCA) occlusion remains unclear. Therefore, this study aimed to compare the effects of direct MT and bridging therapy, and to elucidate the correlation between thrombus composition and stroke subtypes. Read More

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http://dx.doi.org/10.1177/0963689718823206DOI Listing
January 2019
2 Reads

Trends in Interhospital Transfers and Mechanical Thrombectomy for United States Acute Ischemic Stroke Inpatients.

J Stroke Cerebrovasc Dis 2019 Jan 7. Epub 2019 Jan 7.

Department of Neurology, University of Rochester Medical Center, Rochester, NY. Electronic address:

Objective: Stroke care in the US is increasingly regionalized. Many patients undergo interhospital transfer to access specialized, time-sensitive interventions such as mechanical thrombectomy.

Methods: Using a stratified survey design of the US Nationwide Inpatient Sample (2009-2014) we examined trends in interhospital transfers for ischemic stroke resulting in mechanical thrombectomy. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.018DOI Listing
January 2019
1 Read

Impact of Stent Retriever Size on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry.

Stroke 2019 Feb;50(2):441-447

Departments of Neurology, Neurosurgery, and Radiology, Vanderbilt University Medical Center, Nashville, TN (M.T.F.).

Background and Purpose- The safety and efficacy of mechanical thrombectomy in patients with acute ischemic stroke has been demonstrated. However, the impact of stent retriever size on clinical and angiographic outcomes is not well established. Methods- This was a retrospective ad hoc analysis of data from the STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) registry-a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever. Read More

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https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.022987
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http://dx.doi.org/10.1161/STROKEAHA.118.022987DOI Listing
February 2019
6 Reads

Clinical effect of successful reperfusion in patients presenting with NIHSS < 8: data from the BEYOND-SWIFT registry.

J Neurol 2019 Mar 8;266(3):598-608. Epub 2019 Jan 8.

Department of Neurology, University Hospital Bern, Inselspital, University of Bern, Freiburgstrasse 8, 3010, Bern, Switzerland.

Background And Purpose: If patients presenting with large vessel occlusions (LVO) and mild symptoms should be treated with endvoascular treatment (EVT) remains unclear. Aims of this study were (1) assessing the safety and technical efficacy of EVT in patients with NIHSS < 8 as opposed to a comparison group of patients presenting with NIHSS ≥ 8 and (2) evaluation of the clinical effect of reperfusion in patients with NIHSS < 8.

Methods: Patients included into the retrospective multicenter BEYOND-SWIFT registry (NCT03496064) were analyzed. Read More

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http://link.springer.com/10.1007/s00415-018-09172-1
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http://dx.doi.org/10.1007/s00415-018-09172-1DOI Listing
March 2019
8 Reads
3.377 Impact Factor

Intra-arterial administration of cell-based biological agents for ischemic stroke therapy.

Expert Opin Biol Ther 2019 Mar 21;19(3):249-259. Epub 2019 Jan 21.

a 2nd Department of Radiology, Division of Interventional Radiology, School of Medicine , National and Kapodistrian University of Athens, Attikon University Hospital , Athens , Greece.

Introduction: Ischemic stroke is becoming a primary cause of disability and death worldwide. To date, therapeutic options remain limited focusing on mechanical thrombolysis or administration of thrombolytic agents. However, these therapies do not promote neuroprotection and neuro-restoration of the ischemic area of the brain. Read More

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http://dx.doi.org/10.1080/14712598.2019.1566454DOI Listing
March 2019
3 Reads

Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke.

J Neurosurg Pediatr 2019 Jan 4:1-6. Epub 2019 Jan 4.

2Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China.

OBJECTIVEMechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS. Read More

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http://dx.doi.org/10.3171/2018.9.PEDS18242DOI Listing
January 2019
2 Reads

Predictive Value of Susceptibility Vessel Sign for Arterial Recanalization and Clinical Improvement in Ischemic Stroke.

Stroke 2019 Feb;50(2):512-515

From the Departement of Neuroradiology (J.D., C.M., G.B., A.G., G.A., M.R., A.C.J., P.T., O.M., F.B., C.C.), CHU de Toulouse, France.

Background and Purpose- Our goal was to evaluate whether the presence of a low signal intensity known as susceptibility vessel sign (SVS) on T2*-gradient echo imaging sequence was predictive of arterial recanalization and the early clinical improvement after mechanical thrombectomy. Methods- This observational study was based on a prospective database of acute ischemic strokes treated by mechanical thrombectomy. Inclusion criteria were patients with acute anterior ischemic stroke, diagnosed by magnetic resonance imaging, including a T2*-gradient echo imaging sequence, and treated by mechanical thrombectomy. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.022912DOI Listing
February 2019
5.723 Impact Factor

Stent Expansion and In-Stent Thrombus Sign in the Trevo Stent Retriever Predict Recanalization and Possible Etiology During Mechanical Thrombectomy: A Case Series of 50 Patients with Acute Middle Cerebral Artery Occlusion.

World Neurosurg 2018 Dec 28. Epub 2018 Dec 28.

Department of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, Japan.

Background: Interaction between the stent retriever and clot is a key factor for recanalization during mechanical thrombectomy. The aim of this study was to evaluate the association between radiographically apparent features during thrombectomy and angiographic outcomes using the Trevo stent retriever with a fully radiopaque strut.

Methods: We retrospectively reviewed 50 patients with acute middle cerebral artery occlusion who were treated with the Trevo. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.12.087DOI Listing
December 2018
1 Read

Are Postprocedural Blood Pressure Goals Associated With Clinical Outcome After Mechanical Thrombectomy for Acute Ischemic Stroke?

Neurologist 2019 Jan;24(1):44-47

Departments of Neurology.

Mechanical thrombectomy (MT) is the standard of care for patients who present with an acute ischemic stroke within 6 hours of symptom onset, and up to 24 hours in appropriately selected patients. However, optimal postoperative management of these patients remains uncertain, especially with regard to blood pressure control. To review the existing literature to define potential blood pressure goals in the immediate postoperative period in patients who undergo MT for acute ischemic stroke. Read More

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http://Insights.ovid.com/crossref?an=00127893-201901000-0001
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http://dx.doi.org/10.1097/NRL.0000000000000223DOI Listing
January 2019
3 Reads

Impact of Microbleeds on Outcome Following Recanalization in Patients With Acute Ischemic Stroke.

Stroke 2018 Dec 7:STROKEAHA118023084. Epub 2018 Dec 7.

Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (K.-H. Choi, K.-W.K., J.-T.K., S.-M.C., S.-H.L., M.-S.P., B.-C.K., M.-K.K., K.-H. Cho,).

Background and Purpose- We analyzed the association between cerebral microbleeds (CMBs) and clinical outcome in acute ischemic stroke patients and especially in a subgroup of patients with successful recanalization. Methods- A total of 1532 acute ischemic stroke patients treated with intravenous thrombolysis or mechanical thrombectomy were enrolled in this prospective cohort study. The primary outcome was measured using the modified Rankin Scale at 3 months, according to the CMB status based on magnetic resonance imaging at admission. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.023084DOI Listing
December 2018
1 Read

Comparison of Mechanical Thrombectomy with Contact Aspiration, Stent Retriever, and Combined Procedures in Patients with Large-Vessel Occlusion in Acute Ischemic Stroke.

Med Sci Monit 2018 Dec 22;24:9342-9353. Epub 2018 Dec 22.

Department of Applied Mathematics, VŠB-Technical University of Ostrava, Ostrava, Czech Republic.

BACKGROUND We investigated the properties and effects of 5 mechanical thrombectomy procedures in patients with acute ischemic stroke. The relationships between the type of procedure, the time required, the success of recanalization, and the clinical outcome were analyzed. MATERIAL AND METHODS This prospective comparative analysis included 500 patients with acute ischemic stroke and large-vessel occlusion. Read More

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http://dx.doi.org/10.12659/MSM.913458DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320656PMC
December 2018
2 Reads

The effects of neutrophil to lymphocyte and platelet to lymphocyte ratios on prognosis in patients undergoing mechanical thrombectomy for acute ischemic stroke.

Ann Ital Chir 2018 ;89:367-373

Introduction: The aim of the study was to investigate the effect of neutrophil lymphocyte (NLR) and platelet lymphocyte ratio (PLR) on prognosis in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy.

Material-method: A retrospective study was made of the data of 56 patients aged 20-80 years who were diagnosed with AIS and underwent mechanical thrombectomy. Thrombolysis in Brain Ischemia (TIBI) status was evaluated with transcranial Doppler after treatment. Read More

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January 2018
2 Reads

Stroke Lesion Outcome Prediction Based on MRI Imaging Combined With Clinical Information.

Front Neurol 2018 5;9:1060. Epub 2018 Dec 5.

Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland.

In developed countries, the second leading cause of death is stroke, which has the ischemic stroke as the most common type. The preferred diagnosis procedure involves the acquisition of multi-modal Magnetic Resonance Imaging. Besides detecting and locating the stroke lesion, Magnetic Resonance Imaging captures blood flow dynamics that guides the physician in evaluating the risks and benefits of the reperfusion procedure. Read More

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http://dx.doi.org/10.3389/fneur.2018.01060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290552PMC
December 2018
6 Reads

Gadolinium to the rescue for mechanical thrombectomy in acute ischemic stroke.

Interv Neuroradiol 2018 Dec 19:1591019918815298. Epub 2018 Dec 19.

2 Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.

Introduction: Mechanical thrombectomy in the setting of acute ischemic stroke (AIS) requires cerebral digital subtraction angiography (DSA), typically performed with iodinated contrast medium. We present a case of emergent cerebral DSA and mechanical thrombectomy using gadolinium-based contrast for cerebral DSA in a patient with a history of anaphylaxis to iodinated contrast agents (ICs).

Case Report: A 72-year-old man developed left ventricle assist device thrombus while on anticoagulation. Read More

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http://dx.doi.org/10.1177/1591019918815298DOI Listing
December 2018
2 Reads

Intravenous thrombolysis and mechanical thrombectomy in patients with minor or rapidly improving neurological deficits.

Curr Opin Neurol 2019 Feb;32(1):13-18

Department of Neurology, St. John's of God Hospital, Vienna, Austria.

Purpose Of Review: A substantial proportion of patients with ischemic stroke present with mild neurological deficits ('Stroke with mild symptoms,' SMS). Treating these patients with thrombolysis or with thrombectomy is controversial and clinical practice is different. We will highlight the importance of these treatment decisions by reviewing the recent advances in this area. Read More

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http://dx.doi.org/10.1097/WCO.0000000000000647DOI Listing
February 2019
1 Read

Analysis of revascularisation in ischaemic stroke with EmboTrap (ARISE I study) and meta-analysis of thrombectomy.

Interv Neuroradiol 2018 Dec 18:1591019918817406. Epub 2018 Dec 18.

7 Departments of Neuroradiology and Clinical Neuroscience, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.

Background And Purpose: The goal of the analysis of revascularisation in ischaemic stroke with EmboTrap study (ARISE I) was to demonstrate the effectiveness of EmboTrap.

Methods: ARISE I was an open label, single arm, multicentre, prospective study for the treatment of acute stroke due to large vessel occlusion. The primary outcome was revascularisation of the target vessel as measured by the modified thrombolysis in cerebrovascular infarction (mTICI) score of at least 2b following thrombectomy with EmboTrap. Read More

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http://journals.sagepub.com/doi/10.1177/1591019918817406
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http://dx.doi.org/10.1177/1591019918817406DOI Listing
December 2018
2 Reads

Thromboembolism and bleeding in patients with cancer and mechanical heart valves.

J Thromb Thrombolysis 2018 Dec 17. Epub 2018 Dec 17.

Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Ctra. Canyet s/n, 08916, Badalona, Spain.

Mechanical heart valves (MHV) require life-long anticoagulation with vitamin K antagonists (VKA), but anticoagulation management is complex in patients with cancer due to a high risk of thrombosis and bleeding. This is a retrospective, single-center study to assess anticoagulation management and thrombotic (stroke/valve thrombosis) and bleeding events in patients with active cancer and MHV. The incidence of thrombotic complications was compared to a control group (matched 1:1) of patients with MHV but without cancer. Read More

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http://dx.doi.org/10.1007/s11239-018-1790-3DOI Listing
December 2018
1 Read

Functional Outcome and Safety of Intracranial Thrombectomy After Emergent Extracranial Stenting in Acute Ischemic Stroke Due to Tandem Occlusions.

Front Neurol 2018 20;9:940. Epub 2018 Nov 20.

Klinik für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Germany.

Various endovascular approaches to treat acute ischemic stroke caused by extra- intracranial tandem occlusions (TO) exist: percutaneous transluminal angioplasty with or without emergent extracranial carotid stenting (ECS) due to high-grade stenosis preceded or followed by intracranial mechanical and/or aspiration thrombectomy (MT). Which treatment strategy to use is still a matter of debate. From our ongoing prospective stroke registry we retrospectively analyzed 1,071 patients with anterior circulation stroke getting endovascular treatment within 6 h of symptom onset. Read More

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http://dx.doi.org/10.3389/fneur.2018.00940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256428PMC
November 2018
2 Reads

Impact of Relative Blood Glucose Changes on Mortality Risk of Patient with Acute Ischemic Stroke and Treated with Mechanical Thrombectomy.

J Stroke Cerebrovasc Dis 2019 Jan 24;28(1):213-219. Epub 2018 Oct 24.

Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address:

Background And Purpose: The impacts of stress hyperglycemia and hypoglycemia on mortality of acute ischemic stroke patients treated with mechanical thrombectomy (MT) are largely unclear. This study aimed to use stress hyperglycemia ratio (SHR) to evaluate the influence of pretreatment relative blood glucose changes on mortality risk after MT.

Methods: The study retrospectively enrolled 321 acute ischemic stroke patients treated with MT. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057183055
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.09.036DOI Listing
January 2019
7 Reads
1.993 Impact Factor

Predictive and individualized management of stroke-success story in Czech Republic.

EPMA J 2018 Dec 25;9(4):393-401. Epub 2018 Oct 25.

1Department of Neurology, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 66 Plzen, Czech Republic.

The model of centralized stroke care in the Czech Republic was created in 2010-2012 by Ministry of Health (MH) in cooperation with professional organization-Cerebrovascular Section of the Czech Neurological Society (CSCNS). It defines priorities of stroke care, stroke centers, triage of suspected stroke patients, stroke care quality indicators, their monitoring, and reporting. Thirteen complex cerebrovascular centers (CCC) provide sophisticated stroke care, including intravenous thrombolysis (IVT), mechanical thrombectomy (MTE), as well as other endovascular (stenting, coiling) and neurosurgical procedures. Read More

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http://link.springer.com/10.1007/s13167-018-0150-x
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http://dx.doi.org/10.1007/s13167-018-0150-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261911PMC
December 2018
9 Reads

Successful mechanical thrombectomy in stroke with thrombolysis-associated intracerebral hemorrhage-a case report.

J Stroke Cerebrovasc Dis 2019 Feb 24;28(2):285-287. Epub 2018 Oct 24.

Department of Neurology, University Hospital Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany. Electronic address:

Background: Intravenous thrombolysis and mechanical thrombectomy are the standard of care for patients with acute ischemic stroke with large vessel occlusion. Intracerebral hemorrhage is a main complication of intravenous thrombolysis, however, no data are available on the efficacy and safety of mechanical thrombectomy in patients with thrombolysis-associated intracerebral hemorrhage. This constellation is expected to become more frequent as increasing numbers of patients are treated under the drip-and-ship paradigm. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057183056
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.09.045DOI Listing
February 2019
5 Reads
1.993 Impact Factor

Management of Stroke in the Neurocritical Care Unit.

Continuum (Minneap Minn) 2018 Dec;24(6):1658-1682

Purpose Of Review: This article provides updated information regarding the diagnosis and treatment (specifically critical care management) of acute ischemic stroke. This article also discusses the increased use of thrombolysis and thrombectomy in clinical practice.

Recent Findings: Stroke is the leading cause of disability in the United States. Read More

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http://dx.doi.org/10.1212/CON.0000000000000670DOI Listing
December 2018
1 Read

Effects of Intermediate Catheter Evolution on Technical Outcome of Mechanical Thrombectomy-A Comparison of the Performance of Two Distal Access Catheters in Mechanical Thrombectomy of Acute Ischemic Stroke.

World Neurosurg 2018 Nov 27. Epub 2018 Nov 27.

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

Objective: Fast and secure access to intracranial vessel occlusion is essential for mechanical thrombectomy (MT) in the treatment of acute ischemic stroke. We compared 2 intermediate distal access catheters (DAC: Distal Access Catheter [C1] and SOFIA: Soft torquable catheter Optimized For Intracranial Access [C2]) for procedural speed and safety of MT as well as clinical outcome at discharge and after 90 days.

Methods: This is a retrospective study of all 398 consecutive patients receiving MT with C1 or C2 for the treatment of acute ischemic stroke between September 2010 and June 2016, using a propensity score matched cohort. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.11.185DOI Listing
November 2018
1 Read

A Direct Aspiration First Pass Technique in Japanese Real-World Clinical Setting.

Oper Neurosurg (Hagerstown) 2018 Nov 28. Epub 2018 Nov 28.

Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.

Background: It is debatable whether mechanical thrombectomy has benefits in a real-world setting outside the more rigid and selective clinical trial environment.

Objective: To evaluate clinical outcomes, efficacy, and safety of mechanical thrombectomy in single-center retrospective cohort case series.

Methods: We reviewed prospectively collected data from our large-vessel occlusion stroke database to identify patients undergoing mechanical thrombectomy using Penumbra catheters (Penumbra, Almeida, California) as first-line devices. Read More

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http://dx.doi.org/10.1093/ons/opy349DOI Listing
November 2018
2 Reads

Effects of mechanical thrombectomy for acute stroke patients with etiology of large artery atherosclerosis.

J Neurol Sci 2019 Jan 19;396:178-183. Epub 2018 Oct 19.

Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China. Electronic address:

Aims: Atherosclerosis is more prevalent in Asian population. This distinct etiology of stroke might disadvantage Asian patients when applying. mechanical thrombectomy (MT). Read More

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http://dx.doi.org/10.1016/j.jns.2018.10.017DOI Listing
January 2019
6 Reads

Equal performance of aspiration and stent retriever thrombectomy in daily stroke treatment.

J Neurointerv Surg 2018 Nov 24. Epub 2018 Nov 24.

Department of Radiology, Rijnstate Hospital, Arnhem, The Netherlands.

Background: Mechanical thrombectomy with stent retrievers has proved to be safe and effective in endovascular treatment of acute ischemic stroke. Direct aspiration has shown revascularization rates comparable to those of stent retrievers in the recent ASTER and COMPASS trials. However, the efficacy of aspiration in routine clinical practice has not yet been shown. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014270DOI Listing
November 2018
2 Reads

Reasons for failed endovascular recanalization attempts in stroke patients.

J Neurointerv Surg 2018 Nov 24. Epub 2018 Nov 24.

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Purpose: Mechanical thrombectomy (MT) is a highly effective therapy in patients with acute ischemic stroke due to large vessel occlusion (LVO). However, complete recanalization of the occluded vessel cannot be achieved in all patients, leading to poor clinical outcome. We analyzed the reasons for failed recanalization to help direct future improvements in therapy. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0140
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http://dx.doi.org/10.1136/neurintsurg-2018-014060DOI Listing
November 2018
8 Reads