Use of intracranial stent as rescue therapy after mechanical thrombectomy failure —9-year experience in a comprehensive stroke centre

AbstractPurposeThere is no established rescue treatment in patients with mechanical thrombectomy (MT) failure. Our aim is to analyse whether the use of an intracranial stent improves prognosis in these patients.MethodsRetrospective analysis of a prospective cohort of patients with ischemic stroke due to middle cerebral artery occlusion (MCA) or distal intracranial carotid artery (ICA) occlusion, from September 2009 to April 2019 in our comprehensive stroke care centre. Patients with MT failure were identified and dichotomized into two groups according to whether or not an intracranial stent was implanted. We analysed clinical outcomes in both groups.ResultsThere was MT failure in 60 patients (14%) of the 433 with large vessel occlusion in distal ICA and proximal MCA. A stent was placed in 20 of them (33.3%). Compared to patients without rescue stenting, they showed better rates of independence at 3  months (mRS ≤ 2) 45% vs 2.5% (p 
Source: Neuroradiology - Category: Radiology Source Type: research

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AbstractAimsImpaired autonomic nervous system regulation is frequently observed in patients with stroke. The aim of this prospective study was to evaluate the impact of cardiac autonomic tone on functional outcome after the early post ‐stroke rehabilitation.Methods and resultsOne hundred and three consecutive patients (67  ± 11 years, body mass index (BMI) 27.1 ± 5.4 kg/m2, 64% men) with ischaemic (84% of patients) and haemorrhagic stroke were studied. Depressed heart rate variability (HRV), as a surrogate marker of increased sympathetic tone, was defined by the standard deviat...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
CONCLUSION: The Tigertriever offers a safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies. PMID: 32529306 [PubMed - as supplied by publisher]
Source: Nuklearmedizin - Category: Radiology Authors: Tags: Clin Neuroradiol Source Type: research
ConclusionThe Tigertriever offers a  safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies.
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
AbstractBackgroundEndovascular treatment (EVT) is an established procedure in patients with acute ischemic stroke due to occlusion of the proximal M1-segment of middle cerebral artery. The assessment of distal thrombectomy in daily clinical routine has not yet been sufficiently evaluated.MethodsPatients with M2-segment-occlusions treated by EVT in the local department (January 2012 –December 2017) were included (n = 57, mean National-Institutes-of-Health-Stroke-Scale of 11, range 0–20). Patients were grouped according to localization of M2-occlusion (Cohort A (n = 14): central region onl...
Source: Neurological Sciences - Category: Neurology Source Type: research
Publication date: Available online 24 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): Paola Caruso, Miloš Ajčević, Giovanni Furlanis, Mariana Ridolfi, Carlo Lugnan, Tommaso Cillotto, Marcello Naccarato, Paolo ManganottiAbstractIntroductionRecombinant tissue plasminogen activator (rt-PA) is the first-line therapy demonstrated to be safe and effective in acute ischemic stroke. People with pre-existing severe dementia or physical disability are usually excluded from rt-PA. The aim of our study was to investigate rt-PA safety and effectiveness in acute stroke with pre-existing disability (mRS ≥ ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: The CATCH+ device is a safe and effective mechanical thrombectomy device for the first-line treatment of acute ischemic stroke.
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
Conclusions: The results support that the direct aspiration technique for those acute ischemic stroke patients may have better functional outcomes, less procedure related-adverse events and a tendency of faster revascularization time as compared to the stent-retriever thrombectomy, with a similar successful recanalization rate. However, major limitations of current evidence (mainly from retrospective and observational studies and a small number of patients population) indicate a need for adequately powered, multicenter randomized controlled trials (RCT) to answer this question.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
Conclusions The factors relating to a worse functional outcome were symptomatic hemorrhage transformation, lack of recanalization and complications during EVT. The factors relating to mortality were symptomatic hemorrhage and hydrocephalus. Distal flow was achieve in most cases with a low complication rate. Half of the patients presented functional independence one year after the stroke.
Source: Medicina Intensiva - Category: Intensive Care Source Type: research
The objective of this study was to explore the relationship between patients ’ sex and post-stroke health outcomes and received care in a Swedish setting.MethodsPatients with a registered diagnosis of acute intracerebral hemorrhage (ICH) or ischemic stroke (IS) within regional administrative systems (ICD-10 codes I61* or I63*) and the Swedish Stroke Register during 2010 –2011 were included and followed for 1 year. Data linkage to multiple other data sources on individual level was performed. Adjustments were performed for age, socioeconomic factors, living arrangements, ADL dependency, and stroke severity ...
Source: Biology of Sex Differences - Category: Biology Source Type: research
Conclusions There is no reason to withhold mechanical thrombectomy on the basis of age alone. Small infarct core, low NIHSS, male gender and use of IVT are associated with a better functional outcome.
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
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