Author contributions. Methods Patients with middle cerebral artery occlusion confirmed by DSA from 1 January 2018, to 31 December 2019, were retrospectively analyzed. Peer Review reports Background We aimed to estimate the benefits of ERT added to standard therapy in acute ischemic stroke. Neurological deterioration (ND) is a devastating complication for patients with ischemic stroke after endovascular recanalization therapy (EVT). 12, 13 . Mel J.SharafuddinMDab Rachael M.NicholsonMDa Timothy F. KresowikMDa Parth B.AminMDa Jamal J.HoballahMDa William J. SharpMDa Request PDF | Endovascular treatment of distal medium vessel occlusions using microcatheter aspiration thrombectomy | Background and purpose Recent studies suggest that endovascular treatment (EVT . Case description: Two patients presented with recurrent transient ischemic attacks due to subacute occlusion of intracranial vessels (left MCA M1 and basilar artery). Procedural and clinical outcomes of endovascular recanalization therapyin patients with cancerrelated stroke. Introduction. Endovascular therapy has several theoretic advantages over IV rtPA, including site specificity, longer treatment windows, and higher recanalization rates. Rupture of the stent graft occurred on the right limb. New randomized controlled trials should investigate safety and efficacy in extended indications as advanced time windows or more extensive signs of ischemia on initial imaging. Considering the angle between the occluded stump and the subclavian artery, the operations were successfully conducted via the radial artery route. We aimed to investigate the time course and clinical relevance of ND after EVT. Interv Neuroradiol. 7 - 10 tissue water uptake after stroke onset caused by a large vessel occlusion (lvo) Some small-sample clinical studies have also discussed endovascular recanalization for sNA-ICAO; however, there is currently a lack of evidence from multicenter, prospective, large-sample cohort trials. A significant percentage of these occlusions can likely be reopened through endovascular techniques. In four patients, recanalization via the femoral artery failed. Finally, for patients who are not good candidates for open repair because of severe comorbidities or cachexia, stenting can be used as a "bridge" to open surgical bypass, or endovascular recanalization can be attempted to treat complex lesions. Thrombolysis or endovascular therapy has been limited to patients who present within hours of symptom onset. In this article, we will review the various pharmacologic strategies for acute stroke treatment, providing both a historic context and the state of the art. Recanalization was not observed in the SMA (Figure 4). Conclusions: Endovascular treatment of COICA gives a 70% rate of successful recanalization, with 5% morbidity. Endovascular Recanalization of juxtarenal high grade aortic stenosis 70 yo man with Restpain. Background: We hope to illustrate the feasibility of endovascular recanalization for intracranial symptomatic arterial occlusion in the subacute period without adjunctive stenting. Procedural characteristics and functional outcome at discharge and 90 days were compared between patients with and without ongoing IVT at flow restoration. DOI: 10.1212/WNL.0000000000011520 Corpus ID: 230817561; Tenecteplase vs Alteplase Before Endovascular Therapy in Basilar Artery Occlusion @article{Alemseged2021TenecteplaseVA, title={Tenecteplase vs Alteplase Before Endovascular Therapy in Basilar Artery Occlusion}, author={Fana Alemseged and Felix C. Ng and Cameron J Williams and Volker Puetz and Gr{\'e}goire Boulouis and Timothy John Kleinig . The ADR was calculated as M2 segment diameter/M1 segment diameter . The decision to perform endovascular intervention was based on a case-by-case evaluation in an interdisciplinary decision-making process between neurologists and interventional neuroradiologists and was limited to cases with severe or refractory . Future randomized trials need to determine if recanalization is of any value for this population. Unlike arteries, in which landmarks such as wall calcifications provide indirect guidance . Background and Purpose - To assess the outcome in acute ischemic stroke patients not eligible for systemic thrombolysis (outside the 3-hour time window, after surgery, or on anticoagulant) undergoing endovascular recanalization therapy (ERT) at the Columbia University Medical Center (CUMC) and to determine US nationwide usage and . Treatment options include endovascular management with venoplasty and stenting. Along with the local thrombolysis, significant potential in the treatment of . The indications for endovascular iliocaval recanalization and reconstruction include deep venous occlusion secondary to recurrent DVT, severe PTS, and caval thrombosis leading to significant lifestyle limitations. Endovascular recanalization and remodeling of the abdominal stent graft CTO was performed with a combination of bare stents and stent grafts. Ten patients (45.5%) demonstrated significant clinical improvement during hospitalization (NIHSS improved 4 points). Using data from the Endovascular Treatment f. Alexander MJ, Zauner A, Chaloupka JC, Baxter B, Callison RC, Gupta R, Song SS, Yu W. 15.3 ): An 90 cm-length 8F guiding catheter (Cordis, Miami Lakes, Florida) was introduced transfemorally into the left common carotid artery proximal to the occlusion. Therefore, major reasons for failed endovascular recanalization were difficult anatomical access and hard or resistant occlusions that might reflect hard thrombi or pre-existing atherosclerotic stenosis. Two articles in this supplement provide reassurance regarding these 2 fundamental . Methods: From a literature search of RCTs testing ERT, we performed a meta-analysis to estimate an overall efficacy and safety of ERT for . Google Scholar; 12 Cho BH, Yoon W, Kim JT, Choi KH, Kang KW, Lee JH, Cho KH, Park MS. Outcomes of endovascular treatment in acute ischemic stroke patients with current malignancy. The aim of our present study was to evaluate the technical feasibility and safety of endovascular recanalization for sNA-ICAO. A second covered stent was . We aim to evaluate the feasibility and safety of endovascular recanalization for nonacute intracranial vertebral artery occlusion and propose a new angiographic classification. Endovascular recanalization therapy (ERT) comprises a wide range of pharmacologic and mechanical techniques, such as intra-arterial thrombolysis (IAT), mechanical disruption and/or mechanical thrombectomy [ 5, 6 ]. Endovascular recanalization of the great vessels with the use of distal embolic protection devices requires multiple catheters and complex endovascular techniques but is feasible and safe. The advanced endovascular therapy with the highest rate of recanalization is the most likely to become the best treatment for PCS, according to the similar history of reperfusion therapy for acute myocardial infarction (Widimsky, Coram, & AbouChebl, 2014) and for ACS (Sardar et al., 2015; Tsivgoulis, Geisler, et al., 2018; Tsivgoulis . Passage with the tip of the glidewire rather than a loop is more often successful. 1, 2 Pooled data suggests that recanalization of BAO, whether through endovascular thrombectomy (EVT) or intravenous thrombolysis (IVT), leads to lower mortality and dependency rate. Fifty percent of patients had good outcomes (modified Rankin Scale 2) after a median follow-up of 3 months. Endovascular Recanalization of Chronic Venous Obstruction Fig. INTRODUCTION. Fig. CVO in 10 patients between April 2005 and September 2010. 2018; 24:5208. Procedural complications such as dissection or perforation played a minor role. 9 successful recanalization (extended thrombolysis in cerebral infarction [etici] 2b) rates for lvos have achieved great progress, but the 90-day clinical outcomes have not improved in Results The technical success rate was 96.2% (25/26). All patients confirmed TICI grade 2b or 3. Duration of endovascular recanalization, local recanalization and tissue reperfusion rates, rates of interventional complications, and rates of successfully applied mechanical recanalization method are presented in Table 2.Duration of endovascular treatment was significantly longer in ICA occlusions than it was in M1 or M2 segment occlusions (p < 0.001), while duration of thrombectomy did not . Immediate post-operative aneurysm occlusion after endovascular treatment of intracranial aneurysms with coiling or balloon-assisted coiling in a prospective multicenter cohort of 1189 patients: Analysis of Recanalization after Endovascular Treatment of intracranial Aneurysm (ARETA) Study. The most common device used for endovascular thrombectomy was a stent retriever (609 [78%] of 777 patients) in which the most common occlusion was at the M1 segment of the middle cerebral artery (310 [48% . GNT Pharma Provides Update on Two Phase III Studies of Nelonemdaz for Acute Ischemic Stroke Patients Treated with tPA (ENIS-3) or Endovascular Thrombectomy (RODIN) September 19, 2022 Promising efficacy and safety profiles were observed in prior Phase II studies in acute ischemic stroke patients treated with recanalization therapies. 2016; 47: 1571-1576. . Endovascular recanalization with balloon angioplasty, aspiration, and local thrombolysis of thrombosed cerebral venous sinuses can be safely performed without the need of decompressive hemicraniectomy in early-pregnancy patients with malignant brain edema caused by progressive CVST. Methods The mean age of the patients was 65.3 years, 2/10 cases were female, and the origin of cause of CVO in 7/10 cases was the hemodialysis access in the upper extremity. "The main message is that endovascular thrombectomy in children can be performed with a similar safety profile and recanalization rate as in adults. Color Doppler ultrasound (CDUS) and computed tomography (CT) angiography revealed thrombosis of the entire bypass graft. Endovascular recanalization of SFA CTO was performed for 26 consecutive CLI patients with failed bypass grafts from 2016 to 2020. Are there enough skilled neurointerventionalists and is there enough money? This is needed for adequate guidewire and catheter support to . Because treatment is done locally closer to the site of the occlusion and (additional) mechanical devices may be used, major advantages of endovascular recanalization therapy (ERT) are a lower dose of thrombolytics is needed to recanalize the occluded vessel, higher recanalization rates, and possibly a lower rate of subsequent hemorrhages. Minim Invasive Surg. Chronic venous occlusion is common particularly in cancer patient due to hypercoagulate state associated with venous compression. Over a median clinical follow-up duration of 11.0 months, 74.1% of patients with successful recanalization achieved favorable clinical outcomes (mRS score 2). Endovascular recanalization can be safe and feasible for reasonably selected patients with non-acute BAO, especially type I lesions, and offers an alternative choice for those with progressive or recurrent vertebrobasilar ischemic symptoms despite aggressive medical therapy. Endovascular recanalization of total occlusions of the mesenteric and celiac arteries Presented in part at the Thirty-fifth Annual Meeting of the Midwestern Vascular Surgical Society, Chicago, Ill, September 15-17, 2011. Treatment With EkoSonic Endovascular System (EKOS) of Massive Pulmonary Thrombosis Following Recovery From COVID-19 Infection Ugur Cetingok Sr. , Cayan Akkoyun , Zulkuf Isik , Orhan Gungor . Endovascular recanalization of native CTOs was performed via retrograde or antegrade femoral approach with the use of 6- or 7-F sheaths. Patients with favorable outcomes had significantly lower recanalization quotients (p = 0.008). "Endovascular recanalization will become first-line therapy in children with acute ischemic stroke due to large-vessel occlusion," he said. The procedure of endovascular recanalization was as follows (Fig. Basilar artery occlusions (BAO) account for only 1% of all ischemic strokes but have a dismal natural history with greater than 80% mortality rate. Background:To date, few data have been reported on clinical outcomes following interventions in elderly populations with acute basilar artery occlusion. Study Design: Zi-Liang Wang Abstract: OBJECTIVE: Endovascular recanalization is considered first-line therapy for chronic central venous occlusion (CVO). Neurol Sci. Abstract. The endovascular recanalization of chronic total occlusions (CTO) of the native superficial femoral artery (SFA) after a failed femoropopliteal bypass is a safe and effective therapeutic option in patients unfit for surgery with critical limb ischemia. 11 Acute thrombus is generally defined as those aged less than 2 weeks, while chronic thrombus is defined as being present for more . 13.2 Computed tomography angiography is the most useful imaging study to plan revascularization. Purpose This study aimed to investigate the relationship between the artery diameter ratio (ADR) after recanalization and clinical outcomes. A 125 cm-length 4F diagnostic catheter (Tempo 4; Cordis) was placed in the 8F guiding catheter and was advanced . Keywords Angioplasty Intracranial atherosclerosis Stents Stroke ASJC Scopus subject areas Surgery Methods We included patients with IVT and successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b) after ET from an observational multicenter cohort, the German Stroke Registry - Endovascular Treatment trial. The same applies for new devices apart from stent retrievers. Stroke. Recanalization can be challenging in patients with complete venous occlusion secondary to significant external compression by a mass. The Eagle Eye Gold catheter (Volcano Corporation, San Diego, CA) is a 5-F-compatible imaging catheter that performs intravascular analysis of the culprit lesion measuring both grayscale images and virtual histology over a .014-inch guidewire. At 3 months, mortality occurred in 202 patients (36.7%) and the rate of favorable functional outcome was 38.8%. The patients were treated with primary stent placement and evaluated with immediate technical success rate and post-interventional patency rate after the procedure . In addition, this intervention may also improve survival and reduce morbidity by restoration of blood flow to penumbral areas and decreasing stroke volume. Platinum coils were implanted into canine maxillary, vertebral or lingual arteries. Endovascular recanalization is considered first-line therapy for chronic central venous occlusion (CVO)" Schwein et al (2017). Therefore, recanalization of PVO was attempted. The recanalization process involves blind threading of a glidewire through the trabeculated vein. Summary of Case We report a case of basilar artery occlusion and successful endovascular recanalization 80 days after symptom onset. 3 36.1 The TriForce Peripheral Crossing Set (Cook Medical, Bloomington, Indiana) An advanced adjunctive technique that can be used to increase the trackability of balloons and stents across chronically occluded venous lesions is the " body floss technique " [ 12 ]. 1 - 6 however, studies on the association between reperfusion and ischemic edema described conflicting results. Patient demographics, bypass and lesion characteristics, procedural data, technical, and clinical outcomes were evaluated. Background and purpose: Endovascular recanalization for patients with nonacute intracranial vertebral artery occlusion remains clinically challenging. several randomized controlled trials (rcts) have confirmed that rapid endovascular recanalization can improve functional outcomes and reduce mortality in patients with acute ischemic stroke with proximal vessel occlusion ( 4 - 6 ), but there is no consensus for whether endovascular treatment is feasible and safe for symptomatic subacute to Only a few case reports have revealed that endovascular recanalization appeared to be a tool to prevent stroke recurrence ( 7 - 10 ).