Neurovascular Intervention

From 2004-2015, hemicraniectomy rates have seen substantial increases in all age, sex, and race groups. The increasing rates of hemicraniectomies among those over age 60 suggest that there has been at least partial acceptance of DESTINY 2 study results.

The word crisis in Chinese is composed of 2 characters, one representing danger, the other opportunity. We cannot see this dangerous enemy, the coronavirus. Every opportunity and detail to recalibrate our acute neurological workflow to protect our frontline healthcare workers, our families, our colleagues, and our patients should be sought, implemented, and adapted to a resource-constrained environment. It is incumbent upon us to protect each other so that we are not unknowingly exposed or spread to our most vulnerable patients, while at the same time, providing optimal care, patient safety, and access for our patients with stroke.

The COVID-19 pandemic has added an additional layer of complexity to endovascular treatment (EVT) for acute ischaemic stroke. Drawing on recently published guidelines, this article provides a conceptual framework for EVT in the COVID-19 era, outlining key principles for ensuring safe and timely EVT while minimizing the risk of infectious exposure for health-care workers and patients.

Results show therapy was well-tolerated and support potential benefits in mortality, ventilator-free days, ICU-free days and quality of life outcomes. Separately, data pooled from two independent studies provide further evidence of potential clinically meaningful benefit of MultiStem as a treatment for ARDS patients

A global study into causes of stroke has found that one in 11 survivors experienced a period of anger or upset in the one hour leading up to it. One in 20 patients had engaged in heavy physical exertion. The suspected triggers have been identified as part of the global INTERSTROKE study, which analyzed 13,462 cases of acute stroke, involving patients with a range of ethnic backgrounds in 32 countries.

Several types of strokes have been shown to benefit from endovascular mechanical thrombectomy (MT). In peripheral small vessel stroke and in primary vessel occlusions which are non-eligible for intravenous thrombolytics (IVT), MT is often the only treatment option. Similarly, patients with large vessel occlusions have been shown to benefit from recanalization with MT. Nevertheless, few randomized controlled clinical trials have been conducted to demonstrate the benefit of endovascular interventions in small strokes.

For the last decade and a half, patients presenting with acute ischemic stroke have had one active option for emergency intervention: intravenous tissue plasminogen activator (tPA). In the context of ongoing controversy, pervasive conflicts of interest, and a paucity of conclusive trials, use of tPA for stroke has increased but hardly taken hold. Many professional organizations still oppose its mandated use, and the basic assumptions of its efficacy continue to be challenged.

Adherence was poor in half of AF patients who survived an ischaemic stroke. Independent patient-related factors, rather than composite scores, were associated with poor adherence in these patients.

In this meta‐analysis of patients with acute ischemic stroke, we found no significant differences in 90‐day functional outcome or mortality between dMT and BT, but a lower rate of symptomatic intracranial hemorrhage for dMT. These findings support the use of dMT without intravenous thrombolysis bridging therapy.

Although the incidence and mortality rates of stroke in China were decreased from 1990 to 2019, the number of incident cases and deaths nearly doubled. A sharp increase in the incidence rate of ischemic stroke was observed. A higher incidence rate of ischemic stroke in the women was also observed.

In a new study from the National University of Ireland, researchers found that one in 11 stroke survivors experienced a period of anger or upset in the hour leading up to it. One in 20 patients had engaged in heavy physical exertion.

Sensome, the company pioneering the connected medical device revolution with the world’s smallest biological tissue sensor, announced today that Gold Coast University Hospital (GCUH) in Australia enrolled the first patients in the Company’s CLOT OUT first-in-human study evaluating safety and performance of the Clotild® Smart Guidewire System in large-vessel acute ischemic stroke patients.

Also known as a cerebrovascular accident, a stroke is a medical emergency that arises when arteries that supply blood to the brain get affected. As a result, the brain doesn’t receive sufficient blood, and when the brain doesn’t get oxygen and nutrients even for a few minutes, it can result in paralysis or even death. There are two main types of strokes: ischemic stroke and haemorrhagic stroke. While an ischemic stroke is caused due to a block in the blood vessel, a haemorrhagic stroke is caused by bleeding through a tear in the blood vessel.

More than half a century ago, Thomas Kuhn questioned the prevailing view that scientific progress was solely the product of a sequential accumulation of observations. Rather, he posited that significant transformations occurred as nonlinear, saltatory advances that often challenge a well‐established dogma.

In conclusion, we found a certain correlation between obesity-related parameters and PSA instead of PSD, suggesting that controlling obesity, especially abdominal obesity, may reduce the occurrence risk of PSA. We look forward to future studies to confirm this thesis.

Aktiia’s blood pressure monitoring system automatically measures blood pressure over the course of hours, days and weeks without any effort required by the wearer. The data is visualised in a free companion application, through which a digital summary can be easily shared with a physician or family member.

Compared to the clopidogrel based regimen, ticagrelor can also reduce TEs without increasing bleeding tendency for SACE of UIAs. Ticagrelor combined with low-dose aspirin is a safe and effective alternative option for SACE.

Mechanical thrombectomy using the Tigertriever13 appears to be safe and effective for DMVO. Clinical and anatomical results are in line with those of patients with proximal occlusions.

Vasoconstriction after acetylcholine infusion in the peri-treated region was less pronounced in the DCB arm than in the DES arm, suggesting that endothelial function in treated coronary vessels could be better preserved by DCB than by new-generation DES.

Clinical outcomes did not differ according to selection by noncontrast computed tomography (CT), computed tomography perfusion (CTP), or magnetic resonance imaging (MRI) of patients for proximal anterior circulation mechanical thrombectomy in the extended time window, according to a study published online Nov. 8 in JAMA Neurology.

Biosensors International Group Ltd., a developer and manufacturer of innovative medical devices, announced the results of the BIO-RISE CHINA study, sponsored by its sister company, JW Medical Systems Ltd. (Shangdong, China). BIO-RISE CHINA is a multi-center, randomized controlled, superiority trial performed in 10 centers across China under the leadership of Prof. Han Yaling, principal investigator, and co-principal investigators, Dr. Guosheng Fu and Dr Yujie Zhou. This first-in-human study assessed the safety and efficacy of a Biolimus A9 (BA9) coated balloon (DCB) in patients with small vessel coronary artery disease undergoing PCI.

Currently, less than 10% of ischaemic stroke patients receive mechanical thrombectomy, a well-proven treatment that significantly improves patient outcomes, the release continues. While Rapid Medical’s TIGERTRIEVER 13 has already been used to treat nearly 1,500 patients in Europe and the Middle East, the DISTALS study aims to extend these benefits to an additional 25–40% of stroke patients. It focuses on far territories in the brain, such as M3 blood vessels, and allows intervention within 24 hours from symptoms onset.

In the study, increasing operator experience was “significantly associated” with recanalisation success rates as a dichotomous variable, both in univariable analysis and in the multivariable model. The researchers also assessed for a ceiling effect in the association between experience and successful recanalisation by sequentially excluding prior procedures, and found the loss of significance of the association happened between 80 (p=0.03) and 100 procedures (p=0.08).

The treatment of acute ischemic stroke due to large vessel occlusion (LVO) has revolutionized in the last decade. We sought to compile the most relevant literature published about the evolution in treating this disabling and fatal disease.

The Cascade Net (Perflow)—a non-occlusive remodelling net used in the treatment of cerebral aneurysms—is the first and only device capable of providing continuous blood flow during these repair procedures, and is designed to allow physicians to pack embolisation coils while also preventing risks of protrusion or entanglement into the mesh of the device. Paul Bhogal (Royal London Hospital, London, UK) discusses his experiences with this innovative technology, and how it compares to what was previously available in this space.