Background: Acute stroke due to distal intracranial internal carotid artery (ICA) occlusion has a poor natural history. Outcome in patients who receive intravenous tissue plasminogen activator (tPA) is also unsatisfactory. The objective of this study is to evaluate the effectiveness and safety of endovascular treatment with retrievable stents in these patients.
Methods: Data from a prospective register of patients with acute stroke treated with an endovascular procedure in a single centre were analysed.
Results: A total of 20 patients with distal ICA occlusion were collected. Mean baseline National Institutes of Health Stroke Scale score was 18. Eight cases (40%) had received previous intravenous tPA. Mean time from stroke to recanalization was 393 min. Retrievable stents with proximal occlusion and aspiration were used in all cases. In 3 patients, 2 retrievable stents were used simultaneously. Complete recanalization (thrombolysis in cerebral infarction 2b/3) was accomplished in 85% of cases. A favourable clinical outcome (modified Rankin Scale score 0-2) was achieved in 13 patients (65%). Mortality occurred in 2 cases (10%).
Conclusions: Endovascular treatment of patients with distal ICA occlusion seems safe and effective. Retrievable stents may be the treatment of choice, although randomized clinical trials are necessary. The use of 2 retrievable stents at the same time could be an alternative technique useful in thrombi of larger size.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1159/000351352 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Delayed open-heart operation to remove migrated intracardiac inferior vena cava stents in a living donor liver transplantation recipient: a case report.
Nagoya J Med Sci
November 2024
School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Intracardiac migration of inferior vena cava (IVC) filter or stent is a rare but potentially fatal complication of endovascular venous device placement. There is no consensus whether migrated stents should be surgically removed by open cardiac surgery or retrieved by the percutaneous endovascular route and whether an intervention should be performed immediately or expectantly. Herein, we report a 39-year-old female who received emergent left lobe living donor liver transplantation (LDLT) owing to posthepatectomy liver failure.
View Article and Find Full Text PDFImpact of thrombus composition on virtual thrombectomy procedures using human clot analogues mechanical data.
J Mech Behav Biomed Mater
January 2025
Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Italy.
Endovascular thrombectomy (EVT) aims at restoring blood flow in case of acute ischemic stroke by removing the thrombus occluding a large cerebral artery. During the procedure with stent-retriever, the thrombus is captured within the device, which is then retrieved, subjecting the thrombus to several forces, potentially leading to its fragmentation. In silico studies, along with mechanical characterisation of thrombi, can enhance our understanding of the EVT, helping the development of new devices and interventional strategies.
View Article and Find Full Text PDFEmbolized Transcatheter Aortic Valve Replacement Diagnosed With Transesophageal Echocardiography and a Novel Management Strategy Using a Thoracic Endovascular Aneurysm Repair Stent.
A A Pract
January 2025
Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas.
Transcatheter aortic valve replacement (TAVR) is a common treatment for severe aortic stenosis (AS), but it carries the risk of severe complications, including device embolization. We present a case of a TAVR valve embolization into the left ventricular outflow tract (LVOT), diagnosed with transesophageal echocardiography (TEE) shortly after device deployment. The dislodged valve was successfully retrieved from the LVOT into the aorta, flattened, and stabilized with a thoracic endovascular aneurysm repair (TEVAR) stent, enabling the successful implantation of a new TAVR valve.
View Article and Find Full Text PDFMigration of a ureteral stent made from a nasogastric tube into the inferior vena cava: A case report.
Int J Surg Case Rep
December 2024
School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Introduction: This case report presents a rare instance of a ureteral stent, fashioned from a nasogastric tube, migrating into the inferior vena cava (IVC). The report underscores the importance of timely diagnosis and intervention to prevent severe complications.
Presentation Of Case: A 38-year-old woman presented with a ureteral stent, made from a nasogastric tube, found in the IVC following a previous surgery.
Clinical outcomes and complications of retained biliary stents during the COVID-19 pandemic: a case series.
J Surg Case Rep
January 2025
Department of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathamndu 44600, Nepal.
Biliary stents are widely used following endoscopic management of choledocholithiasis. Removal is recommended within 3-6 months to prevent complications. This study analyzed cases of retained biliary stents managed at our institution.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!