Publications by authors named "Christian Commodaro"
Article Synopsis
- * 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
- 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.
Background: Patients with minor stroke and M2 occlusion undergoing best medical management (BMM) may face early neurological deterioration (END) that can lead to poor long-term outcome. In case of END, rescue mechanical thrombectomy (rMT) seems beneficial. Our study aimed to define factors relevant to clinical outcome in patients undergoing BMM with the possibility of rMT on END, and find predictors of END.
View Article and Find Full Text PDFBackground: The purpose of this study was to evaluate the effectiveness of mechanical thrombectomy (MT) in patients with isolated M2 occlusion and minor symptoms and identify possible baseline predictors of clinical outcome.
Methods: The databases of 16 high-volume stroke centers were retrospectively screened for consecutive patients with isolated M2 occlusion and a baseline National Institutes of Health Stroke Scale (NIHSS) score ≤5 who received either early MT (eMT) or best medical management (BMM) with the possibility of rescue MT (rMT) on early neurological worsening. Because our patients were not randomized, we used propensity score matching (PSM) to estimate the treatment effect of eMT compared with the BMM/rMT.
Mechanical thrombectomy in acute ischemic stroke due to large vessel occlusion in the anterior circulation and low baseline National Institute of Health Stroke Scale score: a multicenter retrospective matched analysis.
Neurol Sci
May 2022
Article Synopsis
- - The study investigates the effectiveness of mechanical thrombectomy (MT) for patients with acute ischemic stroke (AIS) and mild neurological symptoms (NIHSS score ≤ 5), as previous benefits of MT in this subgroup have been unclear.
- - Researchers reviewed data from 9 Italian stroke centers, comparing immediate MT patients to those receiving best medical management (BMM) with a potential for rescue MT if needed, ultimately finding that MT significantly improved outcomes at 90 days.
- - Results indicated 80.5% of the MT group achieved an excellent outcome compared to 65.9% in the BMM/rescue MT group; however, further dedicated clinical trials are needed for definitive recommendations.
Article Synopsis
- - The study compares two endovascular techniques, aspiration technique (AT) and combined technique (CT), for treating acute ischemic strokes caused by internal carotid artery occlusion, aiming to determine their effectiveness and safety.
- - Researchers analyzed data from seven Italian stroke centers, categorizing 353 patients into AT or CT groups and applying various statistical methods to compare outcomes.
- - Results showed that the CT approach led to more successful recanalizations and better clinical outcomes at discharge and three months later, indicating it may be a superior first-line treatment compared to AT for this condition.
A 71-year-old man, with a pial micro-arteriovenous malformation (pAVM) draining into the confluence of the vein of Trolard and the vein of Labbé was surgically removed, sparing these cortical veins. 4-months MR and angiographic controls showed a de novo dural arteriovenous fistula (dAVF) draining into the previously spared cortical veins. It was removed using intraoperative motor evoked potentials (MEP).
View Article and Find Full Text PDFPurpose: Intracranial carotid artery occlusion represents an underinvestigated cause of acute ischemic stroke as well as an indication for mechanical thrombectomy. We investigated baseline and procedural characteristics, outcomes and predictors of outcome in patients with acute ischemic stroke secondary to intracranial carotid artery occlusion.
Methods: A retrospective analysis of the Italian Registry of Endovascular Treatment in Acute Stroke was performed.
Complications of mechanical thrombectomy for acute ischemic stroke: Incidence, risk factors, and clinical relevance in the Italian Registry of Endovascular Treatment in acute stroke.
Int J Stroke
October 2021
Background: There are limited data concerning procedure-related complications of endovascular thrombectomy for large vessel occlusion strokes.
Aims: We evaluated the cumulative incidence, the clinical relevance in terms of increased disability and mortality, and risk factors for complications.
Methods: From January 2011 to December 2017, 4799 patients were enrolled by 36 centers in the Italian Registry of Endovascular Stroke Treatment.