Thrombus Migration in the Middle Cerebral Artery: Incidence, Imaging Signs, and Impact on Success of Endovascular Thrombectomy Stroke

ConclusionsPreinterventional TM does not seem to be facilitated by intravenous recombinant tissue plasminogen activator and often occurs spontaneously. However, TM is associated with the risk of incomplete reperfusion in subsequent thrombectomy, suggesting increased clot fragility. Occurrence of TM may thereby have a substantial impact on the outcome of endovascularly treated stroke patients.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Revascularization, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Research Source Type: research

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This study aimed to evaluate the hemodynamics of basilar artery fenestration (BAF) using computational fluid dynamics (CFD).Methods: Patients with BAF and normal vertebrobasilar system were recruited and separately evaluated using CFD. Specific geometric vascular models were reconstructed based on 3D-rotational angiography (3D-RA). Patients were divided into the BAF group and control group (i.e., patients with the normal vertebrobasilar system). Hemodynamic and geometric variables were calculated and compared between groups using Student's t-test or Wilcoxon rank-sum test.Results: Overall, 24 patients were included, with 1...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
We describe a severe case of vaccine-induced immune thrombotic thrombocytopenia (VITT) after the first dose of the ChAdOx1 nCoV-19 vaccine leading to massive ischemic stroke.MethodsA 42-year-old woman developed acute left hemiparesis (NIHSS 12) 9  days after the first vaccine dose.ResultsThe blood tests revealed low platelets (70 103/ μL) and severe increment of D-dimer (70,745 ng/mL FEU). Brain non-contrast computed tomography and multiphasic CT angiography demonstrated a right middle cerebral artery occlusion. The patient was treated with primary thrombectomy, steroids, immunoglobulin, and fondaparinux. Desp...
Source: Neurological Sciences - Category: Neurology Source Type: research
We reported thrombolysis with intraarterial urokinase for MeVO with thrombus migration after MT.METHODS: We included 122 patients who were treated by MT with LVO stroke at our institution between April 2019 and March 2021. Of 26 patients (21.3%) who developed MeVO with thrombus migration after MT, 11 (9.0%) underwent additional MT (MT group) and 15 (12.3%) received intraarterial urokinase (UK group). The procedure time; angiographically modified Treatment in Cerebral Ischemia Scale (mTICI); functional independence, which was defined as modified Rankin Scale 0-2, on day 30 or upon discharge; and symptomatic and asymptomatic...
Source: Interventional Neuroradiology - Category: Radiology Authors: Source Type: research
CONCLUSION: In the evaluation of patients with acute/hyperacute strokes, CTA provides important information, identifying occlusion, as well as helping define the etiology and inform decisions regarding treatment.PMID:34866695 | PMC:PMC8630949 | DOI:10.1590/0100-3984.2020.0168
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
CONCLUSION: Patients with CVT have a higher risk of thrombolysis-related intracranial hemorrhage than other stroke mimics. A greater focus on noncontrast brain CT and the venous phase of CT angiography help identifying this stroke mimic before thrombolysis.PMID:34841501
Source: Acta Neurologica Taiwanica - Category: Neurology Authors: Source Type: research
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