Endovascular Treatment of Acute Ischemic Stroke

AbstractPurpose of reviewEndovascular thrombectomy (ET), the standard of treatment for emergent large vessel occlusion (ELVO) strokes, has been subject to rigorous efforts to further improve its usage and delivery for optimised patient outcomes. This review aims to provide an outline and discussion about the recently established and emerging recommendations regarding endovascular treatment of stroke.Recent findingsThe indications for ET have expanded continually, with perfusion imaging now enabling selection of patients presenting 6 –24 h after last-known-well, and improved device and operator proficiency allowing treatment of M2-MCA occlusions and tandem occlusions. Further inclusion of paediatric patients and patients with larger infarct core or milder stroke symptoms for ET has been proposed; however, this remains unprove n. This growing applicability is supported by more efficient systems of care, employing modern techniques such as telemedicine, mobile stroke units and helicopter medical services. Ongoing debate exists regarding thrombolytic agent, thrombectomy technique, anaesthesia method and the role of advanced neuroimaging, with upcoming RCTs expected to provide clarification.SummaryThe journey to further improving the efficacy of ET has advanced and diversified rapidly over recent years, involving improved patient selection, increased utility of advanced neuroimaging and ongoing device redevelopment, within the setting of more efficient, streamlined syst...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research

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CONCLUSIONS: MHR may be a significant and independent predictor of poor functional outcome in patients with AIS. PMID: 31941849 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
ConclusionFast T2*W sequences demonstrated very good diagnostic performance and inter-reader agreement for detecting SVS in the M1 segment in patients with acute ischemic stroke.
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research
eng Tsong-Hai Lee Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagn...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Purpose of review Diagnosis of stroke and understanding the mechanism of stroke is critical to implement optimal treatment. RNA expressed in peripheral blood cells is emerging as a precision biomarker to aid in stroke diagnosis and prediction of stroke cause. In this review, we summarize available data regarding the role of RNA to predict stroke, the rationale for these changes, and a discussion of novel mechanistic insight and clinical applications. Recent findings Differences in RNA gene expression in blood have been identified in patients with stroke, including differences to distinguish ischemic from hemorrhagic s...
Source: Current Opinion in Neurology - Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research
Intravenous thrombolysis therapy (IVT) bridged with intra-arterial thrombectomy (IAT) has recently been recommended as favorable treatment option to ensure that the thrombolytic effect is delivered to the affe...
Source: BMC Neurology - Category: Neurology Authors: Tags: Research article Source Type: research
CONCLUSIONS: Homocysteine could be a potential biomarker to discriminate the effects of dual and single antiplatelet therapy in female patients with minor ischemic stroke or high-risk transient ischemic attack. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00979589. PMID: 31941381 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners. PMID: 31932552 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Conclusions: Machine learning algorithms can be employed to develop prognostic predictive biomarkers for stroke outcomes in ischemic stroke patients, particularly in regard to identifying acute gene expression changes that occur during stroke.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSION: Clots in diabetic patients had more fibrin and fewer erythrocyte components compared with patients without diabetes mellitus, while hyperglycemia on admission did not show association with clot composition. Further studies are needed to confirm these results. PMID: 31924102 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
A 57-year-old man with atherosclerosis obliterans was admitted with sudden-onset sensory aphasia and right hemiparesis. Brain MRI revealed acute cerebral infarctions in the left temporal lobe and magnetic resonance angiography showed occlusion of the posterior branch of the left middle cerebral artery. Transesophageal echocardiography and ultrasonography respectively confirmed a patent foramen ovale and deep vein thrombosis in the bilateral femoral veins. Blood findings showed low protein S antigen, low protein S activity, and a missense mutation of the PROS 1 gene.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
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