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Source: Journal of NeuroInterventional Surgery
Management: National Institutes of Health (NIH)
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Total 18 results found since Jan 2013.
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
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
P74 Keep it simple: MAC (Manual Aspiration with Contrast) technique for the endovascular management of acute ischemic stroke (LVO & MVO)
We report a prospectively collected clinical experience with a simple technique: MAC (Manual Aspiration Contrast Enhancement) as the primary method for vessel recanalization.Gently contrast injection while the aspiration catheter is advancedto the thrombus and subsequentlycreating a closed-loop system with the contrast column within the cathetercan result in better visualization during the aspiration, thus improving the FPEavoiding clot fragmentation, multiple passes and blind movements of catheter by a single operator.Methods47 prospectively patients with ELVO and 3 cases of middle vessel occlusion (MVO) at four instituti...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Pabon, B., Torres, V., Patino, M., Pelaez, F., Mutis, J. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research
E-023 Predictors of outcomes in tandem anterior circulation occlusions following mechanical thrombectomy
In this study, we present outcomes of patients undergoing tandem mechanical thrombectomy. We demonstrate that stenting is associated with improved final reperfusion, but increased odds of asymptomatic ICH. Additional clinical trials should be performed to optimize the procedure and improve patient outcomes.Disclosures J. Catapano: None. D. Farhadi: None. A. Naik: None. S. Koester: None. E. Winkler: None. V. Srinivasan: None. K. Karahalios: None. J. Rulney: None. S. Desai: None. A. Jadhav: None. F. Albuquerque: None. A. Ducruet: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Catapano, J., Farhadi, D., Naik, A., Koester, S., Winkler, E., Srinivasan, V., Karahalios, K., Rulney, J., Desai, S., Jadhav, A., Albuquerque, F., Ducruet, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research
E-065 Experience with neuroform atlas stenting as rescue endovascular treatment after failed mechanical thrombectomy secondary to intracranial atherosclerosis
ConclusionsOur series provides preliminary safety and efficacy data regarding the use of the Neuroform Atlas stent as a rescue modality in ICAS-ELVO cases.Disclosures O. Lajthia: None. E. Almallouhi: None. K. Kicielinski: None. J. Lena: None. A. Spiotta: None. S. Al Kasab: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lajthia, O., Almallouhi, E., Kicielinski, K., Lena, J., Spiotta, A., Al Kasab, S. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research
E-204 Outcomes of radial and femoral access in mechanical thrombectomy for posterior circulation occlusions: a multicenter propensity-adjusted analysis
In this study, we compare outcomes for radial and femoral access for MT in posterior circulation strokes.MethodsA retrospective analysis of all patients with a posterior circulation large vessel occlusion whom underwent mechanical thrombectomy at two large comprehensive stroke centers was performed. Data on demographics, clinical presentation, procedural data, including radial or femoral access, and outcomes were tabulated. Outcomes of interest included National Institute of Health Stroke Scale at discharge and 24-hours. The Thrombolysis in Cerebral Infarction (TICI) scale was used to ascertain revascularization after inte...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Catapano, J., Naik, A., Smoot, M., Vitek, G., Koester, S., Winkler, E., Srinivasan, V., Desai, S., Ducruet, A., Albuquerque, F., Jadhav, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research
EP55 Keep it simple: the SNACE (Sofia non-wire aspiration contrast enhancement) technique for the endovascular management of acute ischemic stroke
We report a prospectively collected clinical experience with a simple technique: SNACE (Sofia Non-wire Aspiration Contrast Enhancement) as the primary method for vessel recanalization.Methods38 prospective patients with ELVO at four institutions were included in the study. The SNACE technique was utilized in all patients. Procedural and clinical data were analyzed.ResultsThe SNACE approach using SOFIA 6 Plus Catheter was successful in achieving Thrombolysis in Cerebral Infarction (TICI) 2b or 3 revascularizations in 88% of cases. The first Pass effect was obtained in 75%. The average time from groin puncture to at least TI...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Pabon, B., Torres, V., Mejia, J., Patino, M., Vargas, O., Serna, N., Pelaez, J. Tags: Treatment Source Type: research
Paradoxical cerebral air embolism causing large vessel occlusion treated with endovascular aspiration
We present a novel therapeutic approach for treatment of cerebral air embolism causing large vessel occlusion, using endovascular aspiration. Our patient developed a cerebral air embolism following sclerotherapy for varicose veins. This caused near total occlusion of the superior division of the M2 segment of the right middle cerebral artery. Symptoms included unilateral paralysis, unintelligible speech, and hemianopia; National Institutes of Health Stroke Scale (NIHSS) on presentation was 16. The air embolism was treated using a distal aspiration technique. Angiography following aspiration showed Thrombolysis in Cerebral ...
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Belton, P. J., Nanda, A., Alqadri, S. L., Khakh, G. S., Chandrasekaran, P. N., Newey, C., Humphries, W. E. Tags: Ischemic stroke Source Type: research
E-057 Process Improvement in Door-to-Groin Puncture Times at a Comprehensive Stroke Center Shows a Trend Towards Reduced Mortality at 90 Days
ConclusionOur systematic process improvement initiative significantly reduced door-to-groin puncture times and showed a trend towards reduced mortality at 90 days. A multidisciplinary approach and ensuring hospital system investment are key to an effective process.DisclosuresY. Kayan: 2; C; Medtronic, Penumbra. J. Delgado Almandoz: 2; C; Medtronic, Penumbra. M. Young: None. J. Fease: None. J. Scholz: None. A. Milner: None. T. Hehr: None. M. Mulder: None. P. Roohani: None. R. Tarrel: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Kayan, Y., Delgado Almandoz, J., Young, M., Fease, J., Scholz, J., Milner, A., Hehr, T., Mulder, M., Roohani, P., Tarrel, R. 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
Efficacy of intra-arterial therapy in the elderly requires further study
We salute Dr Ghobrial and colleagues for their important contribution regarding the endovascular management of elderly ischemic stroke patients.1 Although this topic is relatively new to the literature, it is of critical importance to the field of intra-arterial therapy (IAT), given the increasing use of catheter based stroke therapies2 and the expanding population of elderly Americans who are at the highest risk for ischemic stroke. The authors conducted an extensive, retrospective, single center study using chart review that identified elderly patients (aged >75 years) that underwent IAT between 2006 and 2012. Th...
Source: Journal of NeuroInterventional Surgery - June 11, 2016 Category: Neurosurgery Authors: Hirsch, J. A., Mehta, B. P., Chandra, R. V., Leslie-Mazwi, T. M., Rost, N. S., Yoo, A. J. Tags: PostScript Source Type: research
Tribulations of stroke trials
The recent JNIS editorial, ‘The tribulations of stroke trials’,1 discusses three recent failed endovascular stroke treatment trials, including the Interventional Management of Stroke III (IMS III) trial. The authors assess the impact of these trials on patient treatment, as well as on future trials. However, some clarifications of the data presented and the statements made in that editorial regarding IMS III are needed. The authors are incorrect to suggest that large vessel occlusion (LVO) was the ‘index disease’ for IMS III. As stated clearly in the protocol and trial design, the index disease for ...
Source: Journal of NeuroInterventional Surgery - June 11, 2016 Category: Neurosurgery Authors: Broderick, J., Tomsick, T. A., on behalf of the IMS III investigators Tags: PostScript Source Type: research
