The 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy (TTST) took place in Houston, Texas on 21-22 October 2018. Attended by 150+ invited global experts, the objectives of TTST 2018 were to explore the changing landscape of acute ischemic stroke therapy and to address current controversies in thrombolysis and thrombectomy, including expanding access and systems of care with global relevance. This article summarizes the proceedings of TTST 2018. The key points of each session are listed below, the full text of presentations and discussion are available in the online supplement, and the full list of contributing authors appear in the Appendix at the end of this article.
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[Thrombectomy : Stent retriever vs aspiration].
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Klinik für Diagnostische und Interventionelle Radiologie, Städtisches Klinikum Lüneburg, Bögelstraße 1, 21339, Lüneburg, Deutschland.
Besides intravenous thrombolysis, endovascular therapy (EVT) is also a standard treatment option for acute ischemic stroke. The clinical efficacy and safety of this procedure was proven in 2015 by several randomized controlled trials. The aim of EVT is to achieve the fastest possible recanalization of an occluded artery supplying the brain and, thus, reperfusion of the brain tissue.
View Article and Find Full Text PDFImpact of workflow times on successful reperfusion after endovascular treatment in the late time window.
Neuroradiol J
January 2025
Calgary Stroke Program, Department of Clinical Neurosciences and Radiology, University of Calgary, Canada.
Background And Purpose: Successful and complete reperfusion should be the aim of every endovascular thrombectomy (EVT) procedure. However, the effect of time delays on successful reperfusion in late window stroke patients presenting 6-to-24 h from onset has not been investigated.
Materials And Methods: We pooled individual patient-level data from seven trials and registries for anterior circulation stroke patients treated with EVT between 6 and 24 h from onset.
Intra-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke: The POST-TNK Randomized Clinical Trial.
JAMA
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Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Importance: The impact of adjunctive intra-arterial tenecteplase administration following near-complete to complete reperfusion by endovascular thrombectomy (EVT) for acute ischemic stroke is unknown.
Objective: To assess the efficacy and adverse events of adjunctive intra-arterial tenecteplase in patients with large vessel occlusion stroke who had achieved near-complete to complete reperfusion (defined as a score on the expanded Thrombolysis in Cerebral Infarction [eTICI] scale of 2c to 3) after EVT.
Design, Setting, And Participants: Investigator-initiated, randomized, open-label, blinded outcome assessment trial implemented at 34 hospitals in China among 540 patients with stroke due to proximal intracranial large vessel occlusion within 24 hours of the time they were last known to be well, with an eTICI score of 2c to 3 after EVT, and without prior intravenous thrombolysis.
Intra-Arterial Urokinase After Endovascular Reperfusion for Acute Ischemic Stroke: The POST-UK Randomized Clinical Trial.
JAMA
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Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Importance: Persisting or new thrombi in the distal arteries and the microcirculation have been reported to limit the benefits of successful endovascular thrombectomy for patients with acute ischemic stroke. It remains uncertain whether intra-arterial thrombolysis by urokinase following near-complete to complete reperfusion by thrombectomy improves outcomes among patients with ischemic stroke due to large vessel occlusion.
Objective: To assess the efficacy and adverse events of intra-arterial urokinase after near-complete to complete reperfusion by thrombectomy for acute ischemic stroke due to large vessel occlusion.
Utilizing Quantitative Analysis of CSF Volume from Clinical T1-Weighted MRI to Predict Thrombectomy Outcomes.
J Neuroimaging
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Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Background And Purpose: Endovascular thrombectomy (EVT) is the standard for acute ischemic stroke from large vessel occlusion, but post-EVT functional independence varies. Brain atrophy, linked to higher cerebrospinal fluid volume (CSFV), may affect outcomes. Baseline CSFV could predict EVT benefit by assessing brain health.
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