Neurovascular Intervention

The current proposal for cerebral venous thrombosis guideline followed the Grading of Recommendations, Assessment, Development, and Evaluation system, formulating relevant diagnostic and treatment questions, performing systematic reviews of all available evidence and writing recommendations and deciding on their strength on an explicit and transparent manner, based on the quality of available scientific evidence. The guideline addresses both diagnostic and therapeutic topics.

When comes to the ‘obesity paradox’, inherent limitations of BMI as an index of adiposity, as well as methodological biases and the presence of confounding factors, may account for the observed findings of clinical studies, but also may distort the true relationship between obesity and mortality. Obese individuals generally present earlier, so disease states may be recognized and treated earlier. The obesity paradox may just be an over representation of cachexia. Therefore, it is possible that observations supporting the existence of an obesity paradox could be driven by both the limitations of BMI as an obesity index and clinical studies per se and may represent an epiphenomenon rather than a true causal relationship.

Resveratrol is a nutraceutical compound that has exciting pharmacological potential in different diseases, including stroke. Due to its low bioavailability, the efficacy of resveratrol is minimal. Hence, the present study is aimed to synthesize and characterize nanoparticles of resveratrol (NR) followed by evaluating the neuroprotective role and elucidate the mechanism of NR in a rat model of middle cerebral artery occlusion (MCAO).

Resveratrol (3, 4′, 5-trihydroxy-trans-stilbene, RSV), a nutraceutical, has recently attracted lots of attention because of its outstanding pharmacological potential. The effects of RSV on non-alcoholic fatty liver disease (NAFLD) remain inconclusive, although a wealth of research has been done. The major obstacle presented was RSV's poor bioavailability due to its poor aqueous solubility, chemical instability and intestinal metabolism. In this study, nanotechnology was used to encapsulate RSV to enhance its stability, water solubility and bioactivity, which can be used to treat NAFLD by HepG2 hepatocytes-induced in vitro. RSV-loaded poly (d, l-lactide-co-glycolide acid) (PLGA) nanoparticles (RSV-PLGA-NPs) were prepared according to an oil/water (O/W) emulsion technique.

Mechanical thrombectomy is now well - established first - line treatment for selected patients with large artery occlusions of the anterior circulation. However, number of technical and procedural issues remains open to assure optimal outcomes in majority of patients including those suffering from posterior circulation perfusion defects. This brief review addresses some of the open issues and refers to the ongoing trials to close the existing knowledge gaps.

Chaque mois, un panorama des appels à candidatures que vous ne devez pas rater. Que vous réserve le mois de mars 2021 ?

Biomodex has announced its partnership with two of the top medical centres in France and a health system in the USA to develop Evias Plus, a training solution for treatment of ischaemic stroke.

Complete and near-complete reperfusion after MT appear to confer comparable outcomes in patients with acute stroke.

With stroke, time is brain - every second counts. The quicker and more completely a clot can be removed to restore blood flow to the brain the better it is for the patient. The greatest benefits to a patient is when mechanical thrombectomy retrieves (or catches) the stroke causing clot entirely at the first pass or attempt. When the first pass is successful, it avoids repeated clot retrievals attempts, therefore reducing the risk of complications and procedure time.

Longeviti Neuro Solutions, a medtech company based in Maryland, has announced that its ClearFit cranial implant has been cleared by the FDA for post-surgery ultrasound imaging. The clear implants are used for cranial reconstruction after brain surgery, and are custom-made for each patient. The company uses patient CT scans and 3D printing to produce the custom implants, and then sends the sterile constructs directly to surgeons.

Endovascular treatment with detachable coils is followed by angiographic recurrences in 33.6% of cases. These recurrences are sizable in 20.7%. The most important factors associated with recurrences are treatment after rupture, size >10 mm, and incomplete occlusions. The 6-month follow-up angiogram is insufficient to detect most recurrences.

B Braun has revealed that 12-month results from the LOCOMOTIVE EXTENDED study of the company’s Multi-Loc multiple stent delivery system have been published in Vasa: European Journal of Medicine. The study authors, Klaus Amendt (Diakonissenkrankenhaus Mannheim, Mannheim, Germany) and colleagues conclude that the Multi-Loc “provides promising results concerning target lesions revascularisation and primary patency at 12 months”.

Royal Philips has announced the final, five-year results of two randomised controlled trials (RCTs) that show no difference in all-cause mortality between patients treated with the Stellarex drug-coated balloon (DCB) and those treated with percutaneous transluminal angioplasty (PTA), the current standard of care. Moreover, the studies showed no difference in mortality between the Stellarex DCB and PTA at every 12-month endpoint over the course of the study. Results from the two RCTs were presented at LINC 2021 (The Leipzig Interventional Course; 25–29 January, online).

Israel’s Rapid Medical has won European regulatory clearance to introduce its TIGERTRIEVER XL device for removing large ischemic stroke-causing clots from intracranial vessels. The company calls its line of devices “stentrievers,” as these look and operate similar to stents but can retrieve clots out of the body.

The nanodroplets are made out of lipid spheres packed with low-boiling point liquid perfluorocarbons (PFCs). When the PFCs are released from the spheres, their tiny size allows them to get into the tiniest of crevices within a clot. Once there, a shower of ultrasound activates them to turn into expanding boiling microbubbles. Further ultrasound makes these microbubbles vibrate and break apart the clot mass.

HRQoL after treatment of a ruptured intracranial aneurysm was better after endovascular coiling compared to neurosurgical clipping, which contributed significantly to the QALYs gained over a 10-yr period.

Global neurovascular devices market was segmented by product, application and end user. On the basis of the product the market is segmented as neurothrombectomy devices, aneurysm coiling & embolization devices, cerebral balloon angioplasty & stenting systems and support devices. Based on the application the market is segmented into cerebral aneurysms, ischemic strokes, arteriovenous malformation & fistulas and other applications. The end user segment is classified into hospitals, ambulatory surgical centers and specialized clinics.

New single-centre clinical study data published in the Journal of Neuroradiology claims to support the Anaconda Neurovascular Access (ANA) catheter system for the treatment of ischaemic stroke.
Investigators at Hospital Vall d’Hebron, Barcelona, Spain, are participating in the multi-centre SOLONDA (“SOL”itaire in combination with the ANA Catheter system manufactured by Anac”ONDA”) clinical trial, a 125-patient, prospective study that will assess system safety and reperfusion measured using the modified treatment in cerebral infarction (mTICI) score.

Researchers in China and Switzerland have developed electronic blood vessels that can be actively tuned to address subtle changes in the body after implantation. The vessels, made from a metal-polymer conductor membrane, are flexible and biodegradable, mimicking natural blood vessels. The researchers showed in the labs that electrical stimulation from the blood vessel was also able to encourage new blood vessel cells to migrate and grow, indicating it might also help with healing blood vessels. The researchers were able to replace major arteries in rabbits successfully, showing the technology has promise, but say more research is needed before human trials. They also hope this tech could be combined with AI in the future, to collect detailed patient information such as blood sugar levels and blood pressure.

The proposed indication for use includes “The MagicTouch SCB Sirolimus Coated Balloon Catheter is indicated for percutaneous transluminal coronary angioplasty, after appropriate vessel preparation, of small coronary artery lesion lengths of 6 – 36mm in coronary arteries with reference vessel diameters of 1.50 – 2.75mm.”

The rigidity and relatively primitive modes of operation of catheters equipped with sensing or actuation elements impede their conformal contact with soft-tissue surfaces, limit the scope of their uses, lengthen surgical times and increase the need for advanced surgical skills. Here, we report materials, device designs and fabrication approaches for integrating advanced electronic functionality with catheters for minimally invasive forms of cardiac surgery.