Publications by authors named "Andres Fernandez Prieto"

Background And Purpose: Endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with M2 segment occlusion of the middle cerebral artery (MCA) is debatable. This study assessed the efficacy, safety, and functional outcomes of EVT in M2 occlusion patients, examining differences in outcomes based on the dominance of the occluded segment (DomM2 vs. Non-DomM2).

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Background: The increasing availability of neuroimaging tests has led to a rise in the identification of incidental unruptured intracranial aneurysms (UIAs). Their management is under debate, with no consensus on their follow-up strategy, which can cause anxiety in patients. Our aim is to evaluate the impact of diagnosis and imaging follow-up on daily activities and quality of life.

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Introduction: Poststroke hyperglycaemia is an independent risk factor for poorer outcomes in patients treated with mechanical thrombectomy (MT) and is associated with a lower probability of functional recovery and higher mortality at 3 months. This study aims to evaluate the association between glucose levels during cerebral reperfusion with MT and functional recovery at 3 months, measured by subcutaneous continuous glucose monitoring (CGM) devices.

Methods: This prospective observational study aims to recruit 100 patients with ischaemic stroke and large anterior circulation vessel occlusion, in whom MT is indicated.

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Background: Recent randomized trials have demonstrated the efficacy of mechanical thrombectomy in treating acute ischemic stroke, however, further research is required to optimize this technique. We aimed to evaluate the impact of guide catheter position and clot crossing on revascularization rates using A Direct Aspiration First Pass Technique (ADAPT).

Methods: Data were collected between January 2018 and August 2019 as part of the Spanish ADAPT Registry on ACE catheters (SARA), a multicenter observational study assessing real-world thrombectomy outcomes.

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Background: Chest CT has been proposed as a screening test to rule out SARS-CoV-2 lung infection in acute stroke. Our objectives are to analyze the predictive value of neck CT angiography (CTA) source images compared with conventional chest CT, the interobserver concordance and the reliability of the diagnosis using a mobile app.

Methods: A retrospective observational study that included acute stroke patients admitted to a stroke center.

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Article Synopsis
  • A multicenter clinical trial called POWER FAST III is set to compare high-power short-duration (HPSD) radiofrequency ablation with standard techniques for treating atrial fibrillation (AF), aiming to reduce procedure time without sacrificing safety or effectiveness.
  • The study involves two groups: one using higher power settings (70 W and 9-10 seconds) and another using lower power (25-40 W), measuring atrial arrhythmia recurrence and the risk of esophageal damage.
  • Results are expected to potentially validate the HPSD approach, influencing future clinical practices for AF ablation procedures.
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  • The study investigates the use of a smartphone app called JOIN to enhance communication and coordination among stroke team members during emergency situations at La Paz University Hospital in Madrid.
  • Results showed that using the app significantly reduced key time metrics for stroke treatment, such as imaging-to-thrombolysis and door-to-thrombolysis times.
  • A majority of healthcare professionals found the app beneficial for diagnosis and decision-making, although improvements were needed for better integration with clinical records.
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Objective: The mechanical thrombectomy (MT) benefit is related to the degree of reperfusion achieved. First pass effect (FPE) is defined as complete/near revascularisation of the large-vessel occlusion (modified Thrombolysis in Cerebral Infarction (mTICI) 2c-3) after a single device pass. This study assessed the health benefit and economic impact of achieving FPE for acute ischaemic stroke (AIS) patients from the Spanish National Health System (NHS) perspective.

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Introduction: Thrombotic events are potentially devastating complications of coronavirus disease 2019 (COVID-19) infection. Although less common than venous thromboembolism, arterial thrombosis has been reported in COVID-19 cohorts in almost 3% of patients. We describe a patient with COVID-19 infection and concurrent cerebral and noncerebral infarction.

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Introduction: The concurrency of both, acute stroke and acute myocardial infarction in normal conditions, outside the pandemic is rare. Coagulopathy has been associated with the inflammatory phase of coronavirus disease (COVID-19) and might be involved in this concurrency.

Cases Report: We describe 2 patients with previous mild or no symptoms of COVID-19, admitted for acute stroke with recent/simultaneous myocardial infarction in whom admission polymerase chain reaction was negative but serologic testing diagnosed COVID-19.

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Article Synopsis
  • The study evaluated the technical success and safety of the Silk Vista (SV) device for treating intracranial aneurysms across multiple institutions.
  • It reviewed data from 57 procedures involving 60 aneurysms, showing high success rates in device opening (91%) and complete wall apposition (92%).
  • The findings indicated that the SV device is both feasible and technically safe, with a low rate of complications and no reported mortality.
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Background And Purpose: To investigate the efficacy and safety of mechanical thrombectomy in patients with acute ischemic stroke according to the oral anticoagulation medication taken at the time of stroke onset.

Materials And Methods: A retrospective multicenter study of prospectively collected data based on data from the registry the Madrid Stroke Network was performed. We included consecutive patients with acute ischemic stroke treated with mechanical thrombectomy and compared the frequency of intracranial hemorrhage and the modified Rankin Scale (mRS) score at 3 months according to anticoagulation status.

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Bleomycin has progressively been used to treat low-flow vascular malformations in children. No significant systemic side effects have been reported in large series after low doses, but some authors are still concerned about its use. We report a case of a severe acute lung toxicity after a low dose of a second bleomycin intralesional injection in a 5-year-old girl.

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Article Synopsis
  • - The study analyzed outcomes and complications of mechanical thrombectomy (MT) for basilar artery occlusions (BAO) compared to anterior circulation occlusions, finding that BAO patients experienced longer procedure times and a lower recanalization rate.
  • - Patients with BAO had a higher rate of mortality (33% vs 12%) and lower independence at 3 months (40% vs 58%) compared to those with anterior circulation occlusions, along with a trend of more procedural complications.
  • - The findings suggest that MT is more complex with a higher chance of futile recanalization in BAO cases, particularly influenced by older age and longer procedure durations, indicating a need for refined endovascular approaches for better outcomes. *
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Background And Purpose: The complexity of endovascular revascularization treatment (ERT) in acute ischemic stroke and the small number of patients eligible for treatment justify the development of stroke center networks with interhospital patient transfers. However, this approach might result in futile transfers (ie, the transfer of patients who ultimately do not undergo ERT). Our aim was to analyze the frequency of these futile transfers and the reasons for discarding ERT and to identify the possible associated factors.

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The high incidence of fractures by fragility and, especially of the vertebral fractures in osteoporotic postmenopausal women, forces us to approach this subject once more. In this manuscript epidemiological data that indicates the magnitude of the problem will be updated. Treatment alternatives to decrease back pain produced by vertebral fracture are will be reviewed, and the prevention of the occurrence of new osteoporotic fractures of any type, through the administration of suitable antiresorptive and bone-forming pharmacological agents to increase bone mineral density will also be addressed.

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Purpose: To evaluate the long-term effectiveness of nasolacrimal stents for the treatment of obstructive epiphora, and the complications related to the procedure.

Methods: This study is a non-randomized prospective clinical trial. Eighty-five patients underwent fluoroscopally-guided placement of polyurethane stent in 86 lacrimal systems for the treatment of severe idiopathic obstructive epiphora.

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