Publications by authors named "Rebecca Sugg"
Rescue Therapy for Failed Mechanical Thrombectomy in Acute Ischemic Stroke: A Pooled Analysis of the Society of Vascular and Interventional Neurology Registry.
Ann Neurol
August 2024
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.
Cerebral cavernous malformations (CCMs) are the second most common type of cerebral vascular lesions. They are often associated with other vascular lesions, typically developmental venous anomalies. CCMs are not known to be associated with cerebral aneurysms and there is a paucity of literature on this occurrence.
View Article and Find Full Text PDFBackground: Studies that have analyzed the association between cannabis use and acute ischemic stroke (AIS) have provided conflicting results. In this study, we aim to determine the association of recent cannabis use detected through urine drug screen (UDS) among patients admitted with AIS.
Methods: A retrospective observational study was performed using the medical records database.
Context: We describe a case of unilateral posterior upper cervical spinal cord infarction and propose a pathophysiologic mechanism causing this lesion after vertebral artery endovascular intervention.
Findings: A 70-year-old male presented with subacute onset of left hemibody sensory changes and gait instability following a left vertebral angioplasty procedure. MRI cervical spine revealed upper posterior cervical spinal cord infarction (PSCI).
Hypereosinophilic syndrome presenting acutely with neurologic signs.
Ann Allergy Asthma Immunol
May 2018
Background And Purpose: General anesthesia (GA) for endovascular therapy (EVT) of acute ischemic stroke may be associated with worse outcomes.
Methods: The Interventional Management of Stroke III trial randomized patients within 3 hours of acute ischemic stroke onset to intravenous tissue-type plasminogen activator±EVT. GA use within 7 hours of stroke onset was recorded per protocol.
Background And Purpose: Endovascular strategies provide unique opportunity to correlate angiographic measures of collateral circulation at the time of endovascular therapy. We conducted systematic analyses of collaterals at conventional angiography on recanalization, reperfusion, and clinical outcomes in the endovascular treatment arm of the Interventional Management of Stroke (IMS) III trial.
Methods: Prospective evaluation of angiographic collaterals was conducted via central review of subjects treated with endovascular therapy in IMS III (n=331).
Background And Purpose: Argatroban is a direct thrombin inhibitor that safely augments recanalization achieved by tissue-type plasminogen activator (tPA) in animal stroke models. The Argatroban tPA Stroke Study was an open-label, pilot safety study of tPA plus Argatroban in patients with ischemic stroke due to proximal intracranial occlusion.
Methods: During standard-dose intravenous tPA, a 100-μg/kg bolus of Argatroban and infusion for 48 hours was adjusted to a target partial thromboplastin time of 1.
Background And Purpose: External counterpulsation (ECP) improves coronary perfusion, increases left ventricular stroke volume similar to intraaortic balloon counterpulsation, and recruits arterial collaterals within ischemic territories. We sought to determine ECPs effect on middle cerebral artery (MCA) blood flow augmentation in normal controls as a first step to support future clinical trials in acute stroke.
Methods: Healthy volunteers were recruited and screened for exclusions.
Background And Purpose: Ultrasound transiently expands perflutren-lipid microspheres (muS), transmitting energy momentum to surrounding fluids. We report a pilot safety/feasibility study of ultrasound-activated muS with systemic tissue plasminogen activator (tPA).
Methods: Stroke subjects treated within 3 hours had abnormal Thrombolysis in Brain Ischemia (TIBI) residual flow grades 0 to 3 before tPA on transcranial Doppler (TCD).
Background And Purpose: The optimal approach for acute ischemic stroke patients who do not respond to intravenous recombinant tissue plasminogen activator (IV rt-PA) is uncertain. This study evaluated the safety and response to intra-arterial thrombolytics (IATs) in patients unresponsive to full-dose IV rt-PA.
Methods: A case series from a prospectively collected database on consecutive acute ischemic stroke patients treated with IATs after 0.
Background: The benefit of intravenous recombinant tissue plasminogen activator (rtPA) in acute stroke is linked to clot lysis and artery recanalization. Argatroban is a direct thrombin inhibitor that safely augments the benefit of rtPA in animal stroke models. There are no human data on this combination.
View Article and Find Full Text PDFObjective And Importance: We describe the first documented endovascular treatment of proximal intracranial mycotic aneurysms by a self-expanding, flexible, dedicated, intracranial Neuroform stent. Treatment with this stent rapidly obliterated the aneurysms, eliminated the need for additional coiling, and maintained the patency of the parent arteries.
Clinical Presentation: A 47-year-old male patient with infective endocarditis presented with ischemic stroke and minimal subarachnoid hemorrhage.
Background: Endovascular therapy (ET) of internal carotid artery (ICA) stenosis is equivalent to carotid endarterectomy for stroke prevention; however, patients with ICA occlusion and acute symptoms are traditionally not candidates for ET. We report our experience in endovascular recanalization of acute stroke patients with ICA occlusion.
Patients And Techniques: We reviewed our registry for acute stroke patients treated with ET who had (1) ICA occlusion by digital subtraction angiography (thrombolysis in myocardial ischemia=0) with location of type II (above ophthalmic artery involving M1 or A1 but not both) or type III (proximal to the ophthalmic artery but distal to the bifurcation); (2) acute stroke symptoms from the index lesion presenting 3 hours after onset of symptoms; (3) minimal ischemic changes on brain CT scan (less than one third of the MCA territory); (4) attempted ET.