Endovascular Stroke Treatment: How Far Downstream Should We Go?

Cardiovascular and Interventional Radiology
Benjamin FriedrichJohannes Kaesmacher

Abstract

Endovascular thrombectomy has become the de facto standard in the treatment of large vessel occlusion. Previously, a correlation between good outcome and the occlusion site, measured by the 'distance to thrombus' (DT)-as the distance from the carotid T to the beginning of the thrombus-after thrombolysis could be shown. In the present study, we analyze the differences between the chances of a good outcome in respect of DT between patients treated endovascularly or intravenously. A dual-center database analysis including patients with stroke due to occlusion of the middle cerebral artery (MCA) was performed. Inclusion criteria were a completed treatment and full documentation of the clinical course. DT was measured in pre-treatment images. DT was correlated with the mRS at 90 days stratified according to the different treatment methods. A total of 280 patients could be included. We were able to show a correlation between the chances of good clinical outcome and the occlusion site measured by DT after i.v. thrombolysis. The outcome after endovascular treatment showed no correlation with DT (p = 0.227). After a DT of 26 mm, the chances of a good outcome after i.v. thrombolysis exceeded those after endovascular treatment. In patient...Continue Reading

References

Feb 1, 1981·Journal of Neurosurgery·H GiboR J Mitchell
Jun 6, 2006·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·D ToniM Prencipe
Sep 25, 2008·International Journal of Stroke : Official Journal of the International Stroke Society·Volker PuetzUNKNOWN Calgary CTA Study Group
Aug 8, 2013·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatUNKNOWN STIR Thrombolysis in Cerebral Infarction (TICI) Task Force
Jan 1, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Robin LemmensMaarten G Lansberg
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
Apr 18, 2015·The New England Journal of Medicine·Tudor G JovinUNKNOWN REVASCAT Trial Investigators
May 9, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Franziska DornThomas Liebig
Sep 9, 2015·Journal of Neurointerventional Surgery·Donald LobsienBenjamin Friedrich
Nov 14, 2015·AJNR. American Journal of Neuroradiology·J M CoutinhoV M Pereira
Mar 5, 2016·Journal of Neurointerventional Surgery·Justus F KleineJohannes Kaesmacher
Feb 17, 2017·Journal of the American Heart Association·Johannes KaesmacherJustus F Kleine
Feb 17, 2017·Cerebrovascular Diseases·Verena van GinnekenJochen B Fiebach

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.