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Acute ischemic stroke: The role of emergency carotid endarterectomy in isolated extracranial internal carotid artery occlusion
CONCLUSIONS: Emergency CEA in isolated eICA occlusion has proved to be a safe and effective treatment option in selected patients. CT perfusion, imaging the ischemic penumbra and quantifying the tissue suitable for reperfusion, offers a valid support in the diagnostic-therapeutic workup. Indeed, we can infer that the area of the ischemic penumbra is directly proportional to the margin of clinical improvement after revascularization, supposing that the appropriate intervention timing is respect.PMID:37594376 | DOI:10.1177/17085381231192712
Source: Vascular - August 18, 2023 Category: Surgery Authors: Pierfilippo Acciarri Alice Camagni Maddalena Bressan Gladiol Zenunaj Ilaria Casetta Andrea Bernardoni Vincenzo Gasbarro Luca Traina Source Type: research

A Systematic Review and Meta-analysis of Peri-Procedural Outcomes in Patients Undergoing Carotid Interventions Following Thrombolysis
CONCLUSION: Peri-procedural ICH and local haematoma were significantly more frequent in patients undergoing CEA after TT (vs. no TT), although there were no randomised comparisons. Peri-procedural hazards were also significantly higher for CAS after TT. The inverse relationship between timing to CEA and peri-procedural stroke/death mandates careful patient selection and suggests that it may be safer to defer CEA for six-seven days after TT.PMID:34266765 | DOI:10.1016/j.ejvs.2021.06.003
Source: PubMed: Eur J Vasc Endovasc ... - July 16, 2021 Category: Surgery Authors: Stavros K Kakkos Melina Vega de Ceniga Ross Naylor Source Type: research

Carotid Endarterectomy Following Intravenous Thrombolysis in the UK
CONCLUSION: The use of ivTT before CEA in stroke patients was not associated with an increased risk of 30 day stroke, but there was an increase in the risk of neck haematoma.PMID:34088616 | DOI:10.1016/j.ejvs.2021.03.033
Source: PubMed: Eur J Vasc Endovasc ... - June 5, 2021 Category: Surgery Authors: Amundeep S Johal A Ross Naylor Arun D Pherwani Qiuju Li Panagiota Birmpili Sam Waton Richard O'Neill Jonathan R Boyle David A Cromwell Source Type: research

Intravenous Recombinant Tissue-Type Plasminogen Activator Thrombolysis for Acute Central Retinal Artery Occlusion
Discussion: This meta-analysis indicated that intravenous rt-PA thrombolysis could be an effective and safe strategy for the management of CRAO. However, a more detailed large-scale clinical trial is warranted to strengthen the evidence-based therapeutic guidance.
Source: Journal of Craniofacial Surgery - January 1, 2021 Category: Surgery Tags: Clinical Studies Source Type: research

Contemporary trends and outcomes of thrombolytic therapy for acute lower extremity ischemia.
Conclusion Thrombolysis remains an effective treatment for acute limb ischemia with increased utilization over time. There was a significant increase in thrombolysis and endovascular procedure leading to improved outcomes. Thrombolysis alone carried the highest mortality and stroke rate, with T+OPEN associated with the highest amputation and complications. Although thrombolysis is effective, 25% of patients required an open procedure suggesting that patient selection for thrombolysis first instead of open surgery continues to be a clinical challenge. PMID: 30193552 [PubMed - as supplied by publisher]
Source: Vascular - September 7, 2018 Category: Surgery Authors: Bath J, Kim RJ, Dombrovskiy VY, Vogel TR Tags: Vascular Source Type: research

PC164 Fast-Track Thrombolysis for Acute Lower Extremity In-Stent Occlusions: A Novel Approach to Minimize Complications of Standard Thrombolytic Therapy
The role of catheter-directed thrombolysis (CDT) in the treatment of acute lower extremity ischemia may require prolonged periods of time to achieve successful lysis. Prolonged thrombolysis infusion has demonstrated increased incidence of intracranial bleeding, stroke, and local complications. It is expensive and increases hospital length of stay. To minimize these potentially negative outcomes, we developed a fast track approach (FTA) that included the use of aggressive balloon angioplasty and stenting before the thrombus was completely lysed.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Syed Ali Rizvi, Anil Hingorani, Enrico Ascher, Natalie Marks Tags: C10: Poster Competition Source Type: research

Trapped cerebral thrombectomy device: A case report of a rare complication.
Abstract Intravenous thrombolysis with recombinant tissue plasminogen activator is currently the standard therapy for acute ischaemic stroke when started within 4.5 h of symptom onset. Systemic thrombolytic therapy can, however, lead to potentially lethal bleeding complications and is contra-indicated in several circumstances. Intra-arterial thrombolysis and/or intra-arterial thrombectomy can overcome these drawbacks and even increase the rate of recanalization. While intravenous thrombolysis is a relatively non-complex treatment, intra-arterial therapy in acute ischaemic stroke patients requires a dedicated int...
Source: Vascular - May 12, 2014 Category: Surgery Authors: Geuzebroek GS, Wille J, Vries JP, Schonewille W, Vos JA Tags: Vascular Source Type: research

Nationwide Experience of Cardio- and Cerebrovascular Complications During Infrainguinal Endovascular Intervention for Peripheral Arterial Disease and Acute Limb Ischaemia
Conclusions: In this population-based study we found a low risk of cardiac complications, but catheter-administered thrombolytic therapy entailed a non-negligible risk of major stroke.
Source: European Journal of Vascular and Endovascular Surgery - January 21, 2013 Category: Surgery Authors: J. Nordanstig, K. Smidfelt, M. Langenskiöld, B. Kragsterman Tags: Peripheral Arterial Disease Source Type: research

Nationwide Experience of Cardio- and Cerebrovascular Complications During Infrainguinal Endovascular Intervention for Peripheral Arterial Disease and Acute Limb Ischaemia.
CONCLUSIONS: In this population-based study we found a low risk of cardiac complications, but catheter-administered thrombolytic therapy entailed a non-negligible risk of major stroke. PMID: 23333098 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - January 17, 2013 Category: Surgery Authors: Nordanstig J, Smidfelt K, Langenskiöld M, Kragsterman B Tags: Eur J Vasc Endovasc Surg Source Type: research