Right heart thrombi can be seen in a minority of patients with acute pulmonary embolism and are associated with an increased mortality risk. The optimal treatment option comprises thrombolysis or surgical thrombectomy either with catheterbased interventions or with open surgery. Open right atrial thrombectomy is usually performed under cardiopulmonary bypass due to the need for concomitant pulmonary embolectomy. Nevertheless, cardiopulmonary bypass has major drawbacks such as the risk of stroke, coagulopathy, and myocardial and respiratory dysfunction, particularly in high-risk patients. Herein, we report a case of successful off-pump surgical thrombectomy performed for the right atrial clot-in-transit following failure of the catheter-based intervention.
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http://dx.doi.org/10.5606/tgkdc.dergisi.2023.24477 | DOI Listing |
BMJ Open
December 2024
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xian, China
Introduction: Despite the implementation of mechanical thrombectomy, acute ischaemic stroke with large vessel occlusion (AIS-LVO) remains a significant health concern, characterised by substantial morbidity and mortality. Our trial aims to evaluate the efficacy and safety of minocycline in reducing infarct volume and improving functional outcomes in patients undergoing mechanical thrombectomy for anterior circulation AIS-LVO.
Methods And Analysis: The MIST-A trial is a prospective, randomised, open-label, blinded-endpoint trial to be conducted across 12 medical centres.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan.
Background: Eagle syndrome is characterized by an elongated styloid process causing mechanical stress on the internal carotid artery (ICA). The authors present the case of a patient who had cervical ICA dissection with a nonelongated styloid process.
Observations: A 43-year-old man presented with left hemiparesis and hemispatial neglect.
Eur J Neurol
January 2025
Stroke Unit, Udine University Hospital, Udine, Italy.
Background: Although mechanical thrombectomy (MT) represents the standard of care for ischemic stroke due to large-vessel occlusion (LVO), the impact of sex on outcomes in tandem occlusions remains unclear. We investigated sex-based differences in outcomes after MT for tandem occlusions.
Methods: This multicenter observational study included consecutive patients with tandem occlusion treated with MT across three stroke centers (2021-2023).
J Neuroimaging
January 2025
Neurointerventional Department CDI, Hospital Clinic de Barcelona, Barcelona, Spain.
Background And Purpose: The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).
Methods: We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group).
J Neuroimaging
January 2025
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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