Periprocedural Cost-Effectiveness Analysis of Mechanical Thrombectomy for Acute Ischemic Stroke in the Stent Retriever Era
Background: Early reperfusion is critical for favorable outcomes in acute ischemic stroke (AIS). Stent retrievers lead to faster and more complete reperfusion than previous technologies. Our aim is to compare the cost-effectiveness of stent retrievers to the previous mechanical thrombectomy devices. Methods: Retrospective review of endovascularly treated large-vessel AIS. Data from all consecutive patients who underwent thrombectomy from January 2012 through November 2012 were collected. Baseline characteristics, the total procedural cost, the rates of successful recanalization [modified thrombolysis in cerebral ischemia (...
Source: Interventional Neurology - March 5, 2015 Category: Neurology Source Type: research
Thrombolysis in Chinese Ischemic Stroke Patients with Renal Dysfunction
Background: Current data concerning the relationship between renal function and clinical outcome among stroke patients treated with intravenous thrombolytic therapy are conflicting. Our aim is to analyze whether the clinical outcome of Chinese ischemic stroke patients treated with thrombolytic therapy is affected by the presence of renal dysfunction. Methods: Chinese patients who received intravenous thrombolytic therapy for acute ischemic stroke were recruited. Renal dysfunction was defined as an estimated glomerular filtration rate (eGFR) (Source: Interventional Neurology)
Source: Interventional Neurology - February 27, 2015 Category: Neurology Source Type: research
Implementation of Intraoperative Neurophysiological Monitoring during Endovascular Procedures in the Central Nervous System
Conclusions: IOM may provide continuous real-time data about the functional status of eloquent areas and pathways of the central nervous system in patients under general anesthesia. It therefore allows us to detect early neurological damage in time to perform specific actions that may prevent irreversible neurological deficits.Intervent Neurol 2014;3:85-100 (Source: Interventional Neurology)
Source: Interventional Neurology - January 20, 2015 Category: Neurology Source Type: research
High-Flow Carotid Cavernous Fistula and the Use of a Microvascular Plug System: Initial Experience
Conclusion: The microvascular plug is a new addition to current endovascular embolization devices for the treatment of high-flow, direct carotid cavernous fistulas. This technique offers easy navigability through tortuous arteries, precise localization and immediate occlusion, which may allow shorter procedure and fluoroscopy times and increased cost-effectiveness. Larger case series are needed to support our observation.Intervent Neurol 2014;3:78-84 (Source: Interventional Neurology)
Source: Interventional Neurology - December 15, 2014 Category: Neurology Source Type: research
The Development of Carotid Stent Material
Endovascular angioplasty with stenting is a promising option for treating carotid artery stenosis. There exist a rapidly increasing number of different stent types with different materials. The bare-metal stent is the most commonly used stent with acceptable results, but it leaves us with the problems of thrombosis and restenosis. The drug-eluting stent is a breakthrough as it has the ability to reduce the restenosis rate, but the problem of late thrombosis still has to be addressed. The biodegradable stent disappears after having served its function. However, restenosis and degradation rates remain to be studied. In this ...
Source: Interventional Neurology - December 11, 2014 Category: Neurology Source Type: research
Aggressive Medical Care in Young Chinese Patients with Ischemic Stroke of Undetermined Etiology: A Retrospective Study
Conclusion: Compared with RMM, AMM is more efficacious in the prevention of secondary ischemic stroke and progressive arterial lesions among young adults with ischemic stroke of undetermined etiology.Intervent Neurol 2014;3:56-66 (Source: Interventional Neurology)
Source: Interventional Neurology - December 8, 2014 Category: Neurology Source Type: research
Large Deep White Matter Lesions May Predict Futile Recanalization in Endovascular Therapy for Acute Ischemic Stroke
Conclusion: Patients with large preintervention DWI-DWM lesions may be poor candidates for endovascular therapy.Intervent Neurol 2014;3:48-55 (Source: Interventional Neurology)
Source: Interventional Neurology - December 8, 2014 Category: Neurology Source Type: research
Endovascular Treatment of Proximal Aortic Arch Lesions through a Retrograde Approach
We report our experience in the hybrid surgical and endovascular treatment of complex proximal CCA and IA lesions. Eleven patients who underwent hybrid procedures with surgical exposure (with or without endarterectomy) of the carotid artery and retrograde endovascular intervention of a proximal lesion were included in the study. The mean percentage of stenosis was 81%. Seven patients underwent a carotid endarterectomy (CEA), and 4 patients underwent only a surgical cutdown for retrograde endovascular access of the IA or left CCA. All procedures were technically successful. Eight patients had no symptoms within 30 days of t...
Source: Interventional Neurology - November 27, 2014 Category: Neurology Source Type: research
Endovascular Revascularization for Basilar Artery Occlusion
Basilar artery occlusion is one of the most devastating neurological conditions known to man. Though rare, patients with clinical syndromes localized to this anatomical region are often referred to acute stroke and endovascular units. Recent studies evaluating the efficacy of endovascular approaches to stroke have focused on anterior circulation syndromes. In this review, we examine the approaches to stroke syndromes due to basilar artery thrombosis. We share the relevant data for intravenous and intra-arterial tissue plasminogen activator as well as mechanical approaches to restoring perfusion in this critical area of the...
Source: Interventional Neurology - November 14, 2014 Category: Neurology Source Type: research
Pulmonary Arteriovenous Malformation as a Cause of Embolic Stroke: Case Report and Review of the Literature
We describe an 82-year-old woman without history of respiratory or neurological diseases, who presented at our observation unit with acute onset of cerebral ischemia. Clinical, laboratory and radiological findings diagnosed a PAVM. Key Messages: Usually, endovascular procedures based on embolization or, alternatively, surgery represent the recommended treatment. However, both hormonal therapy and thrombolytic therapy can be used. In our patient, treatment with warfarin induced a remission of symptoms. This strategy should be tested in larger studies.Intervent Neurol 2014;3:27-30 (Source: Interventional Neurology)
Source: Interventional Neurology - November 10, 2014 Category: Neurology Source Type: research
10th International Stroke Summit, June 13-15, 2014, Nanjing, China: Abstracts
Intervent Neurol 2013;2:169-177 (Source: Interventional Neurology)
Source: Interventional Neurology - November 7, 2014 Category: Neurology Source Type: research
Cerebrospinal Venous Outflow in Multiple Sclerosis Patients versus Fatigue and/or Depression
Conclusions: We found no significantly impaired cerebrospinal venous outflow in patients with MS versus sex- and age-matched controls. Furthermore, we did not find any correlation between anxiety or depression and impaired venous outflow in MS patients.Intervent Neurol 2013;2:193-200 (Source: Interventional Neurology)
Source: Interventional Neurology - November 7, 2014 Category: Neurology Source Type: research
Radiation-Induced Carotid Artery Stenosis: A Comprehensive Review of the Literature
In recent decades, with the improvement of radiotherapy (RT) technology and comprehensive treatment, the survival rate of head and neck malignancies has gained remarkable progress. Vascular injury and subsequent carotid stenosis following RT, as the backbone of treatment, have received increasing attention. Many investigations have demonstrated that radiation can result in the increase in carotid intima-media thickness, carotid stenosis and consequently lead to a higher risk of cerebrovascular events such as transient ischemic attack and stroke. In this review, we will examine the incidence of radiation-induced carotid art...
Source: Interventional Neurology - November 7, 2014 Category: Neurology Source Type: research
Predictors and Outcomes Associated with Rescue Therapy in SWIFT
Conclusions: Merci treatment group and age were predictors of rescue therapy, while a trend toward an increased need of rescue therapy was observed with hypertension and proximal clot location. Rescue therapy was associated with fewer good outcomes. These findings may reflect targets for improvement in endovascular therapy.Intervent Neurol 2013;2:178-182 (Source: Interventional Neurology)
Source: Interventional Neurology - November 7, 2014 Category: Neurology Source Type: research
Hyperbaric Oxygen Therapy in Acute Ischemic Stroke: A Review
Stroke, also known as cerebrovascular disease, is a common and serious neurological disease, which is also the fourth leading cause of death in the United States so far. Hyperbaric medicine, as an emerging interdisciplinary subject, has been applied in the treatment of cerebral vascular diseases since the 1960s. Now it is widely used to treat a variety of clinical disorders, especially hypoxia-induced disorders. However, owing to the complex mechanisms of hyperbaric oxygen (HBO) treatment, the therapeutic time window and the undefined dose as well as some common clinical side effects (such as middle ear barotrauma), the wi...
Source: Interventional Neurology - November 7, 2014 Category: Neurology Source Type: research
