Influence of Arterial Occlusion on Outcome After Intravenous Thrombolysis for Acute Ischemic Stroke Clinical Sciences

Background and Purpose— We aimed to assess the interaction between intravenous thrombolysis (IVT) and arterial occlusion on acute cervicocerebral computed tomographic angiography on the outcome of patients with acute ischemic stroke. Methods— Patients from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) registry with onset-to-door-time ≤4 hours, acute cervicocerebral computed tomographic angiography, a premorbid modified Rankin Scale ≤2, and a National Institute of Health Stroke Scale (NIHSS)>4 were selected. Patients with significant intracranial arterial obstruction (≥50%–99%) and undergoing acute endovascular treatment were excluded. An interaction analysis of IVT and initial arterial occlusion for favorable 3 months outcome (modified Rankin Scale
Source: Stroke - Category: Neurology Authors: Tags: Arterial thrombosis, CT and MRI, Acute Cerebral Infarction, Thrombolysis, Other Stroke Treatment - Medical Clinical Sciences Source Type: research

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Conclusions: Transcirculation approaches may be used to access the target lesion when the parent artery cannot be crossed through conventional antegrade routes. These techniques are feasible but should be reserved as a bailout maneuver when anterograde MT is not possible. Newer endovascular devices have improved neurological and angiographic outcomes in transcirculation cases.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSIONS: Acute ischemic stroke with large-vessel occlusion due to calcified emboli is a rare entity in patients undergoing thrombectomy, with considerably worse angiographic outcome and a higher mortality compared with patients with noncalcified thrombi. Good functional recovery at 3 months can still be achieved in about a quarter of patients.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: INTERVENTIONAL Source Type: research
CONCLUSION: Higher GI and GL were positively associated with a higher degree of carotid stenosis in these Chinese cerebral infarction patients, especially in younger patients and women. PMID: 32147606 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
ConclusionThe PVHS on 3D BB contrast-enhanced MRI is a highly specific tool for evaluating the location and length of a thrombus in AIS patients.
Source: Japanese Journal of Radiology - Category: Radiology Source Type: research
ConclusionImaging of thrombus can be used as an aseessment tool to predict the outcomes and it needs further studies in the future.
Source: Neurological Sciences - Category: Neurology Source Type: research
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSION: Unenhanced CT is a mainstay of acute phase imaging due to its availability and, sensitivity and specificity for detecting acute haemorrhage. Several imaging features can be identified on CT and, along with clinical information, can provide some certainty in diagnosis. For those suitable and where diagnostic uncertainty remains CT angiogram, time-resolved CT angiography and catheter angiography can help identify underlying AVMs, aneurysms, cavernomas and vasculitides. MRI is more sensitive for the detection of subacute and chronic haemorrhage and identification of underlying mass lesions. PMID: 32008532 [PubMed - in process]
Source: Current Medical Imaging Reviews - Category: Radiology Tags: Curr Med Imaging Rev Source Type: research
CONCLUSIONS: Acute ischemic stroke with large-vessel occlusion due to calcified emboli is a rare entity in patients undergoing thrombectomy, with considerably worse angiographic outcome and a higher mortality compared with patients with noncalcified thrombi. Good functional recovery at 3 months can still be achieved in about a quarter of patients. PMID: 32029470 [PubMed - as supplied by publisher]
Source: Nuklearmedizin - Category: Radiology Authors: Tags: AJNR Am J Neuroradiol Source Type: research
Authors: Rossi UG, Ierardi AM, Cariati M Abstract A 77-year-old woman with a history of hypertension developed acute onset of aphasia and right hemiplegia and hemisensory loss. She was urgently referred to emergency department. Cerebral multidetector computed tomographic angiography (MD-CTA) revealed an acute ischemic stroke due to the occlusion of the left middle cerebral artery (Figure 1). Since the symptoms started three hours previously, the patient was candidate for mechanical thrombectomy. The patient then performed a selective digital subtraction angiography (DSA) of the left internal carotid artery that con...
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan 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
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