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Specialty: Neurosurgery
Condition: Thrombosis
Education: Study

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Total 317 results found since Jan 2013.

To Treat or Not to Treat M2 Occlusions? The Question (and Answer) From a Single Institution
CONCLUSION: The results of our single-institution experience suggest that endovascular therapy for M2 occlusions is safe and effective. Additional evaluation with randomized, controlled studies is warranted. ABBREVIATIONS: ADAPT, direct aspiration first-pass technique ECASS, European-Australasian Cooperative Acute Stroke Study ICH, intracranial hemorrhage IMS, Interventional Management of Stroke MERCI, Mechanical Embolus Removal in Cerebral Ischemia mRS, modified Rankin Scale NIHSS, National Institutes of Health Stroke Scale PROACT, Prolyse in Acute Cerebral Thromboembolism TICI, Thrombolysis in Cerebral Infarctio...
Source: Neurosurgery - September 1, 2016 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

Mechanical thrombectomy versus systemic thrombolysis in MCA stroke: a distance to thrombus-based outcome analysis
Conclusions In patients with an acute MCA occlusion and a DT <16 mm, IVT–MT leads to a significantly better outcome than in patients treated with IVT alone.
Source: Journal of NeuroInterventional Surgery - August 11, 2016 Category: Neurosurgery Authors: Lobsien, D., Gawlitza, M., Schaudinn, A., Schob, S., Hobohm, C., Fritzsch, D., Quäschling, U., Hoffmann, K.-T., Friedrich, B. Tags: Ischemic stroke Source Type: research

Validation of the Modified Raymond-Roy classification for intracranial aneurysms treated with coil embolization
Conclusions This study confirms that the MRRC enhances the predictive accuracy of the RROC.
Source: Journal of NeuroInterventional Surgery - August 11, 2016 Category: Neurosurgery Authors: Stapleton, C. J., Torok, C. M., Rabinov, J. D., Walcott, B. P., Mascitelli, J. R., Leslie-Mazwi, T. M., Hirsch, J. A., Yoo, A. J., Ogilvy, C. S., Patel, A. B. Tags: Hemorrhagic stroke Source Type: research

In vitro experiments of cerebral blood flow during aspiration thrombectomy: potential effects on cerebral perfusion pressure and collateral flow
Conclusions These experiments suggest that aspiration is only effective if the catheter tip is in direct contact with the thrombus. If the catheter tip is not in contact with the thrombus, aspirate is drawn from the vessels proximal of the occlusion. This could affect collateral flow in vivo.
Source: Journal of NeuroInterventional Surgery - August 11, 2016 Category: Neurosurgery Authors: Lally, F., Soorani, M., Woo, T., Nayak, S., Jadun, C., Yang, Y., McCrudden, J., Naire, S., Grunwald, I., Roffe, C. Tags: Basic science Source Type: research

E-019 Outcome of the Patients Presenting with Basilar Occlusions in a Busy Stroke Center Treated with new Generation Stent Retrievers
ConclusionAlthough the successful recanalization rate (TICI 2 b or higher) in basilar occlusions is high (18/23 (78.3%)), the mortality (10/23 (43%)) and morbidity with MRS ≥ 3 (5/23 (22%)) remains disappointingly high. In our study, good clinical outcome (MRS 0–2) was achieved in 30% (7/23) of patients, better than the natural course in basilar occlusions, which is encouraging. This group highlights the value of early presentation and a negative CT as strong predictors of a good outcome. The prognosis in patients with basilar occlusions with positive CT findings and unknown time of onset remain guarded.Disclosure...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Akhtar, I., Halpin, J., Holloway, W., Martin, C., Akhtar, N. Tags: Electronic poster abstracts Source Type: research

E-039 Comparison of Medical Therapy vs. Intra-Arterial Therapy for Acute Vertebrobasilar Stroke
ConclusionCompared to medical trials in 2015, which demonstrate clinical benefit for IAT over medical therapy for acute ischemic stroke of the anterior circulation, the posterior circulation is less well studied. Important prognostic factors for stroke due to large vessel occlusion of posterior circulation include posterior ASPECTS score and infarct volume in the brainstem. In this small retrospective study, patients treated with IAT had greater stroke severity than the medical cohort, yet they had similar rates of good functional outcome. Parameters of this retrospective analysis may be used to improve triage and treatmen...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Raymond, S., Leslie-Mazwi, T., Rost, N., Schaefer, P., Hirsch, J., Gonzalez, R., Rabinov, J. Tags: Electronic poster abstracts Source Type: research

E-053 Time is Brain: Standardizing Thrombectomy Metrics Leads to Faster Recanalization
ConclusionsOur initiatives allowed us to refine our process of care, resulting in a significant reduction of time between patient arrival and imaging, imaging to puncture, and puncture to recanalization.DisclosuresD. Frei: 1; C; Penumbra, Medtronic, Stryker, MicroVention, Sequent, Siemens, Codman. 2; C; Penumbra, Stryker, MicroVention, Codman, Siemens. 3; C; Penumbra, Stryker, MicroVention, Codman, Siemens. 4; C; Penumbra. D. Loy: None. R. Bellon: None. D. Huddle: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Frei, D., Loy, D., Bellon, R., Huddle, D. Tags: Electronic poster abstracts Source Type: research

E-054 Correlation between Thrombus Density and Recanalization or Stroke Etiology in Acute Ischemic Stroke
ConclusionIn conclusion, our study found no relationship between thrombus attenuation and recanalization success or stroke etiology. While prior studies have suggested that higher attenuation is associated with good recanalization, our study could not find such a link.4 More studies are required to identify factors that predict successful recanalization in acute ischemic stroke patients.DisclosuresM. Jagani: None. W. Brinjikji: None. D. Kallmes: 1; C; ev3, MicroVention, Sequent, Codman. 2; C; ev3, Medtronic, Codman. 3; C; Microvention.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Jagani, M., Brinjikji, W., Kallmes, D. Tags: Electronic poster abstracts Source Type: research

O-011 Symptomatic Intracranial Hemorrhage After Reperfusion Therapy - Impact of Definition on its Frequency
ConclusionUnder the trial definition, any apparent extravascular blood in the brain or cranium with an increase of 4 or more on the NIHSS, associated or not, is considered a sICH; as a result, the inclusion of hemorrhagic infarctions (HI1 and HI2) in this definition resulted in an apparent relative increase in sICH rates. Subjecting the THERAPY cohort to other definitions yielded notable variance in complication rates. As there is no current standardization for the quantification of sICH, further analysis and data are needed to identify and standardize a succinct and relevant definition.DisclosuresR. von Kummer: 2; C; Penu...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: von Kummer, R., Frei, D., Yoo, A., Zaidat, O., Khatri, P., Gupta, R., Lopes, D., Shownkeen, H., Meyer, D., Buell, H., Bach, V., Kuo, S., Bose, A., Sit, S., Mocco, J. Tags: Oral abstracts Source Type: research

O-025 The Superiority of Thrombectomy over IV rtPA Monotherapy May be Associated with Thrombus Length - Results of the THERAPY Trial
ConclusionExtensive thrombus burden presents a challenge for stroke intervention, posing greater risk of complications and poor clinical outcome. However, this effect is dampened when IAT is the interventional modality, leading to a more favorable prognosis over IV-rtPA alone. This study finding supports the use of aspiration thrombectomy in treatment of extended thrombi, demonstrating relative advantages over thrombolytic monotherapy, and enables better clinical outcomes.DisclosuresR. von Kummer: 2; C; Penumbra, Inc. J. Mocco: 1; C; Penumbra, Inc. O. Zaidat: 6; C; Penumbra, Inc. P. Khatri: 1; C; Penumbra, Inc. R. Gupta: 6...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: von Kummer, R., Mocco, J., Zaidat, O., Khatri, P., Gupta, R., Frei, D., Lopes, D., Shownkeen, H., Berkhemer, O., Meyer, D., Chauke, M., Hak, S., Kuo, S., Buell, H., Bose, A., Sit, S., Yoo, A. Tags: Oral abstracts Source Type: research

P-001 Permanent Implantation of the Solitaire Device as a Bailout Technique for Large Vessel Intracranial Occlusions
ConclusionWith the recent over-whelming evidence demonstrating the effectiveness endovascular therapy in acute ischemic stroke, the expansion of stroke therapy requires that a variety of techniques be available to the operators. Permanent implantation of the Solitaire stent achieves adequate distal flow and good clinical outcomes in the setting of AIS. This case series suggests this technique provides a safe alternative for difficult cases refractory to other revascularization techniques.Key Wordsstroke, revascularization, stentDisclosuresJ. Houde: None. E. Barber: None. M. Kelly: 2; C; Medtronic. 4; C; Blockade. 6; C; Pen...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Houde, J., Barber, E., Kelly, M., Peeling, L. Tags: Oral poster abstracts Source Type: research

P-010 Association of Clot Burden Score with Radiographic and Clinical Outcomes Following Solitaire Stent Retriever Thrombectomy: Analysis of the SWIFT PRIME Trial
ConclusionsThe combination of IV thrombolysis and stent retriever thrombectomy with the Solitaire device is highly effective in achieving successful recanalization and a good clinical outcome throughout the entire range of CBS values.DisclosuresM. Mokin: None. E. Levy: 4; C; Intratech Medical Ltd., Blockade Medical LLC, Medina Medical. 6; C; Covidien (Medtronic), Abbott, Intratech Medical and Blockade Medical. A. Siddqui: 2; C; Codman & Shurtleff, Inc., Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting, Penumbra, Stryker, Pulsar Vascular, MicroVention, Lazarus Effect, Blockade Medical. 3...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Mokin, M., Levy, E., Siddqui, A., Goyal, M., Nogueira, R., Yavagal, D., Pereira, V., Saver, J. Tags: Oral poster abstracts Source Type: research

P-012 Longer Working Length of the Solitaire Retrieval Device Improves Revascularization
ConclusionsThe Solitaire 4 x 40 device showed a statistical trend for achieving better recanalization compared to the shorter devices. However due to our small sample size of patients undergoing treatment with the 4 x 40, further investigation is warranted to determine whether this result is maintained in larger sample size such as the STRATUS registry.DisclosuresW. Holloway: None. I. Akhtar: None. J. Halpin: None. C. Martin: None. N. Akhtar: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Holloway, W., Akhtar, I., Halpin, J., Martin, C., Akhtar, N. Tags: Oral poster abstracts Source Type: research

P-021 Very Delayed Monocular Blindness Following Flow Diversion Treatment of Ophthalmic Artery Aneurysm
ConclusionMonocular vision loss remains a risk, even months to years following flow diversion of ICA aneurysms. Long term clinical follow-up is necessary to define the incidence of this complication.Abstract P-021 Figure 1DisclosuresT. Higashimori: None. D. Sandhu: None. J. Kim: None. A. Grande: None. M. Ezzeddine: None. R. Tummala: None. B. Jagadeesan: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Higashimori, T., Sandhu, D., Kim, J., Grande, A., Ezzeddine, M., Tummala, R., Jagadeesan, B. Tags: Oral poster abstracts Source Type: research

E-004 Factors Associated with Successful Revascularization using the Aspiration Component of ADAPT in the Treatment of Acute Ischemic Stroke
ConclusionsAspiration success was associated with younger age. There was a trend for aspiration failure to be associated with cardiogenic etiology and more difficult vascular anatomy. Our findings suggest that the ADAPT technique can be used for the vast majority of patients but it may be beneficial to use a SR primarily when performing thrombectomy in the elderly. Further research analyzing thrombus characteristics is needed.References1 Turk AS, Frei D, Fiorella D, et al. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg 2014 ;6(4):260–4.2 Turk AS, Turner R,...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Mascitelli, J., Kellner, C., Oravec, C., DeLeacy, R., Oermann, E., Paramasivam, S., Fifi, J., Mocco, J. Tags: Electronic poster abstracts Source Type: research