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Low-dose intravenous recombinant tissue plasminogen activator in acute ischemic stroke without large vessel occlusion screened by 3T MRI
CONCLUSIONS: Our study indicates the efficacy and safety of low-dose rTPA treatment for AIS without LVO within 4.5 hours. Patient selection for rTPA by 3T MRI decreased complications and mortality.PMID:37522667 | DOI:10.26355/eurrev_202307_33126
Source: European Review for Medical and Pharmacological Sciences - July 31, 2023 Category: Drugs & Pharmacology Authors: Q-S Huynh C-C Tran H-T Nguyen-Thi T-T Nguyen H-L Phan-Thi D-T Luu-Dang M-T Le M-D Nguyen Source Type: research

E-126 Multicenter flow diversion in 200 patients for treatment of intracranial aneurysms
ConclusionThis report characterizes patient demographics, aneurysm characteristics, procedure complications and long-term angiographic and clinical outcomes for a large patient population across multiple medical centers treated with flow diversion. Overall, procedures resulted in a high rate of occlusion and low rate of serious complications. Continued iterative outcomes analysis is warranted particularly as flow diversion technology evolves. Despite diverse hospital settings, differences in presentation, patient characteristics and the inclusion of off-label treatments, flow diversion procedures remained safe and effectiv...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Meister, R., Lesko, A., Marginean, H., Deshmukh, V. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-042 Complications of DAPT cessation at 3 months versus 6 months after flow diversion of unruptured intracranial aneurysms
ConclusionsOnly 0.6% (n=1) of patients exhibited complications after 3 month follow-up. We conclude that DAPT duration of 3 months after endoluminal flow diversion of unruptured cerebral aneurysms of the anterior circulation is not associated with increased rates of hemorrhagic or thromboembolic complications compared to a traditional 6-month regimen.Disclosures S. Srinivasan: None. A. White: None. M. Al-Abdulkareem: None. J. Barr: None. L. Pride: None. J. White: None. R. Novakovic-White: None. R. Sillero: None. B. Welch: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Srinivasan, S., White, A., Al-Abdulkareem, M., Barr, J., Pride, L., White, J., Novakovic-White, R., Sillero, R., Welch, B. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

E-261 Variability of response on prophylactic prasugrel for endovascular treatment of intracranial aneurysms: clinical implications
ConclusionIn the neurointerventional field, high BMI and prior use of antithrombotic agents were related to HTPR, and low BMI was associated with LTPR on prophylactic prasugrel. High hematocrit levels decreased the risk of HTPR. When preparing endovascular treatment for intracranial aneurysms, attention to patients with these clinical features is required to address the possibility of ischemic or bleeding complications.Abstract E-261 Table 1Risk factor analysis of high on-treatment platelet reactivity (HTPR) Variables Univariate Analysis Multivariate Analysis OR (95% CI) P OR (95% CI) P Age 1.02 (0.97-1.06) 0.53 Female o...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Son, Y., Hong, N. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-006 U.S. health care system-wide transition from alteplase to tenecteplase before mechanical thrombectomy: functional outcomes, early reperfusion rates, intracranial bleeding and femoral access site complications
ConclusionsThe first-year experience demonstrates the effectiveness and safety of the transitioning from TPA to TNK. The higher early recanalization rates with TNK are striking. Additional studies are required to investigate whether TNK is superior to TPA in the setting of LVO stroke.Disclosures M. Collins: None. C. Schirmer: None. G. Weiner: None. O. Goren: None. I. Melamed: None. S. Dalal: None. M. Kole: None. A. Noto: None. P. Hendrix: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Collins, M., Schirmer, C., Weiner, G., Goren, O., Melamed, I., Dalal, S., Kole, M., Noto, A., Hendrix, P. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Incidence of Ischemic Stroke in Seniors Not Reduced by Low-Dose Aspirin
FRIDAY, July 28, 2023 -- For healthy older adults, low-dose aspirin does not reduce the risk for ischemic stroke but is associated with an increased risk for intracranial bleeding, according to a study published online July 26 in JAMA Network...
Source: Drugs.com - Pharma News - July 28, 2023 Category: Pharmaceuticals Source Type: news

Quest for the Perfect Anticoagulant
The current referenced meta-analysis study by Selvaraj et al1 examines the relative merits of anticoagulation with a direct oral anticoagulant (DOAC) versus vitamin K antagonist (VKA) after transcatheter aortic valve implantation (TAVI) in patients meeting the indications for anticoagulation because of atrial fibrillation (AF). Although guidelines vary, the general consensus appears to indicate noninferiority to superiority of DOACs in the treatment of nonvalvular AF. In the landmark Apixiban for Reduction In Stroke and Other Thromboemoblic Events in Atrial Fibrillation trial comparing apixaban to warfarin in patients with...
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Bryant Fisher, Danny Chu Source Type: research

Direct current cardioversion practices following percutaneous left atrial appendage closure
DiscussionThere is a widely varied practice pattern of TEE, CCTA, and OAC use with DCCV after LAAC, with a 6% rate of LAT/DRT. LAA imaging before DCCV appears prudent in all cases, especially within 1 year of LAAC, to assess for device position, PDL, and LAT/DRT.
Source: Journal of Cardiovascular Electrophysiology - July 26, 2023 Category: Cardiology Authors: Sapan Bhuta, Adnan Shaaban, Nkongho C. Binda, James Antaki, Ralph S. Augostini, Steven J. Kalbfleisch, Salvatore J. Savona, Toshimasa Okabe, Mahmoud Houmsse, Muhammad R. Afzal, Emile G. Daoud, John D. Hummel Tags: ORIGINAL ARTICLE Source Type: research

Endovascular Treatment of Brain Arteriovenous Malformations in Pediatric Patients: A Single Center Experience and Review of the Literature
Conclusion Our experience supports the effectiveness and safety of endovascular treatment of bAVM in selected pediatric patients. A multidisciplinary approach combining surgery and SRS is warranted to achieve higher complete bAVM obliteration rates. Long-term follow-up is important as these lesions may show recurrence over time, especially in the pediatric population. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - July 26, 2023 Category: Neurosurgery Authors: Borges de Almeida, Gon çalo Pamplona, Jaime Baptista, Mariana Carvalho, Rui Concei ção, Carla Lopes da Silva, Rita Sagarribay, Amets Reis, Jo ão Fragata, Isabel Tags: Original Article Source Type: research

Percutaneous left atrial appendage closure in patients with gastrointestinal bleeding associated with oral anticoagulants
CONCLUSIONS: LAAC could be a safe and effective alternative to OAC in patients with non-valvular AF presenting significant, recurrent or potentially unresolvable GIB. This intervention also leads to important savings in the consumption of healthcare resources.PMID:37489111 | DOI:10.1080/00365521.2023.2239973
Source: Scandinavian Journal of Gastroenterology - July 25, 2023 Category: Gastroenterology Authors: Patricia Sanz Segura Javier Jimeno S ánchez Jos é Miguel Arbonés-Mainar Juan S ánchez-Rubio Lezcano Gabriel Galache Osuna Vanesa Bernal Monterde Source Type: research