Publications by authors named "Galecio-Castillo M"
Background: Cerebral Venous Sinus Thrombosis (CVST) is a relatively rare type of stroke, accounting for less than 3% of all stroke cases, and is associated with significant morbidity and mortality in young females. However, when promptly diagnosed and treated, it can have favorable outcomes. Several knowledge gaps remain regarding pathophysiology, diagnosis, and management of CVST, so critical assessment of past and present research could help close these gaps or establish targeted future research goals.
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- A study evaluated the safety and efficacy of endovascular thrombectomy in patients with acute large-vessel occlusion and tandem lesions, focusing on those with low (0-5) and high (6-10) Alberta Stroke Program Early Computed Tomography Scores (ASPECTS).
- The analysis included 691 patients, revealing that those with low ASPECTS had significantly lower odds of achieving a favorable functional outcome (mRS 0-2) and higher odds of suffering symptomatic intracranial hemorrhage compared to those with high ASPECTS.
- The researchers concluded that endovascular thrombectomy may lead to poorer functional recovery in patients with tandem lesions and low ASPECTS, particularly in the
Background: Flow diversion has revolutionized the management of wide-necked intracranial aneurysms (IAs). We aimed to assess the effectiveness and safety of the new generation 64-wire Surpass Evolve for the treatment of unruptured small/medium-sized IAs.
Methods And Results: This is a subanalysis from the SEASE (Safety and Effectiveness Assessment of the Surpass Evolve) registry, an observational cohort study including 15 academic institutions in North America and Europe between July 2020 and October 2022.
Purpose: The aim of this study was to identify factors that predict favorable functional outcomes in elderly patients with large-vessel occlusion acute ischemic stroke (LVO-AIS) who underwent mechanical thrombectomy (MT).
Methods: We conducted a retrospective observational study using the prospectively maintained Bigdata Observatory for Stroke of China (BOSC) to identify eligible patients who underwent MT for LVO-AIS at four comprehensive stroke centers between August 2019 and February 2022. Inclusion criteria included patients aged 80 years or older with a baseline modified Rankin Scale (mRS) 0-2, baseline National Institutes of Health Stroke Scale (NIHSS) > 6, baseline Alberta Stroke Program Early CT Score (ASPECTS) > 6 who received treatment within 24 h from symptom onset.
Background And Objectives: Endovascular therapy (EVT) has emerged as the standard for treating patients with acute ischemic stroke due to large vessel occlusion. The aim of this study was to investigate the relationship between early petechial hemorrhage and patient outcomes after successful EVT of anterior circulation.
Methods: We retrospectively analyzed multicenter data from 316 patients who underwent EVT for acute occlusion of anterior circulation.
Article Synopsis
- Researchers developed a 9-point score to predict positive outcomes for patients undergoing endovascular therapy (EVT) in late-presenting strokes (6-24 hours after last known well), based on a multinational study involving over 3,200 patients.
- The score takes into account factors like age, early CT changes, and stroke severity, with higher scores indicating a better chance of functional recovery at 90 days compared to those receiving only medical management.
- Validation of the score showed it is a useful tool for estimating EVT outcomes, particularly benefiting patients with lower to midrange scores in terms of good functional results and independence.
Article Synopsis
- - The study investigates the effects of acute carotid artery stenting (CAS) on functional outcomes in patients with acute stroke and tandem lesions (TLs) undergoing endovascular therapy (EVT), suggesting that CAS leads to better outcomes.
- - Conducted across 16 stroke centers, the research included 570 patients and found that those who underwent CAS had higher rates of successful reperfusion and favorable functional outcomes compared to those who did not.
- - The analysis indicates that successful reperfusion significantly predicts better functional outcomes, while also showing that it partially mediates the relationship between acute CAS and improved outcomes in stroke patients.
Article Synopsis
- Tandem lesions involve stenosis or occlusion of the cervical internal carotid artery, often due to atherosclerosis or dissection, combined with a large vessel occlusion; this study compares patient outcomes based on the cause of ICA lesions.
- The study analyzed data from 526 patients treated endovascularly between 2015 and 2020, focusing on 90-day functional independence and various secondary outcomes, using matching methods for analysis.
- Results showed no differences in 90-day independence, but patients with dissection had lower successful recanalization rates and higher distal emboli incidents compared to those with atherosclerosis.
Article Synopsis
- A study was conducted to investigate the effects of different anesthesia types (general vs. non-general) during endovascular treatment for strokes caused by distal medium vessel occlusions (DMVO).
- Researchers analyzed data from multiple centers and focused on outcomes like disability after 90 days, successful blood vessel reperfusion, and rates of complications.
- Results showed no significant differences between the two anesthesia groups regarding disability, successful treatment, or safety measures, suggesting that anesthesia type may not impact clinical outcomes in DMVO strokes.
Introduction: The benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0-5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke patients in real-world settings.
Patients And Methods: The CT for Late Endovascular Reperfusion (CLEAR) study recruited patients from 66 centers in 10 countries between 01/2014 and 05/2022.
Article Synopsis
- This study aimed to compare the effectiveness of rescue therapy (RT) versus medical management (MM) in improving functional outcomes for patients who experienced a failed mechanical thrombectomy (MT).
- Analyzing data from 2011 to 2021, the research focused on patients with large vessel occlusions (LVOs) and assessed disability at 90 days using the modified Rankin Scale (mRS).
- Results showed that RT led to better functional independence, lower rates of symptomatic intracranial hemorrhage, and decreased 90-day mortality compared to MM, suggesting that RT might be a more effective treatment strategy for these patients.
Article Synopsis
- - The Surpass Evolve (SE) is a new type of flow diverter used as the primary treatment for certain intracranial aneurysms, and its safety and effectiveness were evaluated in a large, multicenter study called SEASE, involving data from 305 patients treated between 2020 and 2022.
- - Most patients in the study were female, had unruptured saccular aneurysms, and showed an average significant follow-up period during which 73% of aneurysms achieved complete occlusion.
- - The findings indicate that SE demonstrates a high rate of effectiveness in closing aneurysms and exhibits a favorable safety profile, with low rates of major strokes and procedure-related mortality.
Article Synopsis
- Early changes in endovascular therapy (EVT) techniques for ischemic stroke can impact reperfusion outcomes, particularly after initial failed attempts.
- Switching from stent retriever (SR) to combined technique (CT) after two unsuccessful passes significantly improves chances of achieving complete/near-complete reperfusion (eTICI 2c-3).
- Adjusting strategy from contact aspiration (CA) to CT also shows improved outcomes, while changing from CA to SR had no significant benefits, highlighting the importance of flexible approaches in EVT.
Background: Endovascular therapy (EVT) stands as an established and effective intervention for acute ischemic stroke in patients harboring tandem lesions (TLs). However, the optimal anesthetic strategy for EVT in TL patients remains unclear. This study aims to evaluate the impact of distinct anesthetic techniques on outcomes in acute ischemic stroke patients presenting with TLs.
View Article and Find Full Text PDFBackground: The potentially higher risk of hemorrhagic complications is of concern in stent-assisted coiling (SAC) of ruptured wide-necked intracranial aneurysms (IAs). The Woven EndoBridge (WEB) is considered an appealing alternative since antiplatelet therapy is not required. Herein, we aimed to compare the safety and effectiveness of WEB vs.
View Article and Find Full Text PDFObjective: The optimal technique for treating tandem lesions (TLs) with endovascular therapy is debatable. The authors evaluated the functional, safety, and procedural outcomes of different approaches in a multicenter study.
Methods: Anterior circulation TL patients treated from January 2015 to December 2020 were divided on the basis of antegrade versus retrograde approach and included.
Background: Intravenous thrombolysis (IVT) is an effective stroke therapy that remains underused. Currently, the use of IVT in patients with recent direct oral anticoagulant (DOAC) intake is not recommended. In this study we aim to investigate the safety and efficacy of IVT in patients with acute ischemic stroke and recent DOAC use.
View Article and Find Full Text PDFRisk of hemorrhage remains with antiplatelet medications required with carotid stenting during endovascular therapy (EVT) for tandem lesion (TLs). We evaluated the safety of antiplatelet regimens in EVT of TLs. This multicenter study included anterior circulation TL patients from 2015 to 2020, stratified by periprocedural EVT antiplatelet strategy: (1) no antiplatelets, (2) single oral, (3) dual oral, and (4) intravenous IV (in combination with single or dual oral).
View Article and Find Full Text PDFBackground: Infarct growth rate (IGR) differs among patients with acute ischemic stroke due to large vessel occlusion (LVO-AIS), and this variability has critical clinical repercussions. We explored IGR patterns and their association with blood pressure during endovascular therapy (EVT).
Methods: This is a two-center cohort observational study that included consecutive anterior circulation LVO-AIS patients who underwent EVT and achieved modified Thrombolysis in Cerebral Infarction (mTICI) 2 c-3.
Objectives: Intravenous (IV) periprocedural antiplatelet therapy (APT) for patients undergoing acute carotid stenting during mechanical thrombectomy (MT) is not fully investigated. We aimed to compare the safety profile of IV low dose cangrelor versus IV glycoprotein IIb/IIIa (GP-IIb/IIIa) inhibitors in patients with acute tandem lesions (TLs).
Materials And Methods: We retrospectively identified all cases of periprocedural administration of IV cangrelor or GP-IIb/IIIa inhibitors during acute TLs intervention from a multicenter collaboration.
Article Synopsis
- * Results indicated that patients who underwent RS after failed MT had significantly lower disability levels and better functional outcomes at 90 days compared to those who didn't receive RS, as well as a lower mortality rate.
- * Safety metrics, including rates of symptomatic intracranial hemorrhage and procedural complications, were similar between both groups, suggesting that RS is a viable option for improving patient outcomes after failed MT.
Background: While recent studies suggest a benefit of mechanical thrombectomy (MT) for the treatment of patients with isolated large vessel occlusions presenting after 24 hours from the last known well (LKW), the effect of MT for acute cervical tandem lesions (TLs) beyond 24 hours remains unknown. We aimed to evaluate the safety and effectiveness of MT beyond 24 hours of LKW in patients with TLs.
Methods: We conducted a subanalysis study of patients with anterior circulation TL enrolled in a large, multicenter registry between January 2015 and December 2020.