Open Embolectomy of Large Vessel Occlusion in the Endovascular Era: Results of a 12-Year Single-Center Experience

2017 ◽  
Vol 102 ◽  
pp. 65-71 ◽  
Author(s):  
Tetsuyoshi Horiuchi ◽  
Junpei Nitta ◽  
Yoshinari Miyaoka ◽  
Alhusain Nagm ◽  
Keiji Tsutsumi ◽  
...  
Keyword(s):  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Single Center ◽  
Vessel Occlusion ◽  
Single Center Experience

scholarly journals Aspiration Thrombectomy in Patients with Large Vessel Occlusion and Mild Stroke: A Single-Center Experience

2021 ◽  
Vol 27 ◽  
Author(s):  
Jozef Haring ◽  
Miroslav Mako ◽  
Ján Haršány ◽  
Georgi Krastev ◽  
Matúš Hoferica ◽  
...  
Keyword(s):  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Single Center ◽  
Vessel Occlusion ◽  
Aspiration Thrombectomy ◽  
Single Center Experience ◽  
Mild Stroke

Abstract 1122‐000022: Delays in Care for Patients with Acute Stroke During Hospitalization for Other Reasons

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Nicholas Vigilante ◽  
Parth Patel ◽  
Prasanth Romiyo ◽  
Lauren Thau ◽  
Mark Heslin ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Acute Care ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Single Center ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Symptom Recognition ◽  
Risk Patients ◽  
Recognition Imaging

Introduction : In‐hospital stroke (IHS) is defined as stroke that occurs during hospitalization for non‐stroke conditions. We aimed to understand the timing of symptom recognition for patients who experienced IHS and its impact on the care they receive. Methods : A prospective, single center registry of adult patients (9/20/19‐2/28/21) was queried for acute anterior circulation IHS. Indications for hospitalization, delays from last known well (LKW) to symptom recognition, imaging, and treatment were explored. Results : Of 928 consecutively evaluated adults with acute stroke, 85 (9%) developed an anterior circulation IHS, 39 (46%) of whom were female, with a median age of 67 years (IQR 60–76) and median NIHSS of 15 (IQR 4–22). Sixty‐eight (80%) had a >1 hour delay from last known well to symptom recognition. Two patients (2%) received IV thrombolysis, although another 38 (45%) would have been eligible if not for a delay in symptom recognition. An ICA, M1, or M2 occlusion was observed in 18 patients (21%), 7 of whom were treated at a median of 174 minutes after LKW (IQR 65–219). Compared to the 11 patients who did not undergo thrombectomy with large vessel occlusion, those who underwent thrombectomy had non‐significantly shorter delays from LKW until neuroimaging (median 85 [IQR 65‐162] vs. 216 [IQR 133‐507], p = 0.12). Conclusions : While uncommon, patients with IHS experience delays in symptom recognition and treatment, which lead to exclusion from acute care treatment such as thrombolysis and thrombectomy. Earlier detection with more frequent nursing assessments or advanced neuromonitoring devices in at‐risk patients may reduce delays in care.

scholarly journals Rescue, Combined, and Stand-Alone Thrombectomy in the Management of Large Vessel Occlusion Stroke Using the Solitaire Device: A Prospective 50-Patient Single-Center Study

Stroke ◽  
2011 ◽  
Vol 42 (7) ◽  
pp. 1929-1935 ◽  
Author(s):  
Vincent Costalat ◽  
Paolo Machi ◽  
Kyriakos Lobotesis ◽  
Igor Maldonado ◽  
Jean François Vendrell ◽  
...  
Keyword(s):  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Single Center ◽  
Vessel Occlusion ◽  
Single Center Study ◽  
Center Study

Abstract 46: Six of One, Half a Dozen of the Other: Single-Center Retrospective Comparison of Prehospital Large Vessel Occlusion Tools

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
David Ermak ◽  
Alicia Richardson ◽  
Chelsea Hogan ◽  
Amy Brinkley ◽  
Muhammad Niazi ◽  
...  
Keyword(s):  
The Other ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Single Center ◽  
Vessel Occlusion ◽  
Retrospective Comparison

scholarly journals Prior Use of Antiplatelet Therapy and Outcomes after Endovascular Therapy in Acute Ischemic Stroke Due to Large Vessel Occlusion: A Single-Center Experience

2018 ◽  
Vol 7 (12) ◽  
pp. 518 ◽  
Author(s):  
Giovanni Merlino ◽  
Massimo Sponza ◽  
Gian Gigli ◽  
Simone Lorenzut ◽  
Alessandro Vit ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Endovascular Therapy ◽  
Large Vessel ◽  
University Hospital ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Single Center Experience ◽  
Stroke Disability ◽  
Time Of Admission

Endovascular therapy (EVT) represents the gold standard treatment in patients affected by acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Prior antiplatelet (APT) therapy might increase the risk of bleeding and modify the clinical outcome of AIS patients treated with EVT. Thus, we compared effectiveness and safety of EVT in Caucasian patients with and without previous use of APT agents. We recruited consecutive patients admitted to Udine University Hospital with AIS undergoing EVT from January 2015 to December 2017. The following outcomes were documented: successful recanalization, 3-month favorable outcome, symptomatic intracranial hemorrhage (sICH), parenchymal hematoma (PH), and 3-month mortality. The study population included 100 patients (mean age 70.1 ± 11.2 years, 58% males). At time of admission, 34 patients were taking APT agents. Patients on APT pretreatment were older, had more vascular risk factors, and showed higher levels of serum creatinine than APT naïve patients. Moreover, prior APT therapy was associated with a higher rate of pre-stroke disability and a more severe stroke at admission. Patients pretreated with APT had higher rates of successful recanalization (91.2% vs. 74.2%, p = 0.04). Prevalence of 3-month unfavorable outcome and 3-month mortality was significantly higher in APT-pretreated patients than in those without APT pretreatment. However, these associations were not confirmed on multivariable analyses. Prevalence of sICH and PH did not differ in the two groups. APT pretreatment is associated to successful recanalization rate, without increasing the risk of intracranial bleeding in patients with LVO undergoing EVT.

scholarly journals Learning Curve for Endovascular Treatment of Anterior Circulation Large Vessel Occlusion at a Single Center

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiankun Cai ◽  
Yuyou Zhu ◽  
Xianjun Huang ◽  
Lulu Xiao ◽  
Mengmeng Gu ◽  
...  
Keyword(s):  
Learning Curve ◽  
Endovascular Treatment ◽  
Functional Independence ◽  
Large Vessel ◽  
Cusum Chart ◽  
Large Vessel Occlusion ◽  
Single Center ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Curve Effect

Background and purpose: Data concerning the learning curve for endovascular treatment (EVT) of anterior circulation large vessel occlusion are scarce. This study aimed to investigate the relationship between operator experience and the outcome of EVT and to further identify the number of cases needed to acquire the ability to perform successful reperfusion.Materials and methods: Four hundred and thirty-four patients who underwent EVT by seven operators at a single center from January 2016 to September 2019 were enrolled. Procedural experience was defined by the number of cases performed by each operator. Multivariable backward regression analyses were used to investigate the association between procedural experience and functional independence (defined as a modified Rankin Scale score of 0–2), 90-days mortality, successful reperfusion (defined as a modified Thrombolysis in Cerebral Infarction score of 2b-3), and puncture-to-reperfusion time after adjusting for covariates. A risk-adjusted cumulative sum (RA-CUSUM) chart was utilized to identify the number of caseloads needed to overcome the learning curve effect.Results: Procedural experience was independently associated with functional independence, 90-days mortality, successful reperfusion, and puncture-to-reperfusion time reduction (per 10-case increment: OR 1.219, 95% CI: 1.079–1.383, P < 0.001; OR 0.847, 95% CI: 0.738–0.968, P = 0.016; OR 1.553, 95% CI: 1.332–1.830, P < 0.001 and β 8.087 min, 95% CI: 6.184–9.991, P < 0.001, respectively). The RA-CUSUM chart indicated that at least 29 cases were required to overcome the learning curve effect.Conclusions: There was a dose-response relationship between operator case volume and clinical outcome, procedure time, and successful reperfusion. The experience needed for successful EVT was at least 29 cases.

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