Publications by authors named "Alfonso Lopez-Frias"
Article Synopsis
- This study evaluates the transulnar approach in neurointerventional procedures when radial access is not possible, focusing on safety and effectiveness.
- A total of 35 patients were examined, revealing a 97.14% success rate and minimal complications, primarily due to anatomical factors and issues with the radial artery.
- The findings suggest that the transulnar approach is a viable alternative to radial access, warranting further research to confirm its safety and efficacy in larger populations.*
Background: Efficient recanalization of occluded cerebral arteries is crucial in the treatment of acute ischemic stroke. Double stent retrievers have shown the potential to enhance the rates of recanalization on the first pass. This study aims to evaluate the efficacy and safety of the double stent retriever technique and the predictors of achieving first-pass effect in patients with acute ischemic stroke.
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- * Data from 459 patients with vessel perforation showed a 90-day mortality rate of 51.9%, with only 16.3% achieving a favorable recovery (mRS 0-2).
- * The findings indicate that large vessel perforation leads to worse outcomes, while thrombolysis doesn’t worsen prognoses; quick management of bleeding is crucial for survival.
Article Synopsis
- The study examines the effectiveness of different stentrievers (SRs) used in mechanical thrombectomy for large vessel occlusion stroke, focusing on their design characteristics and their impact on the first-pass effect (FPE).
- The research included 610 patients, looking to determine how aspects like model, brand, size, and length of SRs influenced outcomes, specifically comparing modified and true FPE results.
- Findings reveal that these characteristics did not significantly impact the success rates of achieving FPE, suggesting that factors beyond the design of SRs may play a bigger role in treatment outcomes.
Chronic subdural hematoma (CSDH) is a prevalent medical condition with potentially severe consequences if left untreated. While surgical removal has traditionally been the standard approach for treatment, middle meningeal artery (MMA) embolization has emerged as a promising minimally invasive alternative to reduce recurrences. This comprehensive review provides the general radiology community with an overview of MMA embolization as a therapeutic option for managing CSDH.
View Article and Find Full Text PDFObjectives: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is a novel, minimally invasive ablative treatment for essential tremor (ET). The use of a four-tract probabilistic tractography technique, targeting the intersection between the dentato-rubro-thalamic tracts (both decussating and non-decussating), while evaluating the corticospinal tract and the medial lemniscus, may obtain immediate clinical results with reduced adverse events. Our aim is to present our experience with the four-tract technique for patients undergoing ET treatment with MRgFUS.
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- Vessel perforation during thrombectomy is more common in medium vessel occlusion (MeVO) cases compared to large vessel occlusion (LVO), with a rate of 2.4% in MeVO vs. 1.0% in LVO.
- Among patients who experienced perforation, those in the MeVO group had better functional outcomes at 3 months, achieving independence 25.7% of the time compared to 10.9% in the LVO group.
- Common procedural causes of perforation included navigating beyond the occlusion and retracting the stent retriever or aspiration catheter, highlighting the need for further research to improve safety in thrombectomy procedures.
Objective: To demonstrate, by a cost-effectiveness analysis, the efficiency of mechanical thrombectomy (MT) versus medical management (MM) in patients with a low Alberta Stroke Program Early CT Score (ASPECTS) from the RESCUE Study.
Methods: A cost-effectiveness model was designed to project both direct medical costs and quality-adjusted life-years (QALYs) of MT versus MM in eight European countries (Spain, UK, France, Italy, Belgium, Germany, Sweden, and the Netherlands). Our model was created based on previously published health-economic data in those countries.
Background: The optimal endovascular treatment (EVT) technique for middle cerebral artery (MCA) M2 segment occlusions remains unknown. We aim to analyze whether reperfusion rate, procedure times, procedure-related complications, and clinical outcome differed between patients with isolated M2 occlusions who underwent stent-retriever (SR) alone versus combined SR and contact aspiration (CA) as a front-line EVT.
Methods: Patients who underwent EVT for isolated MCA-M2 occlusion were recruited from the prospectively ongoing ROSSETTI registry.
Goyal described occlusions in M2/3, A2/3 and P2/3 as medium vessel occlusions (MeVOs); the only available controlled data of mechanical thrombectomy (MT) in MeVOs is limited to the middle cerebral artery M2 segment, suggesting that MT may be effective and safe with high functional independence and recanalization rates. The Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique in mechanical thrombectomy consists of the simultaneous use of a stent retriever and a distal aspiration catheter (DAC), with the removal of both as a unit when performing the thrombectomy pass; however, so far the low-profile (0.035 inch distal inner diameter) DACs were longer (160 cm) than conventional 0.
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