An acute ischaemic stroke appears when a blood clot blocks the blood flow in a cerebral artery. Intra-arterial thrombectomy, a mini-invasive procedure based on stent technology, is a mechanical available treatment to extract the clot and restore the blood circulation. After stent deployment, the clot, trapped in the stent struts, is pulled along with the stent towards a receiving catheter. Recent clinical trials have confirmed the effectiveness and safety of mechanical thrombectomy. However, the procedure requires further investigation. The aim of this study is the development of a numerical finite-element-based model of the thrombectomy procedure. thrombectomy tests are performed in different vessel geometries and one simulation for each test is carried out to verify the accuracy and reliability of the proposed numerical model. The results of the simulations confirm the efficacy of the model to replicate all the experimental setups. Clot stress and strain fields from the numerical analysis, which vary depending on the geometric features of the vessel, could be used to evaluate the possible fragmentation of the clot during the procedure. The proposed / comparison aims at assessing the applicability of the numerical model and at providing validation evidence for the specific thrombectomy outcomes prediction.
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http://dx.doi.org/10.1098/rsfs.2019.0123 | DOI Listing |
Eur Stroke J
January 2025
Department of Neuroradiology, University Hospital Basel, Basel, Switzerland.
Background: There are limited therapeutic options in cases of failed reperfusion (modified thrombolysis in cerebral infarction [mTICI] score < 2b) after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemic stroke. Despite the absence of data supporting its use, rescue therapy (balloon angioplasty and/or stent implantation) is often utilized in such cases. Studies are limited to large vessel occlusions, while the outcomes and complications after rescue therapy in medium/distal vessel occlusions (MDVOs) have not been reported.
View Article and Find Full Text PDFInt J Stroke
January 2025
Department of Neurosurgery and Interventional Neuroradiology, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, National Center for Neurological Disorders, 45 Changchun St, Beijing 100053, China.
Rationale: The Chemical Optimization of Cerebral Embolectomy (CHOICE) trial suggested that the administration of intra-arterial alteplase after successful endovascular thrombectomy (EVT) may improve neurological outcomes in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) in the anterior circulation. However, the use of adjunctive intra-arterial alteplase following successful EVT in acute posterior circulation stroke remains unexplored.
Aims: This study aims to investigate the efficacy and safety of intra-arterial alteplase after successful EVT for AIS-LVO in the posterior circulation.
Singapore Med J
January 2025
Department of Medicine, Singapore General Hospital, Singapore.
Introduction: Mechanical thrombectomy (MT) is the standard of care in anterior circulation large vessel occlusion. A vital modifiable factor is successful reperfusion. While multiple passes improve the rates of successful reperfusion, previous studies have reported progressively diminishing returns.
View Article and Find Full Text PDFNeurol Res
January 2025
Department of Neurology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Background: It has been suggested that smokers have higher recanalization rate, lower risk of cerebral hemorrhage and better prognosis than non-smokers (smoking paradox) after reperfusion therapy in patients with acute ischemic stroke (IS). This study aimed to assess the effects of smoking on recanalization, intracranial hemorrhage, and clinical outcomes in patients with acute IS following reperfusion therapy.
Methods: Patients were categorized into smokers and non-smokers, with data collected on types of reperfusion therapy, demographics, medication use, comorbidities, stroke etiology, mRS and NIHSS scores, TICI and ECASS classifications.
JVS Vasc Insights
January 2024
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh.
Objective: The aim of this study was to review the most commonly used percutaneous mechanical thrombectomy devices for the treatment of pulmonary embolism today.
Methods: A thorough search of the existing literature was conducted on commonly used percutaneous mechanical thrombectomy devices, most notably Inari Flowtriever, Penumbra's Indigo Aspiration, and Alphavac. Reported qualitative and quantitative information was abstracted and descriptively reviewed to ascertain the clinical utility and effectiveness of these devices.
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