Impact of histological clot composition on preprocedure imaging and mechanical thrombectomy.

Introduction: We studied the relationship of acute ischemic stroke (AIS) large-vessel occlusion clot composition with vessel recanalization and preprocedure imaging.

Subjects And Methods: Individual clots from AIS patients who underwent mechanical thrombectomy (MT) between September 2016 and September 2018 were examined. Clot composition was analyzed histologically through a trichrome staining and image segmentation, and the area occupied by red blood cells (RBCs), fibrin, or mixed composition was quantified.

Preventing Inadvertent Foreign Body Injection in Angiography.

Background Inadvertent injection of foreign material during angiography, particularly neuroangiography, should be avoided to reduce the risk of embolic complications. Woven gauze and cotton fabrics have been identified as sources of inadvertent foreign body embolization. Purpose To find the source of particles that contaminate injections on an angiography table and to identify measures for their reduction.

Quantitative Characterization of Recanalization and Distal Emboli with a Novel Thrombectomy Device.

Purpose: The first-pass effect during mechanical thrombectomy improves clinical outcomes regardless of first-line treatment approach, but current success rates for complete clot capture with one attempt are still less than 40%. We hypothesize that the ThrombX retriever (ThrombX Medical Inc.) can better engage challenging clot models during retrieval throughout tortuous vasculature in comparison with a standard stent retriever without increasing distal emboli.

Complete clot ingestion with cyclical ADAPT increases first-pass recanalization and reduces distal embolization.

Background: Evidence is mounting that first-pass complete recanalization during mechanical thrombectomy is associated with better clinical outcomes in patients presenting with an emergent large vessel occlusion. We hypothesize that aspiration achieving complete clot ingestion results in higher first-pass successful recanalization with quantitative reduction in distal emboli.

Methods: A patient-specific cerebrovascular replica was connected to a flow loop.

The occurrence of neointimal hyperplasia after flow-diverter implantation is associated with cardiovascular risks factors and the stent design.

Background: Neo-intimal hyperplasia (NIH) is frequently observed after flow-diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular response can sometimes lead to delayed ischemic strokes. This study intended to evaluate the factors potentially influencing the rates of NIH following FDS treatment.

Microcatheter navigation through the clot: does size matter?

Background: Despite high recanalization rates achieved with endovascular treatment of acute ischemic strokes, around 50% of eligible patients will not achieve a good outcome. Parameters that may determine patient outcomes include: time from puncture to recanalization, the collateral status, the anesthesia regimen, blood pressure management, and distal emboli. Characterization of distal emboli generated during mechanical thrombectomy has been performed in previous studies.