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Circulation: Cardiovascular Interventions, Ahead of Print. BACKGROUND:Prior clinical trials have demonstrated the efficacy of ultrasound-facilitated catheter-directed thrombolysis (USCDT) for the treatment of acute intermediate-risk pulmonary embolism (PE) using reduced thrombolytic doses and shorter infusion durations.
BACKGROUND:The effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. These studies mainly concerned anterior circulation occlusions. All patients with a posterior circulation occlusion were included.
In our study population of 1000 thrombectomy‐eligible patients (513 women; median age, 77 years [interquartile range, 67–84]), IVT emerged as a predictor of favorable functional outcome (modified Rankin Scale score, 0–2) independent of modified mTICI score (adjusted odds ratio, 0.49 [95% CI, 0.32–0.75];P=0.001). 0.75];P=0.001).
We performed sensitivity analysis using propensity score matching.Results:In our study population of 1000 thrombectomy-eligible patients (513 females, median age 77 [67-84, interquartile range]) IVT emerged as predictor of favorable functional outcome (mRS 0-2) independent of mTICI (adjusted OR 0.49; 95% CI [0.32;0.75]; p=0.001).
Posterior circulation tandem occlusion was defined as stroke due to intracranial vertebral (V4), basilar, or posterior cerebral artery (PCA) occlusions, with tandem steno-occlusive lesion >70% of the extracranial vertebral artery and impaired distal flow or partial filling of the VA from collaterals.
Introduction:Large vessel recanalization (LVR) is a well described phenomenon following intravenous thrombolysis (IVT). The secondary endpoint was 90-day modified Rankin Scale (mRS) outcomes. Conclusions:LVR with IVT prior to EVT was significantly associated with lower odds of infarct progression and better clinical outcomes.
The primary efficacy outcome was good 3-month functional outcome, defined as a modified Rankin scale (mRS) 0-2. The primary efficacy outcome was good 3-month functional outcome, defined as a modified Rankin scale (mRS) 0-2. Safety outcomes were any intracerebral hemorrhage (ICH) and symptomatic ICH (sICH) at 24-36hrs.
Background:The effectiveness and safety of intravenous Tirofiban as an adjunct to endovascular therapy (EVT) in posterior circulation patients with tandem lesions (PCTL) remain uncertain.Methods:This study utilized individual patient data pooled from two multicenter observational studies: the BASILAR and the PERSIST registries.
Patients were dichotomized into those with 90‐day good functional outcome (modified Rankin scale [mRS] score 0–2) and poor functional outcome (mRS score ≥3). Good functional outcome was observed in 44 patients (40%). P < 0.001) and more likelihood of achieving Thrombolysis in Cerebral Infarction 3 (79.5%
Background and Aims:Endovascular treatment (EVT) alone has been confirmed to be non-inferior to intravenous thrombolysis (IVT) followed with EVT in acute ischemic stroke (AIS) due to large-vessel occlusion of the anterior circulation. Stroke, Volume 56, Issue Suppl_1 , Page AWP253-AWP253, February 1, 2025.
IntroductionIntracranial atherosclerotic disease (ICAD) is associated with up to 32% of posterior circulation strokes.1 Rescue treatment with stenting, balloon angioplasty, and/or intraarterial thrombolysis or antiplatelets are often required to treat the underlying stenosis.
We defined two binary outcomes: (1) functional clinical outcome (modified Rankin Scale 0-2) and (2) early symptomatic intracerebral hemorrhage (sICH). 4.14, p=0.9502), but it was associated with a functional clinical outcome at 90 days (OR 3.39, 95% CI 1.11-10.43, 10.43, p=0.0325).Conclusions:The 10.43, p=0.0325).Conclusions:The
However, tPA is a more complex enzyme than expected, being for instance able to promote thrombolysis, but at the same time, also able to influence neuronal survival and to affect the integrity of the blood-brain barrier. In this context, the impact of endogenous parenchymal tPA is limited.
Trichosanthes pericarpium is a well-known Chinese traditional herb described with the effect of activating blood circulation to dissipate blood stasis and improve blood circulation. However, its effects on microcirculation in patients with AMI after primary PCI remain unknown.
Background:Early prediction of functional outcome after rtPA helps clinicians in prognostic conversations with stroke patients and their families. modified Rankin Scale (mRS) at one month, classified into good (mRS 2) and poor (mRS 5) outcomes was noted. 12% of the cohort (n=34) had posterior circulation stroke. 0.90) outcomes.
The primary outcome was routine discharge (home or self‐care). Secondary outcomes were in‐hospital mortality, intracerebral hemorrhage, and length of stay. In multivariable models, intravenous thrombolysis was independently associated with higher odds of routine discharge (adjusted OR, 1.78; 95% CI, 1.57–2.01;P<0.001)
Introduction:Recent randomized control trials suggested that mechanical thrombectomy (MT) was associated with good functional outcomes after acute ischemic stroke (AIS) due to large vessel occlusion (LVO) in patients presenting with low Alberta Stroke Program Early CT Score (ASPECTS) (defined as ASPECTS 2-5). with a score of 2, 17.7%
Circulation: Cardiovascular Interventions, Ahead of Print. Background:The role of advanced therapies (systemic thrombolysis, catheter-based treatment, and surgical thrombectomy) for the management of right heart thrombus is poorly defined. 1.22]), in-hospital mortality (odds ratio, 0.64 [95% CI, 0.17–2.19]),
Circulation: Cardiovascular Interventions, Volume 18, Issue 1 , Page e014499, January 1, 2025. BACKGROUND:The aim of this study was to examine the impact of early versus delayed catheter-based therapies (CBTs) on clinical outcomes in patients with acute intermediate-risk pulmonary embolism (PE).METHODS:This days;P=0.046).
Introduction:Despite comparable outcomes for different frontline techniques in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), there are sparse data regarding if and when to switch techniques if the first pass is unsuccessful. 3.86, P = 0.002) and 90-day good clinical outcome (adjusted odds ratio 2.10, 95% CI: 1.15-3.85,
Background:Atrial fibrillation (AF) has been shown to be associated with better procedural outcomes in patients with anterior circulation large vessel occlusion (aLVO) undergoing endovascular therapy (EVT). Forty-four percent of the no AC group received intravenous thrombolysis (IVT). In the NOAC group, 59.5%
In this context, we need a movement to revive the pre-hospital thrombolysis. best, It has a miniscule 1 % edge in the outcome if performed on time, at a expertise intensive place. Efficiency of thrombolysis is highly reproducible. Circulation 2005;111:761-7. Circulation 2006;114:2019-25
We aimed to examine the impact of dexmedetomidine on outcomes in patients with anterior circulation large vessel occlusion (acLVO) requiring neurocritical care after endovascular therapy (EVT).Methods:We While favorable functional outcome was less frequently observed in the dexmedetomidine than in the comparator group (7.9%
Overall, one in six individuals treated has improved neurologic and functional outcomes. Therefore, a reperfusion score of mTICI 2b may not be sufficient to indicate a high probability of a good functional outcome. No difference in the rate of intracerebral hemorrhage (ICH) following reperfusion between the TICI 2 and 3 groups (17%).Conclusion:Our
Circulation, Ahead of Print. Study end points included timeliness of intravenous thrombolysis and EVT, successful reperfusion, discharge destination, discharge mortality, and functional independence at discharge.RESULTS:Among 84 903 patients, 48 682 received EVT, of whom 73% were treated at CSCs, 22% at PSCs, and 4% at TSCs.
IntroductionCurrent evidence supports endovascular therapy (EVT) for eligible patients with acute ischemic stroke in the anterior and posterior circulation. 1.56, P= 0.28; I2 = 26%, Figure A) and the results of the anterior circulation subgroup showed non‐statistically significant difference (OR = 1.22, 95% CI: 0.90–1.67,
We aimed to determine if there were outcome differences in patients transferred for EVT via HEMS.MethodsA retrospective observational study was performed in the setting of a large regional network with 1 CSC receiving patients directly, or via road ambulance from 3 metropolitan PSCs or HEMS from 13 more distant PSCs.
Circulation, Volume 148, Issue 24 , Page 1919-1928, December 12, 2023. The primary efficacy outcome was a composite of acute limb ischemia, major amputation of a vascular pathogenesis, myocardial infarction, ischemic stroke, or cardiovascular death. mg of rivaroxaban BID or matching placebo and 100 mg of aspirin daily.
Here, we investigate the association of middle cerebral artery(MCA) tortuosity on radiographic and functional outcome.Methods:The Analysis of Revascularization in Ischemic Stroke with EmboTrap II was utilized to identify patients with anterior circulation stroke. Good functional outcomes was defined as mRS0-2 on 90-day followup.
Circulation, Volume 150, Issue Suppl_1 , Page A4141279-A4141279, November 12, 2024. Background:Slow flow phenomenon is impaired coronary flow during percutaneous coronary intervention (PCI) in absence of mechanical obstruction, and it is associated with deteriorated outcome.
Primary outcome was 90‐day utility‐weighted modified Rankin scale. Secondary outcomes also favored MSU: early neurologic recovery (30% improvement in National Institutes of Health Stroke Scale score at 24 hours) 68% versus 52%; adjusted odds ratio 1.98 [95% CI, 1.19–3.33]; in MSU group and 0.51±0.41 4.77],P= 0.002). minutes [50.5–92.0]
A failed MT was defined as a modified Thrombolysis in Cerebral Infarction (mTICI) score of 0 to 2a after multiple attempts to clot retrieval. The primary efficacy outcome was the shift in the degree of disability, as measured by the modified Rankin Scale (mRS), at 90 days. MM: 49.7%, aOR=0.49, 95% CI 0.33‐0.74, 0.74, p=<0.001).ConclusionRS
BACKGROUNDIn patients with acute ischemic stroke secondary to large vessel occlusion, achieving modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3 (excellent recanalization) over mTICI 2b is associated with improved functional outcomes. Stroke: Vascular and Interventional Neurology, Ahead of Print. female).
I have seen cases of Wellens' syndrome that were ignored because of either negative troponins or normal echo or both and the patient did not get an angiogram and had a bad outcome. A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty.
Circulation 1993; 88:896-904. Patients who received CPR or experienced reinfarction or very small infarcts due to thrombolysis also displayed Type II T-wave evolution. Circulation 1995; 91:1659-1668. Circulation 1999; 74:1379-1389. A cutoff of 9 mm for inferior AMI and 13 mm for anterior AMI predicted worse outcome.
Circulation. These patients had worse outcomes than patients with ST depression without occlusion; half of these were circumflex. O'Gara et al. There are several studies that indirectly reveal the proportion of STEMIs that are isolated to the posterior wall, and they range from 3% to 11%. (1, J Am Coll Card 1999;34(3):748-53.
Best Medical Therapy in Acute Ischemic Stroke due to Large VEssel OcclusioN Trial in the Extended Time Window: Raul Nogueira, University of Pittsburgh, Pittsburgh, PA MOST Multi-Arm Optimization of Stroke Thrombolysis Trial: Opeolu Adeoye, Washington University, Saint Louis, MO Thurs.,
We assessed the clinical outcomes of patients with and without a CBF core at stroke onset, who underwent mechanical thrombectomy.Methods:Data from the National Cerebral and Cardiovascular Center Endovascular Thrombectomy database (January 2018 to April 2024) were analyzed. 2.25, p=0.04).Conclusions:Stroke
IntroductionChoice of anesthesia for endovascular thrombectomy in large vessel occlusion of the anterior circulation has been well studied, although practice patterns may still be variable. After adjusting for age, sex, IV thrombolysis, and admission NIHSS, CS usage did not result in an increase in procedural time (β=1.3,
With the evolving technology and newer generation of catheters and devices, the interest in improving the technical and procedural factors that can help better the recanalization success, clinical outcomes, and efficiency is ever‐growing. Most of the patients had MCA occlusion (68.4% with 50.9% of cases.
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