No abstract available.
Thrombectomy*

No abstract available.
Humans ; Thrombectomy

BACKGROUND

Endovascular thrombectomy (EVT) is the gold standard of care for large vessel occlusion strokes, but is underutilized in developing countries.

This single-center retrospective study included patients who underwent EVT during the period of September 2018 to April 2023. Data collected were demographics, underlying co-morbidities, use of anti-thrombotics/coagulants, CT or MR ASPECTS, thrombolysis prior to EVT, technique, timing, TICI score, occlusion site, discharge and 90-day MRS.

Of the 1,595 stroke patients, 57 (3%) cases underwent EVT. The mean age was 65 with a male to female ratio of 6:5. Hypertension, atrial fibrillation, and diabetes were the common comorbidities. Majority of patients (90%, n=54) presented with moderate to severe disability (MRS 3-5). Majority were in the anterior circulation (89%, n=51). Stentriever technique was mostly used (59% n=34) with a 77% (n=44) recanalization rate. Early neurologic improvement (ENI) was seen in 7% (n=4), 2 of which translated to a favorable outcome after 90-days. Mortality occurred in 24% (n=14) of cases, mostly from neurological complications. 24% (n=14) had favorable outcome of MRS 0-2 after 90 days. Among those grouped in the unfavorable outcome, 53% (n=23) were MRS 3, still showing marked improvement of quality of life.

EVT outcomes in this study is aligned with the landmark trials which exhibited a number needed to treat of 2.8-7.4. This local data highlights that EVT is a possible and effective treatment for large vessel strokes despite wide gap in accessibility and use in the country.

No abstract available.
Humans ; Stroke* ; Thrombectomy*

No abstract available.
Angioplasty* ; Thrombectomy* ; Thrombosis*

No abstract available.
Angioplasty* ; Thrombectomy* ; Thrombosis*

No abstract available.
Thrombectomy* ; Venous Thrombosis*

PURPOSE: In recent years, mechanical thrombectomy using Solitaire stent retrieval has been tried for treating acute ischemic stroke with a large artery occlusion. We systematically reviewed published articles to appraise the evidence that supports the safety and efficacy of the mechanical thrombectomy in acute strokes with Solitaire stent. MATERIALS AND METHODS: Systematic searches using Medline and Scopus were performed for studies evaluating mechanical thrombectomy using a Solitaire stent in acute ischemic stroke. Articles were included if they were published since 2008, contained at least 5 subjects, and provided clinical results. RESULTS: Thirteen articles (262 cases) were included in this review. The mean time of the procedures ranged from 37 to 95.6 minutes in 10 studies. The success of recanalization was achieved in 89.7% and the recanalization rate varied from 66.7% to 100% in all 13 studies. The overall rates of the symptomatic hemorrhagic complications and mortality were 6.8% and 11.1%, respectively. A favorable outcome of mRS 2 or under was 47.3%. Procedure-induced complications developed in 3.4%. CONCLUSION: The present review suggested that mechanical thrombectomy using a Solitaire stent in acute ischemic stroke was effective in recanalizing the occluded artery. The rate of procedural complications was small.
Arteries ; Stents ; Stroke ; Thrombectomy

Popliteal arterial occlusion after total knee arthroplasty is a rare complication, and for now various treatment methods have been tried. The authors report a case of acute popliteal artery occlusion after total knee arthroplasty that was treated by thrombectomy.
Arthroplasty* ; Knee* ; Popliteal Artery* ; Thrombectomy

BACKGROUND

Primary percutaneous coronary intervention (PPCI) may be complicated by heavy intracoronary thrombus burden leading to decrease in myocardial perfusion and increase in infarct size. The current meta-analysis aims to investigate the clinical outcomes of aspiration thrombectomy (AT) with intracoronary tirofiban during PPCI.

A systematic search for randomized controlled trials that evaluate the safety and efficacy of AT with intracoronary tirofiban in ST-elevation myocardial infarction (STEMI) patients who underwent PPCI was done using PubMed, MEDLINE, EMBASE, Cochrane, ClinicalTrials.gov., and Herdin PH. Studies included those published between 2010 and 2023 and involved human subjects. Search terms included “aspiration thrombectomy,” “intracoronary tirofiban,” “primary percutaneous coronary intervention,” and “STEMI patients.”

Four randomized controlled trials (n = 490 participants) were included in this metaanalysis comparing AT with intracoronary tirofiban versus AT alone in STEMI patients undergoing PPCI. The results revealed no statistically significant difference in ST-segment resolution (risk ratio [RR], 1.02; 95% confidence interval [CI], 0.97–1.08; P = 0.41, I2 = 0%), myocardial blush grade 2–3, (RR, 1.04; 95% CI, 0.97–1.12; P = 0.22, I2 = 62%), and Thrombolysis In Myocardial Infarction 3 flow (RR, < 1.0; 95% CI, 0.95–1.04; P = 0.87).

The occurrence of major adverse cardiovascular events did not significantly differ between the two groups (RR, 0.46; 95% CI, 0.19–1.09; P = 0.08, I2 = 0%). There was no statistically significant difference in terms of bleeding when combining intracoronary tirofiban to standard medical therapy (RR, 1.35; 95% CI, 0.64–2.84; P = 0.78, four trials [490 patients]).

In PPCI, major adverse cardiovascular event outcomes of AT with intracoronary tirofiban were similar to those for AT alone in terms of improving myocardial perfusion in STEMI patients without increasing the risk for bleeding. Our meta-analysis suggests that AT alone may be the more acceptable standard during PPCI when encountering heavy thrombus burden. Future validated studies may help further investigate the strategy of adding tirofiban during AT.