Intracranial atherosclerotic disease (ICAD) represents one of the most common causes of ischemic stroke worldwide, yet our understanding remains limited regarding the best treatment options for this complex disease with a high recurrence rate of stroke. Although medical therapy has proved to be effective in lowering the risk of stroke, certain high-risk ICAD patients may derive benefit from endovascular therapy. This review presents the current treatment options for the endovascular management of ICAD and highlights the recent relevant literature.
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Resuscitative endovascular balloon occlusion of the aorta for trauma patients with uncontrolled hemorrhage: a retrospective target trial emulation (the AT-REBOA target trial).
Eur J Emerg Med
September 2024
Department of Anaesthesiology and Intensive Care Medicine.
Background: Noncompressible truncal hemorrhage is a major contributor to preventable deaths in trauma patients and, despite advances in emergency care, still poses a big challenge.
Objectives: This study aimed to assess the clinical efficacy of trauma resuscitation care incorporating Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) compared to standard care for managing uncontrolled torso or lower body hemorrhage.
Methods: This study utilized a target trial design with a matched case-control methodology, emulating randomized 1 : 1 allocation for patients receiving trauma resuscitation care with or without the use of REBOA.
Embolized 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 PDFSex-Based Differences in Endovascular Thrombectomy Outcomes for Large Ischemic Stroke: A SELECT2 Subanalysis.
Stroke
January 2025
Neurology, Stroke, University Hospital Cleveland Medical Center - Case Western Reserve University, OH. (A.O., C.S., A.S.).
Background: Several social and biological factors are shown to differentially affect stroke outcomes between men and women. We evaluated whether clinical outcomes and endovascular thrombectomy (EVT) treatment effects differed between the sexes in patients presenting with large ischemic stroke.
Methods: The SELECT2 trial (A Randomized Controlled Trial to Optimize Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke) was a randomized controlled trial assessing the efficacy and safety of EVT in patients with large strokes across the United States, Canada, Europe, Australia, and New Zealand between October 2019 and September 2022.
The broad spectrum of clinical manifestations caused by peripheral arterial disease [PAD] and the morphologic heterogeneity of associated atherosclerotic lesions present a considerable management challenge. Endovascular interventions are recognized an effective treatment for PAD. Within this revascularization strategy the role of atherectomy debulking modalities continue to evolve.
View Article and Find Full Text PDFTrends in Utilization of Common Tests and Procedures in Treating PAD in the Medicare Population from 2011 to 2021.
J Vasc Interv Radiol
December 2024
Department of Interventional Radiology, University of California, Los Angeles, Los Angeles, California.
This study investigated changes in utilization of diagnostic imaging-CT angiography (CTA) and MR angiography (MRA)-and treatments-stent placement, angioplasty, atherectomy, and bypass-in PAD across different physician specialties and healthcare facilities from 2011-2021. Data were gathered from the 2011-2021 Physician/Supplier Procedure Summary files and tallied per 100,000 Medicare beneficiaries. Sites of service included inpatients, physician offices, and hospital outpatient departments.
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