Articles Tagged With: endovascular
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Blood Pressure Management After Endovascular Thrombectomy: What Is the Best Number?
Approximately 50% of patients who undergo endovascular therapy for ischemic stroke still have a severe impairment or will die within 90 days. Therefore, additional interventions are being investigated to improve overall outcome. Current guidelines from the American Heart Association suggest maintaining systolic blood pressure below 180 mmHg for patients who were treated both with intravenous thrombolysis and endovascular thrombectomy. A number of centers around the world have tried different systolic blood pressure thresholds ranging from 120 mmHg to 160 mmHg. Many of these studies have been single-center or small non-randomized studies and have not been designed to get a definitive answer.
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Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?
A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Should Endovascular Thrombectomy Be Performed With or Without Intravenous Alteplase?
With the widespread adoption of endovascular thrombectomy for the treatment of acute ischemic stroke caused by large vessel occlusion, a debate has raged about the role of intravenous thrombolysis. None of the clinical trials published to date have given us a clear evidence-based answer regarding the relative risks and benefits of this approach.
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Endovascular Thrombectomy with or Without Alteplase? Get With The Guidelines
Since 2015, endovascular thrombectomy with intravenous alteplase has been the standard of care for patients with large vessel occlusion and ischemic stroke. However, since that time, the continuing use of alteplase has been questioned by many practitioners and investigators.
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Endovascular Thrombectomy with or Without Alteplase? Get With The Guidelines.
Since 2015, endovascular thrombectomy with intravenous alteplase has been the standard of care for patients with large vessel occlusion and ischemic stroke. However, since that time, the continuing use of alteplase has been questioned by many practitioners and investigators.
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Clinical and Perfusion Mismatch Criteria Both Are Reliable in Identifying Patients Who Will Benefit from Endovascular Therapy
Since 2015, when multiple clinical trials were published showing the efficacy of endovascular thrombectomy (EVT) for large vessel occlusion within six hours of stroke onset, additional criteria have been developed to identify those patients who will benefit from EVT beyond six hours. The AURORA investigators collected patient data from six large clinical trials and performed a meta-analysis to determine if a clinical mismatch or an imaging mismatch protocol was better at predicting good outcomes in patients treated between six hours and 24 hours after the onset of clinical stroke symptoms.
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A Mobile Interventional Stroke Team (MIST) Shows Promise in Performing Rapid Thrombectomy
Since 2015, when multiple international trials were reported showing clear benefit for mechanical thrombectomy in patients with large vessel occlusions, this treatment has been the standard of care. However, the speed of treatment remains paramount for good outcomes, and different models have been developed around the world in different geographic settings.
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Mobile Stroke Units: What Is the Best Way to Use Them?
A recent advance in ischemic stroke treatment is the mobile stroke unit, an ambulance outfitted with specialized equipment, computed tomography for brain imaging, and a specialized team with a stroke neurologist available either onboard or via telemedicine. Intravenous thrombolytics can be administered at the scene with the patient on the ambulance.
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Should Patients with Ischemic Stroke and Large Vessel Occlusions Go Directly to Endovascular Thrombectomy?
Endovascular mechanical thrombectomy has become the standard treatment for patients with acute ischemic stroke caused by large vessel occlusion in both the anterior and posterior circulations. This is predicated on the ability to perform the procedure in a timely fashion or based on a mismatch between the size of infarction and brain perfusion.
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Endovascular Treatment for Acute Basilar Artery Occlusion Is Safe and Effective
Patients with acute basilar artery occlusion treated by endovascular therapy within 24 hours of occlusion time had better functional outcomes and reduced mortality compared to those treated with medical therapy alone.