Background: The optimal management of emergent large vessel occlusion due to underlying intracranial stenosis (intracranial stenosis related large vessel occlusion) remains unknown. The primary aim of this survey analysis was to measure variation in the clinical management of intracranial stenosis related large vessel occlusion during mechanical thrombectomy.
Methods: A survey was designed using a web-based survey-building platform and distributed via the Society of NeuroInterventional Surgery (SNIS) and the Society of Vascular and Interventional Neurology (SVIN) websites for a response. Predictors of respondents' level of comfortability stenting were estimated using a binomial logistic regression model.
Results: We received 105 responses to the survey. Most respondents (54.3%) practiced at an academic Stroke Center. Nearly half of the respondents (49%) had been practicing for 5 or more years independently after fellowship. An average of 54 mechanical thrombectomies were performed by each respondent annually. There was variation in the definition of intracranial stenosis related large vessel occlusion, number of passes performed before pursuing rescue stenting, as well as intra and post-procedural antiplatelet management. Of respondents, 58% felt rescue stenting was very risky, and 55.7% agreed that there was equipoise regarding emergent angioplasty and/or stenting versus medical therapy for intracranial stenosis related large vessel occlusion. Respondents who encountered intracranial stenosis related large vessel occlusion more frequently thought that rescue stenting was less risky.
Conclusion: There is notable variability in the diagnosis and management of intracranial stenosis related large vessel occlusion during mechanical thrombectomy. While most respondents felt rescue stenting was risky, the majority believed the benefit could outweigh the risk. The majority of respondents agreed that equipoise exists regarding the management of intracranial stenosis related large vessel occlusion, highlighting the need for clinical trials in this rare patient population.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/15910199231196618 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Point-of-care ultrasound of the common carotid arteries for detection of large vessel occlusion stroke: Results of the POCUS-LVO study.
Eur Stroke J
January 2025
Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany.
Introduction: Distal arterial occlusions can cause measurable changes in the flow wave profile in proximal segments of the feeding artery. Our objective was to study the diagnostic accuracy of point-of-care ultrasound (POCUS) of the common carotid arteries (CCA) for detection of anterior circulation large vessel occlusion (ac-LVO) in patients with suspected stroke.
Patients And Methods: We conducted a prospective, single-center, observational study of adult patients with suspected stroke admitted in the emergency department.
Correlation of intracranial and extracranial carotid atherosclerotic plaque characteristics with ischemic stroke recurrence: a high-resolution vessel wall imaging study.
Front Neurol
January 2025
Department of Medical Imaging, The Second Affiliated Hospital of Nantong University, Nantong, China.
Objectives: To evaluate the ability of the plaque characteristics of extracranial carotid and intracranial arteries to predict large atherosclerotic ischemic stroke recurrence via head and neck combined high-resolution vessel wall imaging (HR-VWI).
Methods: This prospective cohort study included 169 patients with large atherosclerotic ischemic stroke who underwent head and neck combined HR-VWI from April 2022 to May 2023. The baseline clinical data and atherosclerotic plaque characteristics of the intracranial and extracranial carotid arteries were collected, and the patients were followed up for 1 year, with the endpoint event defined as recurrent ischemic stroke.
Neuroinflammation and iron metabolism after intracerebral hemorrhage: a glial cell perspective.
Front Neurol
January 2025
Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Kunshan, China.
Intracerebral hemorrhage (ICH) is the most common subtype of hemorrhagic stroke causing significant morbidity and mortality. Previously clinical treatments for ICH have largely been based on a single pathophysiological perspective, and there remains a lack of curative interventions. Following the rupture of cerebral blood vessels, blood metabolites activate resident immune cells such as microglia and astrocytes, and infiltrate peripheral immune cells, leading to the release of a series of inflammatory mediators.
View Article and Find Full Text PDFThe Impact of Autosomal Dominant Polycystic Kidney Disease on the Presence of Cerebral Microbleeds: A Case-Control Matched Study.
Acad Radiol
January 2025
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (T.W.L., C.H.W.); Center of Minimal-Invasive Interventional Radiology, National Taiwan University Hospital, Taipei, Taiwan (C.H.W.); Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan (C.H.W.). Electronic address:
Rationale And Objectives: Individuals with autosomal dominant polycystic kidney disease (ADPKD) can present with diverse renal and extra-renal manifestations. Large vessel anomalies, such as cerebral aneurysms, are potentially fatal extra-renal manifestations. However, limited research has been conducted on cerebral small vessel disease (CSVD).
View Article and Find Full Text PDFThree types of side-to-side microvascular anastomosis training models using rat abdominal vessels.
World Neurosurg
January 2025
Department of Neurosurgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, China.
Background: Side-to-side microvascular anastomosis is the most difficult type of anastomosis. The best way to master microvascular anastomosis technique is deliberate practice in the microsurgical laboratory.
Methods: Three types of side-to-side microvascular anastomosis using the rat abdominal vessels were presented.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!