Mechanical thrombectomy is established as standard of care in the management of acute ischemic stroke due to large vessel occlusion and evidence-based guidelines for mechanical thrombectomy have been defined. As research continues to further expand the eligibility criteria for thrombectomy and the number of thrombectomy procedures increase worldwide, there is also growing focus on innovation of thrombectomy devices, procedural techniques, and related outcomes. Thrombectomy primarily involves use of stent retrievers and distal aspiration techniques, but variations and different combinations of techniques have been reported. As this is a rapidly evolving area in stroke management, there is debate as to which, if any, of these techniques leads to improved clinical outcomes over another and there is a lack of data comparing them. In this review, currently published and distinct techniques of mechanical thrombectomy are described methodically along with illustrations to aid in understanding the subtle differences between the techniques. The perceived benefits of each variation are discussed.
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http://dx.doi.org/10.1177/15910199221084481 | DOI Listing |
World J Clin Cases
January 2025
Department of Neurology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing 400000, China.
Background: Autologous fat injection in facial reconstruction is a common cosmetic surgery. Although cerebral fat embolism (CFE) as a complication is rare, it carries serious health risks.
Case Summary: We present a case of a 29-year-old female patient who developed acute CFE following facial fat filling surgery.
Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow-mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet.
View Article and Find Full Text PDFNeurocrit Care
January 2025
Divisions of Vascular Neurology and Neurocritical Care, Inova Fairfax Medical Campus, Inova Neuroscience and Spine Institute, 3300 Gallows Rd., Falls Church, VA, 22042 , USA.
Background: Acute ischemic stroke with medium and large vessel occlusion is a leading cause of morbidity and mortality, in which timely intervention with mechanical thrombectomy (MT) is crucial for restoring cerebral blood flow and improving patient outcomes. Effective analgosedation and hemodynamic management during MT are critical to patient outcomes and typically managed by anesthesia. Because of inconsistent anesthesia support at our institution, we implemented a dedicated neurocritical care rapid response team (NCC-RRT) to manage these aspects of care.
View Article and Find Full Text PDFInterv Neuroradiol
January 2025
Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA.
Background: The impact of certain comorbidities on mechanical thrombectomy (MT) outcomes remains largely unexplored. Diabetes mellitus (DM) and admission hyperglycemia have been associated with poor clinical outcomes for patients treated with MT. In this study, we sought to investigate the effects of DM and admission hyperglycemia on MT outcomes.
View Article and Find Full Text PDFInterv Neuroradiol
January 2025
Promedica Toledo Hospital, Toledo, OH, USA.
Introduction: Mechanical thrombectomy (MT) for medium vessel occlusions (MeVO) is emerging as a promising treatment in acute stroke. We aim to evaluate the utility of additional imaging (CTP) in patients with MeVOs who received thrombolysis at a spoke hospital and were transferred to the hub.
Methods: This was a retrospective review of prospectively collected data from April 2018 to June 2023.
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