2,982 results match your criteria thrombectomy stent

Combination of Rescue Stenting and Antiplatelet Infusion Improved Outcomes for Acute Intracranial Atherosclerosis-Related Large-Vessel Occlusion.

Front Neurol 2021 5;12:608270. Epub 2021 Jul 5.

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.

Intracranial atherosclerosis-related large-vessel occlusion caused by thrombo-occlusion (ICAS-LVO) has been regarded an important reason for refractoriness to mechanical thrombectomy (MT). To achieve better outcomes for ICAS-LVO, different endovascular strategies should be explored. We aimed to investigate an optimal endovascular strategy for ICAS-LVO. Read More

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Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever : Preliminary Clinical Experience.

Clin Neuroradiol 2021 Jul 20. Epub 2021 Jul 20.

IDI-Radiology, University Hospital Dr Josep Trueta, Girona, Spain.

Background: Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices. Read More

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Comparison of balloon guide catheters and standard guide catheters for acute ischemic stroke: A systematic review and meta-analysis.

World Neurosurg 2021 Jul 16. Epub 2021 Jul 16.

Nested Knowledge, Inc, 1430 Avon St N, St. Paul, MN, USA; Superior Medical Experts, 1430 Avon St N, St. Paul, MN, USA; Duke University Law School, Durham, NC, USA. Electronic address:

Background: Balloon guide catheters (BGC) are designed to induce flow arrest during mechanical thrombectomy (MT) procedures for acute ischemic stroke due to large vessel occlusion, and have been associated with improved clinical and angiographic outcomes. We conducted a systematic review and meta-analysis evaluating the relative technical and clinical outcomes associated with BGC vs. non-BGC approaches. Read More

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First-Pass Reperfusion by Mechanical Thrombectomy in Acute M1 Occlusion: The Size of Retriever Matters.

Front Neurol 2021 22;12:679402. Epub 2021 Jun 22.

Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany.

Single-pass complete reperfusion using stent retrievers has been shown to improve functional outcome in patients with large vessel occlusion strokes. The aim of this study was to investigate the optimal size of stent retrievers to achieve one-pass complete reperfusion by mechanical thrombectomy. The study evaluated the results of aspiration-assisted mechanical thrombectomy of acute isolated occlusion of the middle cerebral artery in the M1 segment with a novel 5 × 40-mm stent retriever compared to the usual 4 × 20-mm device. Read More

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Peripheral Non-cerebrovascular Arterial Stent Retriever Applications.

Vasc Endovascular Surg 2021 Jul 15:15385744211028727. Epub 2021 Jul 15.

David Geffen School of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.

Several treatment options exist for acute intra-abdominal arterial thromboembolic events, including systemic thrombolytics, endovascular therapy, and less commonly surgery. A novel alternative treatment intervention for acute intra-abdominal arterial thrombus is the use of stent retriever (SR) devices, tools traditionally applied for treatment of acute vascular thrombosis in stroke patients. This brief report presents two cases of acute intra-abdominal arterial thrombosis successfully managed by deployment of SRs. Read More

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A novel treatment using a guide extension catheter and distal protection device for refractory coronary embolism: case report.

Eur Heart J Case Rep 2021 Jan 15;5(1):ytaa507. Epub 2021 Jan 15.

Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Hyogo 6650873, Japan.

Background: A large thrombus burden in patients with acute myocardial infarction is associated with worse outcomes. Although various methods of thrombus aspiration have been described, there is a potential limitation in the mechanism of eliminating a thrombus with only the use of an aspiration device. In this report, we present a novel method of retrieving massive thrombus using a guide extension catheter and a filter device. Read More

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January 2021

Off-Label Use of a Double-Layer Micromesh Carotid Stent for Hybrid Treatment of Popliteal Artery Aneurism Complicated by Chronic Distal Embolization.

Case Rep Vasc Med 2021 21;2021:5546194. Epub 2021 Jun 21.

Department of General Surgery Nr.3, Vascular Surgery Clinic, Nicolae Testemitanu State University of Medicine and Pharmacy, 165 Stefan cel Mare si Sfant Bd., Chisinau, Moldova.

We report our initial experience in off-label use of the double-layer micromesh (DLM) Roadsaver® stent for the hybrid treatment of a fusiform popliteal artery aneurism complicated by distal embolization and chronic limb threatening ischemia in a COVID-19-positive young male. A 36-year-old male patient was admitted with chronic limb threatening ischemia of the left lower limb. The duplex ultrasound and computer tomography angiography (CTA) demonstrated a fusiform popliteal artery aneurism with a maximal diameter of 14 mm and distal occlusion of peroneal and both tibial arteries. Read More

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Device size selection can enhance Y-stentrieving efficacy and safety as a rescue strategy in stroke thrombectomy.

J Neurointerv Surg 2021 Jul 7. Epub 2021 Jul 7.

Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, and the Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: Despite advancements in stroke treatment, refractory clots are relatively common, prompting the exploration of alternative techniques. Bifurcation occlusions pose specific intraprocedural challenges, occasionally dealt with by two stentrievers deployed in Y-configuration. Previous studies have portrayed this strategy as feasible, yet little is known about its safety and efficacy, and how to best select retrievers. Read More

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Mechanical thrombectomy beyond the circle of Willis: efficacy and safety of different techniques for M2 occlusions.

J Neurointerv Surg 2021 Jul 5. Epub 2021 Jul 5.

Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Background: M2 segment occlusions represent approximately one-third of non-lacunar ischemic stroke and can lead to permanent neurological deficits. Various techniques are available for mechanical thrombectomy beyond the circle of Willis, but data evaluating their effectiveness and safety are lacking.

Methods: A retrospective review of patients with ischemic stroke undergoing mechanical thrombectomy for M2 occlusions from 13 centers in North American and Europe was performed. Read More

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Experimental Evaluation of the Risk of Distal Embolization during Endovascular Clot Retrieval Using Various Techniques.

Asian J Neurosurg 2021 Jan-Mar;16(1):84-88. Epub 2021 Feb 23.

Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi, Japan.

Background: This study was conducted to evaluate various devices and techniques for endovascular thrombectomy that can reduce the risk of intraprocedural distal embolism in a preliminary in vitro setting with different types of thrombi.

Materials And Methods: Endovascular clot retrieval was performed in a vascular model with collateral circulation. White and red thrombi were prepared using whole blood collected from a pig. Read More

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February 2021

Safety and Effectiveness of a Modified ASAP Technique during Mechanical Thrombectomy for Acute Ischemic Stroke: Initial Clinical Experience.

Asian J Neurosurg 2021 Jan-Mar;16(1):56-61. Epub 2021 Mar 20.

Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi, Japan.

Objectives: For patients with acute ischemic stroke, various endovascular approaches have been reported with high recanalization rates and good clinical outcomes. However, the best technique for the first attempt at mechanical thrombectomy remains a matter of debate. In this study, we evaluated the efficacy of a modified version of a stent-retrieving into an aspiration catheter with a proximal balloon (ASAP) technique. Read More

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Does stroke etiology influence outcome in the posterior circulation? An analysis of 107 consecutive acute basilar occlusion thrombectomies.

Neurosurg Focus 2021 Jul;51(1):E7

Objective: Acute basilar artery occlusion (BAO) harbors a more guarded prognosis after thrombectomy compared with anterior circulation large-vessel occlusion. Whether this is a function of a greater proportion of atherosclerotic/intrinsic lesions is not well studied. The authors aimed to elucidate the prevalence and predictors of intracranial intrinsic atherosclerotic disease in patients with acute BAO and to compare angiographic and clinical outcomes between patients with BAO secondary to embolic versus intrinsic disease. Read More

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Comparison of effectiveness and outcomes among different thrombectomy techniques in acute basilar artery occlusion: a dual-center experience.

Neurosurg Focus 2021 Jul;51(1):E8

Departments of1Neurosurgery.

Objective: Acute basilar artery occlusion (BAO) is a rare large-vessel occlusion associated with high morbidity and mortality. Modern thrombectomy with stent retrievers and large-bore aspiration catheters is highly effective in achieving recanalization, but a direct comparison of different techniques for acute BAO has not been performed. Therefore, the authors sought to compare the technical effectiveness and clinical outcomes of stent retriever-assisted aspiration (SRA), aspiration alone (AA), and a stent retriever with or without manual aspiration (SR) for treatment of patients presenting with acute BAO and to evaluate predictors of clinical outcome in their cohort. Read More

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Successful Percutaneous Balloon Angioplasty in a Patient Presenting With STEMI and Acute Intracranial Hemorrhage.

Cureus 2021 May 22;13(5):e15166. Epub 2021 May 22.

Interventional Cardiology, Jersey Shore University Medical Center, Neptune, USA.

Percutaneous coronary interventions (PCI) mandates the administration of anti-platelet and anti-thrombotic agents to prevent intracoronary and post-procedural thrombosis upon introducing thrombogenic foreign bodies such as intracoronary wires, balloons, or stents, especially in the setting of acute coronary syndrome (ACS) given the hypercoagulable state associated with it. This is a case of a 54-year-old female who presented to the emergency department with left-sided weakness and dysarthria for an unknown duration. A CT scan of the head showed acute right middle cerebral artery distribution infarct. Read More

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Mechanical rotational thrombectomy in long femoropopliteal artery and stent occlusion in COVID-19 patient: Case report.

Int J Surg Case Rep 2021 Jul 24;84:106133. Epub 2021 Jun 24.

Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.

Introduction: Coronavirus disease-19 (COVID-19) has been increasingly associated with thromboembolic complications. COVID-19 infection has a thrombogenic potential for stents. Herein, we report a case of stent thrombosis in diabetic obese patient COVID-19 positive where was previously released a Multilayer Flow Modulator stent (MFM) for large popliteal aneurysm. Read More

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Management of Internal Carotid Artery and Intracranial Anterior Circulation Tandem Occlusion with Stenting versus No Stenting: A Multicenter Study.

World Neurosurg 2021 Jun 25. Epub 2021 Jun 25.

Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.

Background: Tandem occlusion (TO) describes not only occlusion of the middle cerebral artery but a contemporaneous occlusion of the cervical internal carotid artery. There is a paucity of data over whether mechanical thrombectomy (MT) alone, MT with angioplasty, or MT with carotid artery stent placement is superior. We aim to address a gap in the literature comparing carotid stenting with mechanical thrombectomy (CSMT) and carotid angioplasty with mechanical thrombectomy (CAMT) in patients presenting with acute anterior circulation TOs. Read More

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Management of tandem occlusions in patients who receive rtPA.

J Thromb Thrombolysis 2021 Jun 23. Epub 2021 Jun 23.

Department of Neurological Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH, 43210, USA.

Background: Tandem occlusions exist in 17-32% of large vessel occlusion (LVO) strokes. A significant concern is bleeding when carotid stenting is performed in tandem with thrombectomy due the administration of antiplatelet agents such as glycoprotein IIb/IIIa inhibitors (GP2b3aI) after receiving rtPA, but data are limited in this setting.

Methods: A mutlicenter, retrospective chart review was conducted at two comprehensive stroke centers to assess the safety and efficacy of using GP2b3aI to facilitate carotid stent placement simultaneously with endovascular thrombectomy in patients who have received rtPA. Read More

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Endovascular therapy in cerebrovascular event due to internal carotid artery tandem injuries: a case report.

Radiol Case Rep 2021 Aug 9;16(8):2095-2098. Epub 2021 Jun 9.

Fundación Valle del Lili, Departamento de Radiología e imágenes diagnósticas, Cra 98 No. 18 - 49, Cali 760032, Colombia.

Internal carotid artery tadndem lesions are common and are associated with a worse prognosis. There is still no clarity on the endovascular therapy strategy that should be used in the setting of acute cerebrovascular events. We present the case of a patient with acute cerebral ischemia secondary to internal caroid artery tandem lesion, who underwent intracranial thrombectomy and early stenting of the extracranial occlusion, who in a 12-month follow-up did not present complications associated with the procedure, sequelae neurological, thromboembolic recurrence or hemorrhagic events. Read More

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The short- and long-term efficacies of endovascular interventions for the treatment of acute ischemic stroke patients.

Am J Transl Res 2021 15;13(5):5436-5443. Epub 2021 May 15.

Department of Neurology, Xi'an Gaoxin Hospital, Affiliated to Northwest University Xi'an, Shaanxi Province, China.

Objective: We aimed to investigate the short- and long-term efficacies of endovascular interventional therapy in acute ischemic stroke (AIS) patients.

Methods: In this retrospective study, 94 patients with AIS were recruited and divided into a control group (n=51) that was administered intra-arterial thrombolysis and an observation group (n=43) that was administered Solitaire stent thrombectomies. The postoperative recanalization and overall response rates were recorded in both groups. Read More

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Safety of Low Dose Intravenous Cangrelor in Acute Ischemic Stroke: A Case Series.

Front Neurol 2021 4;12:636682. Epub 2021 Jun 4.

ProMedica Neurosciences Center, Toledo, OH, United States.

Neurointerventional procedures in acute ischemic stroke often require immediate antiplatelet therapy in the cases of acute stenting and occasionally re-occluding vessels. Intravenous cangrelor is a P2Y12 receptor antagonist with short onset and quick offset. The study objective was to evaluate the safety and efficacy of intravenous cangrelor in patients with acute ischemic stroke requiring urgent antiplatelet effect. Read More

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Analysis of 565 thrombectomies for anterior circulation stroke: A Brazilian registry.

Interv Neuroradiol 2021 Jun 18:15910199211026995. Epub 2021 Jun 18.

Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

Introduction: The benefits of mechanical thrombectomy in the treatment of patients with acute stroke due to large vessel occlusions (LVOs) have been extensively demonstrated by randomized trials and registries in developed countries. However, data on thrombectomy outside controlled trials are scarce in developing countries. The aim of this study was to assess the safety and efficacy, and to investigate the predictors for good and poor outcomes of thrombectomy for treatment of AIS due to anterior circulation LVOs in Brazil. Read More

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Association of Hypotension During Thrombectomy and Outcomes Differs With the Posterior Communicating Artery Patency.

Stroke 2021 Jun 17:STROKEAHA121034542. Epub 2021 Jun 17.

Interventional Neuroradiology Department, Fondation Ophtalmologique A. de Rothschild, Paris, France (B.M., E.R., J.-P.D., F.D., S.H., H.R., S.S., S.E., R.B., M.P., M.M.).

Background And Purpose: Hypotension during endovascular therapy for acute ischemic stroke is associated with worse functional outcomes (FO). Given its important role in intracranial hemodynamics, we investigated whether hypotension during endovascular therapy had the same effect on FO according to the posterior communicating artery (PComA) patency.

Methods: We performed a post hoc analysis of the ASTER trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization). Read More

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Neuroendovascular Management of Acute Ischemic Basilar Strokes: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 Jun 15. Epub 2021 Jun 15.

Division of Neuroendovascular Surgery, Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Basilar artery occlusions (BAOs) are devastating ischemic strokes that account for 1% of all strokes with high morbidity and mortality; however, neuroendovascular techniques such as ADAPT have recently revolutionized the clinical outcomes of these patients.1-3 Common underlying pathology in patients with BAO include intracranial atherosclerotic disease (ICAD) as well as thromboembolic origin.4 Basilar artery ICAD in a setting of acute stroke portends a poor prognosis and post-thrombectomy residual critical flow limiting stenosis treatment options, including balloon angioplasty with or without stent placement. Read More

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Rescue Maneuver of Migrated Coil Using the ERIC Device after Previous Attempts with Conventional Stentrievers.

Neurointervention 2021 Jul 16;16(2):158-164. Epub 2021 Jun 16.

Interventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.

Coil prolapse or migration is a rare but potentially serious complication that may occur during aneurysm embolization, with no standard management currently described. Here we describe our experience with the Embolus Retriever with Interlinked Cages (ERIC) device® (Microvention, Aliso Viejo, CA, USA) for the retrieval of prolapsed or migrated coils in a case series and Flow-Model analysis. First, a retrospective review was performed using our institution database for patients in which coil prolapse or migration occurred during aneurysm embolization, and data was collected and analyzed. 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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Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child.

Front Neurol 2021 28;12:670565. Epub 2021 May 28.

Department of Neuroradiology, Toulouse University Hospital, Université Toulouse III, Toulouse, France.

Despite extensive evidence of benefit of thrombectomy in adult ischemic stroke due to large-vessel occlusion in the 6-h window, its role remains uncertain in very young children. We describe hereafter the case of a 2-year-old female child who had a successful thrombectomy 9 h after stroke onset. The patient presented with right hemiplegia, central facial palsy, a normal level of consciousness, and speech difficulties. Read More

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Increased Postoperative Fasting Glucose Is Associated With Unfavorable Outcomes in Patients Treated With Mechanical Thrombectomy Treatment.

Front Neurol 2021 28;12:668363. Epub 2021 May 28.

Zhejiang Provincial People's Hospital, Hangzhou, China.

Hyperglycemia on admission was associated with worse clinical outcomes after mechanical thrombectomy (MT) of acute ischemic stroke (AIS). We evaluated whether increased postoperative fasting glucose (PFG) was also related to poor clinical outcomes in patients who underwent MT treatment. Consecutive patients with large vessel occlusion underwent MT in our center were included. Read More

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Successful removal of a Life-threatening PE using the INARI flow triever device.

Radiol Case Rep 2021 Jul 25;16(7):1878-1881. Epub 2021 May 25.

McClow, Clark and Berk Radiologists, Jacksonville, Florida.

The authors report a case of a 75-year-old male with pulmonary embolism (PE) successfully treated using the INARI FlowTriever System, a mechanical thrombectomy device. Imaging confirmed deep vein thrombosis and PE presented after two days of left lower extremity (LLE) pain and dyspnea on exertion with history of peripheral vascular disease, coronary artery disease, insulin dependent diabetes mellitus, hyperlipidemia and LLE percutaneous coronary intervention with coronary stent placement. PE treatment with single session clot burden reduction resulted in immediate improvement in oxygenation and echocardiogram confirmed relief of right heart strain. Read More

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