Fig. 2022 Cetingok et al. Endovascular treatment (EVT) is effective for patients with an acute ischemic stroke (AIS) from a large vessel occlusion (LVO) (1-3).Although successful recanalization leads to the restoration of cerebral circulation, these patients may still have a poor functional outcome (4,5), which might be related with advanced age, higher baseline National Institutes of Health Stroke Scale . Study Design: Zi-Liang Wang Endovascular recanalization of superficial femoral artery chronic total occlusions: A multi-disciplinary, single center experience Aparna Swaminathan Department of Medicine, Duke University Medical Center, Durham, NC, USA Yuliya Lokhnygina Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA David Kopin Neurol Sci. Future randomized trials need to determine if recanalization is of any value for this population. Stroke. Endovascular recanalization with balloon angioplasty, aspiration, and local thrombolysis of thrombosed cerebral venous sinuses can be safely performed without the need of decompressive hemicraniectomy in early-pregnancy patients with malignant brain edema caused by progressive CVST. Basilar artery occlusions (BAO) account for only 1% of all ischemic strokes but have a dismal natural history with greater than 80% mortality rate. Knowledge of molecular events following coil occlusion and recanalization could help design specific strategies to promote permanent occlusion. . Therefore, major reasons for failed endovascular recanalization were difficult anatomical access and hard or resistant occlusions that might reflect hard thrombi or pre-existing atherosclerotic stenosis. Case description: Two patients presented with recurrent transient ischemic attacks due to subacute occlusion of intracranial vessels (left MCA M1 and basilar artery). Alexander MJ, Zauner A, Chaloupka JC, Baxter B, Callison RC, Gupta R, Song SS, Yu W. Background and purpose: Recent randomized clinical trials (RCTs) have demonstrated benefits of endovascular recanalization therapy (ERT) contrary to earlier trials. A second covered stent was . Endovascular recanalization can be safe and feasible for reasonably selected patients with non-acute BAO, especially type I lesions, and offers an alternative choice for those with progressive or recurrent vertebrobasilar ischemic symptoms despite aggressive medical therapy. 36.1 The TriForce Peripheral Crossing Set (Cook Medical, Bloomington, Indiana) An advanced adjunctive technique that can be used to increase the trackability of balloons and stents across chronically occluded venous lesions is the " body floss technique " [ 12 ]. We aimed to estimate the benefits of ERT added to standard therapy in acute ischemic stroke. In four patients, recanalization via the femoral artery failed. Conclusions: Endovascular recanalization of unstable intracranial atherosclerotic stenosis in patients who have failed medical therapy is feasible. GNT Pharma Provides Update on Two Phase III Studies of Nelonemdaz for Acute Ischemic Stroke Patients Treated with tPA (ENIS-3) or Endovascular Thrombectomy (RODIN) September 19, 2022 Promising efficacy and safety profiles were observed in prior Phase II studies in acute ischemic stroke patients treated with recanalization therapies. The procedure of endovascular recanalization was as follows (Fig. 2018; 24:5208. 11 Acute thrombus is generally defined as those aged less than 2 weeks, while chronic thrombus is defined as being present for more . Endovascular recanalization can be a challenge if there is a flush occlusion where the vessel origin cannot be adequately identified by angiography. Background and Purpose - To assess the outcome in acute ischemic stroke patients not eligible for systemic thrombolysis (outside the 3-hour time window, after surgery, or on anticoagulant) undergoing endovascular recanalization therapy (ERT) at the Columbia University Medical Center (CUMC) and to determine US nationwide usage and . Procedural characteristics and functional outcome at discharge and 90 days were compared between patients with and without ongoing IVT at flow restoration. Passage with the tip of the glidewire rather than a loop is more often successful. The indications for endovascular iliocaval recanalization and reconstruction include deep venous occlusion secondary to recurrent DVT, severe PTS, and caval thrombosis leading to significant lifestyle limitations. We aimed to investigate the time course and clinical relevance of ND after EVT. Endovascular recanalization for chronic symptomatic intracranial vertebral artery total occlusion. Endovascular treatment (EVT) is currently the most effective method for recanalization of occluded large vessels. Background:To date, few data have been reported on clinical outcomes following interventions in elderly populations with acute basilar artery occlusion. Minim Invasive Surg. This is needed for adequate guidewire and catheter support to . Thrombolysis or endovascular therapy has been limited to patients who present within hours of symptom onset. 1 - 6 however, studies on the association between reperfusion and ischemic edema described conflicting results. Cureus 14(10): e30467. DOI: 10.1212/WNL.0000000000011520 Corpus ID: 230817561; Tenecteplase vs Alteplase Before Endovascular Therapy in Basilar Artery Occlusion @article{Alemseged2021TenecteplaseVA, title={Tenecteplase vs Alteplase Before Endovascular Therapy in Basilar Artery Occlusion}, author={Fana Alemseged and Felix C. Ng and Cameron J Williams and Volker Puetz and Gr{\'e}goire Boulouis and Timothy John Kleinig . Endovascular Recanalization of Chronic Venous Obstruction Fig. The decision to perform endovascular intervention was based on a case-by-case evaluation in an interdisciplinary decision-making process between neurologists and interventional neuroradiologists and was limited to cases with severe or refractory . Mel J.SharafuddinMDab Rachael M.NicholsonMDa Timothy F. KresowikMDa Parth B.AminMDa Jamal J.HoballahMDa William J. SharpMDa The same applies for new devices apart from stent retrievers. We aim to evaluate the feasibility and safety of endovascular recanalization for nonacute intracranial vertebral artery occlusion and propose a new angiographic classification. Chronic venous occlusion is common particularly in cancer patient due to hypercoagulate state associated with venous compression. Conclusions: Endovascular recanalization for nonmalignant symptomatic IVC and associated iliofemoral venous obstruction with balloon angioplasty and self-expanding stents is technically challenging; however, it is safe and durable. Purpose To evaluate the feasibility and safety of endovascular recanalization for symptomatic subacute and chronic internal carotid artery occlusion (ICAO); to propose a newly modified radiographic classification of ICAO that can rigorously identify suitable candidates for endovascular ICAO treatment. Considering the angle between the occluded stump and the subclavian artery, the operations were successfully conducted via the radial artery route. The recanalization process involves blind threading of a glidewire through the trabeculated vein. 1. Given the high risk of recurrent stroke in patients with CIAO, endovascular angioplasty and stenting have been performed in clinical practice and some studies ( 5 - 10 ). background and purpose: to assess the outcome in acute ischemic stroke patients not eligible for systemic thrombolysis (outside the 3-hour time window, after surgery, or on anticoagulant) undergoing endovascular recanalization therapy (ert) at the columbia university medical center (cumc) and to determine us nationwide usage and outcome of ert in Unlike in arterial CTO, no subendothelial or deeper dissection is performed. Endovascular recanalization of SFA CTO was performed for 26 consecutive CLI patients with failed bypass grafts from 2016 to 2020. Introduction. Fifty percent of patients had good outcomes (modified Rankin Scale 2) after a median follow-up of 3 months. Patients aged <70 years, lesions limited to the cervical internal carotid artery, and a shorter duration of the occlusion decreased the risk of complications. Endovascular Recanalization Procedures Venous Doppler ultrasound and direct CT phlebography were systematically performed before each procedure, to confirm the diagnosis of iliocaval occlusion, assess femoral involvement and plan venous recanalization and stent reconstruction. Patient demographics, bypass and lesion characteristics, procedural data, technical, and clinical outcomes were evaluated. "The main message is that endovascular thrombectomy in children can be performed with a similar safety profile and recanalization rate as in adults. Along with the local thrombolysis, significant potential in the treatment of . Rupture of the stent graft occurred on the right limb. 9 successful recanalization (extended thrombolysis in cerebral infarction [etici] 2b) rates for lvos have achieved great progress, but the 90-day clinical outcomes have not improved in The ADR was calculated as M2 segment diameter/M1 segment diameter . However, even if EVT treatment increased the rate of successful recanalization, the prognosis of VBAO patients has not been significantly improved (2, 3). Endovascular recanalization of the great vessels with the use of distal embolic protection devices requires multiple catheters and complex endovascular techniques but is feasible and safe. 3 2016; 47: 1571-1576. . Color Doppler ultrasound (CDUS) and computed tomography (CT) angiography revealed thrombosis of the entire bypass graft. Over a median clinical follow-up duration of 11.0 months, 74.1% of patients with successful recanalization achieved favorable clinical outcomes (mRS score 2). The most common device used for endovascular thrombectomy was a stent retriever (609 [78%] of 777 patients) in which the most common occlusion was at the M1 segment of the middle cerebral artery (310 [48% . Background: We hope to illustrate the feasibility of endovascular recanalization for intracranial symptomatic arterial occlusion in the subacute period without adjunctive stenting. Finally, for patients who are not good candidates for open repair because of severe comorbidities or cachexia, stenting can be used as a "bridge" to open surgical bypass, or endovascular recanalization can be attempted to treat complex lesions. Our study showed that emergency endovascular recanalization is technically feasible in patients with acute stroke due to internal carotid artery occlusion. Successful recanalization was achieved in 86.8% of the study population. Manual as opposed to automated pullback was performed due to excessive lesion length. Endovascular recanalization therapy (ERT) comprises a wide range of pharmacologic and mechanical techniques, such as intra-arterial thrombolysis (IAT), mechanical disruption and/or mechanical thrombectomy [ 5, 6 ]. Intraluminal recanalization was attempted primarily in shorter CTOs (ie, length < 15 cm) and distal tibial lesions, with conversion to a subintimal approach if this failed. Using data from the Endovascular Treatment f. Because of long segmental PVO and steep angle between the intrahepatic PV and the portal trunk, bidirectional transhepatic and transmesenteric approach was selected and resulted in deploying three metallic stents necessitating additional infusion thrombolytic therapy.