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Specialty: Neurosurgery
Management: National Institutes of Health (NIH)
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Total 59 results found since Jan 2013.
Selecting stroke patients for thrombectomy: is CTA+ASPECTS enough?
Since 2014, a series of randomised controlled trails (RCTs) have demonstrated the benefit of endovascular thrombectomy (EVT) on functional outcome for the participants who had acute ischaemic stroke (AIS) with occlusion of a proximal intracranial artery in the anterior circulation. The characteristics of the people enrolled in these RCTs have been used to define recommended criteria to select patients for thrombectomy in clinical practice. The initial group of RCTs largely enrolled participants early after AIS (mostly under 6 hours) who had National Institutes of Health stroke scale scores ≥6 (range 0–42 with lowe...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 14, 2023 Category: Neurosurgery Authors: Powers, W. Tags: Editorial commentaries Source Type: research
P005/44 Using the pEGASUS-stent with antithrombogenic properties and single antiplatelet therapy in a case of thrombectomy
IntroductionRescue stenting is used more and more in stroke cases with large-vessel-occlusion or medium-vessel-occlusion refractory to mechanical thrombectomy. The pEGASUS-stent(Phenox) represents a device which is equipped with a hydrophilic polymer coating(HPC) with antithrombogenic properties. The coating allows for implantation under single antiplatelet therapy, thus possibly reducing the risk of bleeding in acute stroke cases.Case HistoryA 79-year-old woman was rushed to emergency room due to left-sided hemiparesis and National-Institutes-of-Health-Stroke-Scale(NIHSS) of 14. Computed-tomography-image showed an occlusi...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Krug, N., Schulze-Zachau, V., Ntoulias, N., Psychogios, M. Tags: 4.3 CASE PROPOSAL - Acute ischemic stroke Source Type: research
Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study
This study examined the usefulness of thrombectomy in the elderly. We retrospectively analyzed patient data using a multicenter acute ischemic stroke registry (NGT-FAST). We examined outcomes in patients 75 years and older who underwent thrombectomies between January 1, 2021, and December 31, 2021. The patients were divided into two groups: the 75-84-year-old group and the 85+-year-old group. There was no difference in the pretreatment National Institutes of Health Stroke Scale score or Alberta Stroke Program Early Computed Tomography Score between the two groups, but the 85+-year-old group had a significantly lower rate o...
Source: Neurologia Medico-Chirurgica - June 28, 2023 Category: Neurosurgery Authors: Kohei Shibuya Hitoshi Hasegawa Tomoaki Suzuki Haruhiko Takahashi Kei Nishiyama Makoto Oishi Yukihiko Fujii Source Type: research
Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke - hot or not?
Early clinical surrogates for long-term functional outcomes represent valuable clinical adjuncts. Lately, the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after mechanical thrombectomy (MT) for large vessel occlusion (LVO) ischemic stroke has been repeatedly demonstrated to serve as a robust and independent predictor of 90-day functional outcomes.1–5 We read the article ‘Early neurological improvement as a predictor of outcomes after endovascular thrombectomy for stroke: a systematic review and meta-analysis’ by Kobeissi et al with great interest.6 Briefly, the authors synthesized nin...
Source: Journal of NeuroInterventional Surgery - May 16, 2023 Category: Neurosurgery Authors: Hendrix, P., Schirmer, C. M. Tags: Letter Source Type: research
Endovascular therapy may not be beneficial for patients with mild acute ischemic stroke compared to best medical management
We read with great interest the meta-analysis by Lin et al on the comparison of the clinical effectiveness between endovascular therapy (EVT) and best medical management (BMM) in patients with mild acute ischemic stroke (AIS).1 The study is of profound academic importance, and there are some points that we would like to address. In the "Statistical analyses" section, the authors described how they pooled data across studies by using the fixed effects model based on an inverse variance method. Subsequently, in the "Results – Primary outcome" section, the authors stated that for AIS patients with National Institutes of...
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Zheng, F., von Spreckelsen, N., Hu, W. Tags: Letter Source Type: research
Endovascular therapy might be a treatment option for mild stroke due to proximal occlusions but not M2 occlusions
We appreciate the letter from Zheng et al1 suggesting that the random effects model, not the fixed effects model, should be used to pool the results for our meta-analysis.2 In a sensitivity test, pooled results from the random effects model did not significantly show that endovascular therapy (EVT) compared with best medical management was associated with a higher rate of being disability free for patients with acute ischemic stroke (AIS) with National Institutes of Health Stroke Scale (NIHSS) scores of ≤5 due to proximal internal carotid artery (ICA) or middle cerebral artery M1 occlusions. However, the main point of t...
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Lin, C.-H., Saver, J. L., Lee, M. Tags: Letter Source Type: research
Mechanical Thrombectomy for Acute Common Carotid Artery Occlusion
Neurol Med Chir (Tokyo). 2023 Jan 5. doi: 10.2176/jns-nmc.2022-0183. Online ahead of print.ABSTRACTMechanical thrombectomy (MT) is the standard treatment for acute large occlusion of the cerebral artery. Evidence for the success of this procedure was based on the treatment of patients with internal carotid artery and middle cerebral artery thrombi. There are a few reports on thrombi extending to the common carotid artery (CCA). We document our endovascular procedure and the clinical outcome in seven consecutive patients who underwent MT for CCA thrombi between September 2016 and April 2021. Their mean National Institutes o...
Source: Neurologia Medico-Chirurgica - January 4, 2023 Category: Neurosurgery Authors: Minoru Ideguchi Kyongsong Kim Masanori Suzuki Junya Kaneko Shin Sato Kazutaka Shirokane Akio Morita Source Type: research
