1.Initial Experience Using the New pHLO 0.072-inch Large-Bore Catheter for Direct Aspiration Thrombectomy in Acute Ischemic Stroke
Giuseppe LEONE ; Massimo MUTO ; Flavio GIORDANO ; Gianluigi GUARNIERI ; Antonio Di DONNA ; Camilla RUSSO ; Daniele Giuseppe ROMANO ; Paolo CANDELARESI ; Giovanna SERVILLO ; Emanuele SPINA ; Antonio De MASE ; Vincenzo ANDREONE ; Mario MUTO
Neurointervention 2023;18(1):30-37
Purpose:
A direct aspiration, first pass technique (ADAPT) has been introduced as a rapid and safe thrombectomy strategy in patients with intracranial large vessel occlusion (LVO). The aim of the study is to determine the technical feasibility, safety, and functional outcome of ADAPT using the newly released large bore pHLO 0.072-inch aspiration catheter (AC; Phenox).
Materials and Methods:
We performed a retrospective analysis of data collected prospectively (October 2019–November 2021) from 2 comprehensive stroke centers. Accessibility of the thrombus, vascular recanalization, time to recanalization, and procedure-related complications were evaluated. National Institutes of Health stroke scale scores at presentation and discharge and the modified Rankin scale (mRS) score at 90 days post-procedure were recorded.
Results:
Twenty-five patients (14 female, 11 male) with occlusions of the anterior circulation were treated. In 84% of cases, ADAPT led to successful recanalization with a median procedure time of 28 minutes. In the remaining cases, successful recanalization required (to a total of 96%; modified thrombolysis in cerebral infarction score 2b/3) the use of stent retrievers. No AC-related complications were reported. Other complications included distal migration of the thrombus, requiring a stent-retriever, and symptomatic PH2 hemorrhage in 16% and 4%, respectively. After 3 months, 52% of the patients had mRS scores of 0–2 with an overall mortality rate of 20%.
Conclusion
Results from our retrospective case series revealed that thrombectomy of LVOs with pHLO AC is safe and effective in cases of large-vessel ischemic stroke. Rates of complete or near-complete recanalization after the first pass with this method might be used as a new benchmark in future trials.
2.Clinical Use of Doppler Echocardiography in Organic Mitral Regurgitation: From Diagnosis to Patients' Management.
Francesco GRIGIONI ; Antonio RUSSO ; Ferdinando PASQUALE ; Elena BIAGINI ; Francesco BARBERINI ; Marinella FERLITO ; Ornella LEONE ; Claudio RAPEZZI
Journal of Cardiovascular Ultrasound 2015;23(3):121-133
Knowledge of mitral regurgitation (MR) is essential for any care provider, and not only for those directly involved in the management of cardiovascular diseases. This happens because MR is the most frequent valvular lesion in North America and the second most common form of valve disease requiring surgery in Europe. Furthermore, due to the ageing of the general population and the reduced mortality from acute cardiovascular events, the prevalence of MR is expected to increase further. Doppler echocardiography is essential both for the diagnosis and the clinical management of MR. In the present article, we sought to provide a practical step-by-step approach to help either performing a Doppler echocardiography or interpreting its findings in light of contemporary knowledge on organic (but not only) MR.
Cardiovascular Diseases
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Diagnosis*
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Echocardiography
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Echocardiography, Doppler*
;
Europe
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Heart Failure
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Mitral Valve Insufficiency*
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Mortality
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North America
;
Prevalence
3.Interplay Between Cognitive and Bowel/Bladder Function in Multiple Sclerosis
Antonio CAROTENUTO ; Teresa COSTABILE ; Marcello MOCCIA ; Fabrizia FALCO ; Maria PETRACCA ; Barbara SATELLITI ; Cinzia Valeria RUSSO ; Francesco SACCÀ ; Roberta LANZILLO ; Vincenzo BRESCIA MORRA
International Neurourology Journal 2021;25(4):310-318
Purpose:
The aim of this study was to evaluate the prevalence of bowel/bladder dysfunction in multiple sclerosis (MS) and its associations with cognitive impairment.
Methods:
We prospectively enrolled 150 MS patients. Patients were administered the Symbol Digit Modality Test (SDMT), the Neurogenic Bowel Dysfunction Score (NBDS), and the Actionable Bladder Symptom Screening Tool (ABSST). The associations between bowel/bladder dysfunction and cognitive function were assessed through hierarchical regression models using the SDMT and clinicodemographic features as independent variables and NBDS and ABSST scores as dependent variables.
Results:
The prevalence of bowel/bladder deficits was 44.7%, with 26 patients (17.3%) suffering from bowel deficits and 60 patients (40%) from bladder deficits. The total NBDS and ABSST scores were correlated with the SDMT (β=-0.10, P<0.001 and β=-0.03, P=0.04, respectively) after correction for demographic features and physical disability.
Conclusions
Bowel/bladder disorders are common in MS and are associated with both physical and cognitive disability burdens. As SDMT is embedded into routine clinical assessments, a lower score may warrant investigating bowel/bladder dysfunction due to the strong interplay of these factors.