Abstract Background and Purpose— Understanding the hemorrhage risks associated with brain arteriovenous malformations (AVMs) before and after stereotactic radiosurgery (SRS) is important. The aims of this multicenter, retrospective cohort study are to evaluate and compare the rates of pre- and post-SRS AVM hemorrhage and identify risk factors.
Abstract Background and Purpose— The benefit of endovascular therapy in extended time windows has been demonstrated in patients with anterior circulation large vessel occlusion ischemic stroke and favorable imaging profile. We evaluated whether collaterals and thrombus burden influence the associations between revascularization, time-to-treatment, and outcome in endovascular therapy-treated patients with basilar artery occlusion.
Abstract Background and Purpose— Intracranial atherosclerosis (ICAS) is an important cause of large vessel occlusion and poses unique challenges for emergent endovascular thrombectomy. The risk factor profile and therapeutic outcomes of patients with ICAS-related occlusions (ICAS-O) are unclear. We performed a systematic review and meta-analysis of studies reporting the clinical features and thrombectomy outcomes of large vessel occlusion stroke secondary to underlying ICAS (ICAS-O) versus those of other causes (non–ICAS-O).
Abstract Background and Purpose— The clinical course in patients with ischemic stroke treated with mechanical thrombectomy (MT) is heterogeneous. We aimed to study the relevance of the timing of clinical improvement in the prediction of long-term outcome in patients treated with MT.
Abstract Background and Purpose— To evaluate the safety and effectiveness of the Surpass Flow Diverter (Surpass; Stryker Neurovascular, Fremont, CA) in the treatment of large or giant wide-neck intracranial aneurysms at one year, we hypothesize that treatment with Surpass meets or improves on historical safety and efficacy end points.
Abstract Background and Purpose— Based on its mechanism, the use of balloon guide catheters (BGCs) may be beneficial during endovascular treatment, regardless of the type of mechanical recanalization modality used—stent retriever thrombectomy or thrombaspiration. We evaluated whether the use of BGCs can be beneficial regardless of the first-line mechanical endovascular modality used.
Abstract Background and Purpose— Several studies have reported partial reversal of diffusion-weighted imaging (DWI) lesions after acute stroke reperfusion treatment. However, factors associated with DWI reversal have not yet been systematically investigated. We evaluated the factors associated with DWI reversal after endovascular treatment (EVT).
Abstract Background and Purpose— The development of leptomeningeal collateral artery network might be adversely affected by small vessel wall alteration. We sought to determine whether small vessel disease (SVD) burden may impact collateral development in patients treated by mechanical thrombectomy for anterior circulation acute ischemic stroke.
Mechanical thrombectomy (MT) therapy has become the standard of care for selected patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion.1 After MT, the scheme for follow-up brain imaging is currently similar to that for patients treated with intravenous thrombolysis (IVT) or medical treatment: it is performed in emergency in cases of neurological worsening and within 24 hours1 to detect hemorrhagic transformation (HT), guide antithrombotic treatment regimen, and evaluate arterial patency and final infarct volume. Follow-up brain imaging findings nonetheless differ in patients who received MT from those who only received IVT, because of the arterial injection of iodine contrast in the target vessel, direct clot manipulations, and intracranial/cervical catheterization, as well as specific MT-related complications.
Endovascular therapy (ET) for acute ischemic stroke is now broadly recognized as one of the most powerful treatments in our field. Nonetheless, only a highly selected proportion of large vessel occlusion stroke (LVOS) patients are presently being offered treatment. Herein, we discuss some of the scientific and philosophical aspects surrounding the care of LVOS and provide a critical view of the current clinical practice centering our discussions on the concept of personalized medicine.
A 35-year-old woman is found paralyzed in a bathroom. She had been shopping with her mother for bridesmaids’ gifts. She had suffered a severe migraine during the previous 3 weeks and had been evaluated at an outside hospital. For the migraine, she had undergone noncontrast CT head scan and lumbar puncture with normal results. She had been treated with enough narcotics to induce nausea, vomiting, and dehydration but eventually was discharged without headache one week before presentation. The day of admission was her first trip outside the house. After shopping a while, she complained to her mother of a strange feeling and went into the ladies’ room. When she did not return, the mother investigated and found her awake but confused and paralyzed on the left side. Paramedics were summoned who surmised she could be having a stroke and contacted the closest medical center. Upon arrival at the outlying hospital, a neurologist was summoned.
Abstract Background and Purpose— Radial artery catheterization is an alternate route of access that has started to gain more widespread use for neuroendovascular procedures, and there have been few studies that describe its safety and efficacy. We present our institution’s experience in performing neuroendovascular interventions via a transradial approach, with excellent clinical outcomes and patient satisfaction measures.
Abstract Background and Purpose— The DEFUSE 3 trial (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) demonstrated that endovascular thrombectomy in the 6- to 16-hour time window improves functional outcomes of patients with evidence of salvageable tissue on baseline computed tomography or magnetic resonance imaging. The purpose of this study is to assess the effect of endovascular therapy on length of hospital stay, home-time during the first 3 months poststroke, and living situation poststroke in DEFUSE 3.
Abstract Background and Purpose— Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement.
Abstract Background and Purpose— Endovascular treatment for large vessel occlusion in ischemic stroke has proven to be effective in large clinical trials. We aimed to provide real-world estimates of endovascular treatment reperfusion rates and functional outcome on a countrywide scale.
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