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Mechanical Thrombectomy (mechanical + thrombectomy)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Revascularization in acute ischaemic stroke using the penumbra system: the first single center experience

EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2009
I. Q. Grunwald
Background and purpose:, This is the first single center experience illustrating the effectiveness of the penumbra system (PS) in the treatment of large vessel occlusive disease in the arena of acute ischaemic stroke. The PS is an innovative mechanical thrombectomy device, employed in the revascularization of large cerebral vessel occlusions in patients via the utilization of an aspiration platform. Methods:, This is a prospective, non-randomized controlled trial evaluating the clinical and functional outcome in 29 patients with acute intra-cranial occlusions consequent to mechanical thrombectomy by the PS either as mono-therapy or as an adjunct to current standard of care. Patients were evaluated by a neurologist and treated by our in house interventional neuro-radiologists. Primary end-points were revascularization of the occluded target vessel to TIMI grade 2 or 3 and neurological outcome as measured by an improvement in the NIH Stroke Scale (NIHSS) score after the procedure. Results:, Complete revascularization (TIMI 3) was achieved in 21/29 (72.4%) of patients. Partial revascularization (TIMI 2) was established in 4/29 (13.8%) of patients. Revascularization failed in four (13.8%) patients. Nineteen (19) patients (65.5%) had at least a four-point improvement in NIHSS scores. Modified Rankin scale scores of ,2 were seen in 37.9% of patients. There were no device-related adverse events. Symptomatic intra-cranial hemorrhage occurred in 7% of patients. Conclusions:, The PS has the potential of exercising a significant impact in the interventional treatment of ischaemic stroke in the future. [source]

Novel intra-arterial strategies in the treatment of acute ischaemic stroke

JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2008
PP Ng
Summary Acute ischaemic stroke is among the leading causes of death and disability in developed societies. I.v. and intra-arterial thrombolysis, and mechanical thrombectomy carried out within the appropriate time window can result in superior clinical outcomes compared with traditional therapy consisting of anticoagulation and/or aspirin. In cases where thrombolysis and/or thrombectomy have not been proven effective or have failed to result in rapid clinical and/or angiographic improvement, novel intra-arterial strategies may be applied by experienced interventional neuroradiologists to achieve recanalization of recalcitrant vessel occlusions with good clinical outcomes. [source]

MRI Assessment Followed by Successful Mechanical Recanalization of a Complete Tandem (Internal Carotid/Middle Cerebral Artery) Occlusion and Reversal of a 10-Hour Fixed Deficit

JOURNAL OF NEUROIMAGING, Issue 1 2008
Catalina C. Ionita MD
ABSTRACT BACKGROUND Mechanical clot extraction up to 8 hours after stroke onset is an alternative strategy for opening large vessels, especially for patients ineligible for intravenous thrombolysis. Safety beyond this therapeutic window is untested. METHODS An 81-year-old woman presented 8 hours after she developed left-sided weakness and dysarthria with a National Institutes of Health Stroke Scale (NIHSS) score fluctuating between 6 and 13. Neuroimaging revealed a large perfusion deficit with no diffusion abnormalities. An emergent cerebral angiogram revealed a complete internal carotid artery terminus occlusion. RESULTS Successful mechanical thrombectomy was performed without complication and resulted in almost complete reversal of the patient's deficit to an NIHSS score of 1, 10 hours after stroke onset. CONCLUSION Patients with large hypoperfused areas and minimal diffusion abnormalities on the MRI may benefit from mechanical thrombectomy beyond an 8-hour window. [source]

Percutaneous mechanical thrombectomy for massive pulmonary embolism: Improve safety and efficacy by sharing information

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2007
Samuel Z. Goldhaber MD
No abstract is available for this article. [source]

Transradial intervention for native fistula failure

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2006
Osami Kawarada MD
Abstract The native radiocephalic (Brescia-Cimino) fistula is usually constructed with an anastomosis of the cephalic vein and radial artery. Catheter interventions for native fistula failure have until now been performed via the transcephalic or transbrachial approach. Transradial intervention for native fistula failure was prospectively evaluated for a selected consecutive 11 patients. Six patients had a single lesion and 5 patients had double lesions. Twelve lesions were stenotic and 4 were occlusive with thrombus. Balloon angioplasty alone was successful in 10 lesions. In thrombosed fistulas, 2 lesions underwent manual catheter-directed thrombo-aspiration and 2 further lesions underwent a combination of catheter-directed thrombo-aspiration and mechanical thrombectomy. Cutting Balloon angioplasty was performed for 3 resistant venous stenoses and for 1 radial artery stenosis. Technical and clinical success were achieved in all patients. No vessel rupture or perforation was observed in this study, nor was distal embolization in the radial artery or symptomatic pulmonary embolism. No radial artery occlusion or fistula infection was seen during the follow-up. The primary patency rates were 82% at 3 months and 64% at 6 months. Transradial intervention for native fistula failure is considered safe and feasible in a selected population; yet requires further validation. © 2006 Wiley-Liss., Inc. [source]

Catheter-directed therapy for DVT after pancreas transplantation

CLINICAL TRANSPLANTATION, Issue 6 2007
Harish D Mahanty
Abstract:, Introduction:, Iliac vein deep venous thrombosis (DVT) ipsilateral to the pancreas transplant can lead to severe leg edema and compromise graft function. Treatment modalities for iliac vein DVT in the pancreas transplant recipient are limited. Methods:, Medical records of patients receiving pancreas transplants at a single center from November 1989 to July 2003 were reviewed retrospectively, identifying patients with iliac vein DVT. There were 287 pancreas transplants performed during this time. Pancreas transplantation in all recipients was performed in the right iliac fossa with the arterial supply consisting of a donor iliac artery Y interposition graft. Systemic venous drainage was to the iliac vein. Exocrine drainage was enteric or to the bladder. Results:, Four (1.4%) cases of iliac DVT were identified. All patients manifested lower extremity edema ipsilateral to the pancreas transplant. DVT was detected by ultrasound on days 4, 5, 13, and 60 post-transplant. In all cases, the iliac vein caudad to the pancreatic venous anastomosis was noted to be stenotic. Management involved balloon dilatation and endovascular stent placement in one patient, thrombolysis with tissue plasma antigen (t-PA) followed by stent placement in one patient, and percutaneous mechanical thrombectomy in two patients. All patients had improvement in leg edema and two patients continue to have good pancreatic allograft function. Conclusions:, Iliac DVT is a rare complication of pancreas transplantation that usually develops in an area of stenosis caudad to the pancreatic venous anastomosis. Catheter-based treatment modalities with use of endovascular stents for treatment of underlying stenoses can serve as an adjunct in treating these complications. [source]