Publications by authors named "Enrica Franchini"
Background And Objectives: The optimal mechanical thrombectomy technique for distal, medium vessel occlusion (DMVO) stroke remains unknown. We aimed to compare the safety and efficacy of 2 thrombectomy first-line approaches, direct aspiration (DA), and combined technique (CT) in patients with DMVOs.
Methods: We conducted a retrospective review of a prospectively collected multicenter database of patients with DMVOs (at or distal to M2 and A1), who underwent mechanical thrombectomy with JET D reperfusion catheters between January 2020 and December 2021.
Background: Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO.
View Article and Find Full Text PDFArticle Synopsis
- This study looked at how patients with a minor stroke are treated, comparing two methods: one using a drug called IVT and another method called MT, versus just IVT alone.
- They analyzed data from patients treated in Italy to see which method led to better health outcomes after a stroke.
- The results showed that while IVT plus MT had more complications in the short term, both treatment methods had similar long-term recovery outcomes.
Article Synopsis
- The study investigates predictors of hemorrhagic transformation (HT) and cerebral edema (CED) in stroke patients undergoing endovascular treatment after experiencing large vessel occlusion (LVO).
- It analyzes data from 1,400 patients to find clinical and procedural factors associated with these complications, identifying variables like diabetes, NIHSS scores, and ASPECTS ratings as significant predictors.
- Results show that HT occurred in 18% of patients and CED in 19.2%, with general anesthesia linked to a lower risk of HT, while factors like longer onset-to-groin times and invasive procedures raised the risk for both complications.
Background: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF.
Methods: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).
Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke.
Acta Neurol Belg
April 2023
Purpose: The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.
Methods: We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke.
Background And Purpose: We sought to investigate whether there are gender differences in clinical outcome after stroke due to large vessel occlusion (LVO) after mechanical thrombectomy (EVT) in a large population of real-world patients.
Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke due to large vessel occlusion. We compared clinical and safety outcomes in men and women who underwent EVT alone or in combination with intravenous thrombolysis (IVT) in the total population and in a Propensity Score matched set.
Background And Purpose: Poor clinical outcomes are still common in successfully reperfused acute ischemic stroke patients. The aim of our study was to assess the impact of sarcopenia and myosteatosis on neurological outcomes and mortality in successfully reperfused acute ischemic stroke patients.
Materials And Methods: We included in our retrospective observational study 166 consecutive patients who underwent technically successful mechanical thrombectomy for anterior circulation acute ischemic stroke between Jan 2016 and Dec 2019.
Background: Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke.
Methods: We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy.
Purpose: 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.
Article Synopsis
- There is currently no reliable system to predict the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke, prompting the development of a nomogram to address this issue.
- The study analyzed data from 3714 patients treated for large vessel occlusion and created the IER-SICH nomogram based on various factors, including age and procedure time, to assess hemorrhage risk.
- The IER-SICH nomogram demonstrated good predictive ability, with area under the curve values of 0.778 in the training set and 0.709 in the test set, making it the first validated model for early identification of high-risk patients post-thrombectomy.
Article Synopsis
- The study aimed to create and validate a new nomogram, called IER-START, to predict unfavorable outcomes in stroke patients with large vessel occlusion who received intervention within 6 hours.
- This nomogram was based on key factors like the NIH Stroke Scale score, age, previous disability levels, and treatment methods, utilizing data from the Italian Endovascular Registry.
- The IER-START model demonstrated strong predictive performance, with an AUC-ROC of 0.838 in training and 0.820 in testing, making it a reliable tool for assessing patient outcomes after thrombectomy.
High-dose benzodiazepine (BZD) dependence represents an emerging and under-reported addiction phenomenon and is associated with reduced quality of life. To date there are no guidelines for the treatment of high-dose BZD withdrawal. Low-dose slow flumazenil infusion was reported to be effective for high-dose BZD detoxification, but there is concern about the risk of convulsions during this treatment.
View Article and Find Full Text PDFObject: Electroencephalography-functional magnetic resonance imaging (EEG-fMRI) coregistration and high-density EEG (hdEEG) can be combined to map noninvasively abnormal brain activation elicited by epileptic processes. By combining noninvasive imaging techniques in a multimodal approach, we sought to investigate pathophysiological mechanisms underlying epileptic activity in seven patients with severe traumatic brain injury.
Materials And Methods: Standard EEG and fMRI data were acquired during a single scanning session.