Repeated reperfusion treatment in recurrent ischemic stroke: A retrospective single-center case series

Author(s):  
Cristina Dell'Aera ◽  
Fabrizio Giammello ◽  
Antonio Armando Caragliano ◽  
Antonio Ciacciarelli ◽  
Isabella Francalanza ◽  
...  
Author(s):  
Riste Zimoski ◽  
Petar Ugurov ◽  
Lidija Veljanoska-Kiridjievska ◽  
Nikola Hristov ◽  
Enver Idoski ◽  
...  

2019 ◽  
Vol 28 (3) ◽  
pp. 640-648 ◽  
Author(s):  
Marius Georg Kaschner ◽  
Christian Rubbert ◽  
Julian Caspers ◽  
Jennifer Karsten ◽  
Bastian Kraus ◽  
...  

2013 ◽  
Vol 3 (4) ◽  
pp. 521-539 ◽  
Author(s):  
Eric Sussman ◽  
Christopher Kellner ◽  
Michael McDowell ◽  
Peter Yang ◽  
Eric Nelson ◽  
...  

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.


2019 ◽  
Vol 14 (6) ◽  
pp. 1032-1036
Author(s):  
Varun Aggarwal ◽  
Kristen Sexson‐Tejtal ◽  
Wilson Lam ◽  
Santiago O. Valdes ◽  
Caridad M. de la Uz ◽  
...  

Mycoses ◽  
2021 ◽  
Vol 64 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Eelco F. J. Meijer ◽  
Anton S. M. Dofferhoff ◽  
Oscar Hoiting ◽  
Jacques F. Meis

Author(s):  
K Talboom ◽  
I Vogel ◽  
R D Blok ◽  
S X Roodbeen ◽  
C Y Ponsioen ◽  
...  

Abstract In this single center case series with nine percent primary diversion, 86 of 94 patients alive and with complete follow-up at one year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. Meaning: Highly selective fecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared all disadvantages of a diverting stoma. In this single-centre case series, with a primary diversion rate of 9 per cent, 86 of 94 patients who were alive and had complete follow-up at 1 year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. The results indicate that, with highly selective faecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared the disadvantages of a diverting stoma.


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