Purpose Of Review: In the USA, around 30% of 795,000 strokes per year are due to proximal large-vessel occlusion, and these are a major cause of death and disability. We review the most recent advances regarding treatment of ischemic stroke amenable to mechanical thrombectomy.
Recent Findings: In the last four years, clinical trial evidence has expanded the time window for successful endovascular treatment to 24 h. Current research is aimed at expanding patient selection to mild strokes, large ischemic cores and occlusions of smaller, more distal blood vessels. Further, we have developed understanding of how to manage blood pressure after thrombectomy and even had promising results for a neuroprotective agent in these patients. Thrombectomy has transformed the treatment of ischemic stroke due to large-vessel occlusion. Recent research has focused on expanding patient candidacy for endovascular treatment and improving medical management to support better neurologic outcomes.
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http://dx.doi.org/10.1007/s11910-022-01168-9 | DOI Listing |
Geroscience
January 2025
Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Aging remains the foremost risk factor for cardiovascular and cerebrovascular diseases, surpassing traditional factors in epidemiological significance. This review elucidates the cellular and molecular mechanisms underlying vascular aging, with an emphasis on sex differences that influence disease progression and clinical outcomes in older adults. We discuss the convergence of aging processes at the macro- and microvascular levels and their contributions to the pathogenesis of vascular diseases.
View Article and Find Full Text PDFEur J Surg Oncol
December 2024
Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de La Salud, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico. Electronic address:
J Neurointerv Surg
January 2025
Neurology, Boston Medical Center, Boston University Chobanian and Aveidisian School of Medicine, Boston, Massachusetts, USA.
Background: Transverse sinus stenosis (TSS) and sigmoid sinus wall anomalies (SSWAs) are the most common causes of pulsatile tinnitus (PT). While these conditions may co-occur, they usually require different management approaches. This study aims to evaluate whether TSS stenting alone, without targeted treatment of SSWAs, is sufficient to resolve PT in patients presenting with PT, TSS, and SSWAs.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Intervention Neuroradiology, CHU Limoges, Limoges, Aquitaine-Limousin-Poitou-Charentes, France
Background: Hemorrhage is a major complication of brain arteriovenous malformations (AVMs) embolization, which can be related to persistent arteriovenous shunts that were not completely occluded during the embolization. In transvenous embolization (TVE) this risk is deemed higher for AVMs larger than 3 cm featuring multiple veins of drainage. Herein, we will discuss a few selected cases where brain AVMs with more than one draining vein were deemed safe for curative embolization with advanced endovascular techniques after a careful anatomical study through the four dimensional-digital subtraction angiography (4D-DSA) imaging.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Lyerly Neurosurgery, Baptist Medical Center Jacksonville, Jacksonville, Florida, USA
The Artisse intrasaccular device (Medtronic) offers a novel treatment option for unruptured and ruptured wide-neck bifurcating intracranial aneurysms.1 2The Artisse device features enhancements including a distal tip for dome protection, platinum band markers for improved visibility, and a bilayer high-density platinum core nitinol mesh basket for enhanced flexibility and visibility when compared with previous devices.2-7 Data from case series demonstrate the procedural safety and efficacy of the Artisse device.
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