scholarly journals Dual Mechanical Thrombectomy for Recanalization of a Resistant Acute Posterior Circulation Stroke

2017 ◽  
Vol 19 (2) ◽  
pp. 96 ◽  
Author(s):  
Ahmet Peker ◽  
Ayça Akgoz ◽  
Ethem Murat Arsava ◽  
Mehmet Akif Topçuoglu ◽  
Anil Arat
Keyword(s):  
Mechanical Thrombectomy ◽  
Posterior Circulation ◽  
Posterior Circulation Stroke

scholarly journals Transradial Approach for Mechanical Thrombectomy of Posterior Circulation Stroke

2018 ◽  
Vol 12 (6) ◽  
pp. 314-319 ◽  
Author(s):  
Taichiro Mizokami ◽  
Takeshi Uwatoko ◽  
Takashi Furukawa ◽  
Eiji Higashi ◽  
Yusuke Sakaki ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Posterior Circulation ◽  
Transradial Approach ◽  
Posterior Circulation Stroke

Abstract P10: Posterior Circulation Strokes Are Less Likely to Receive Alteplase or Mechanical Thrombectomy: Analysis From the IAC Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Narendra S Kala ◽  
Shadi Yaghi ◽  
Adam H De Havenon ◽  
Ava L Liberman ◽  
Eva Mistry ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
The United States ◽  
Posterior Circulation ◽  
Cardioembolic Stroke ◽  
Stroke Severity ◽  
Fisher Exact Test ◽  
Posterior Circulation Stroke ◽  
Severity Scores ◽  
Treatment Trends ◽  
To Receive

Background: Emergent treatment with intravenous thrombolysis and mechanical thrombectomy improved outcomes in patients with acute ischemic stroke. We aim to identify differences in acute stroke treatment trends between strokes occurring in the anterior versus posterior circulation. Methods: The IAC (Initiation of Anticoagulation after Cardioembolic stroke) study represents pooled data registry of 8 comprehensive stroke centers across the United States and included patients with cardioembolic stroke in the setting of AFib. In a post hoc analysis, we identified and separated patients into posterior circulation stroke (PCS) and anterior circulation stroke (ACS) groups based on imaging. Patients without infarct locations or those with multi-circulation infarcts were excluded. We compared baseline characteristics, stroke severity and the treatment trends with alteplase (tPA) and mechanical thrombectomy (MT) in PCS vs ACS using Fisher exact test, t-test and non-parametric tests. We then performed multivariable logistic regression adjusted for baseline differences to determine the associations between PCS and tPA or MT. Results: Of the 2084 patients in IAC cohort, 1589 met inclusion criteria for this study, in which 294 (22.7%) had PCS. Mean age was 76.8 years, 29.3% received tPA and 26.9% had MT. When compared to ACS, patients with PCS were more likely to be men (55.4% vs 45.6%, p=0.003), have diabetes (42.8% vs 29.8, p< 0.001) and lower median NIHSS score on admission (4 vs 8, p<0.001). Patients with PCS were less likely to receive tPA (16.3% vs 32.3%, p<0.001) or MT (10.9% vs 30.6%, p<0.001). Other variables were not significantly different. When adjusted for baseline differences, patients with PCS remained less likely to be treated with tPA (adjusted OR 0.49, 95%CI 0.35-0.70, p<0.001) or MT (adjusted OR 0.38, 95%CI 0.25-0.58, p<0.001). Conclusion: Posterior circulation strokes are half as likely to receive thrombolytic therapy and almost a third as likely to have thrombectomy, even after adjusting for baseline stroke severity scores. This is possibly due to difficulty in timely identification and diagnostic delays. There is need for better tools incorporating posterior circulation stroke signs and symptoms to allow for early detection and treatment.

scholarly journals Mechanical Thrombectomy for Basilar Artery Occlusion Stroke: A Case Report

2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Subash Phuyal ◽  
Kapil Dawadi ◽  
Raju Paudel ◽  
Ritesh Lamsal ◽  
Pooja Agrawal
Keyword(s):  
Case Report ◽  
Basilar Artery ◽  
Mechanical Thrombectomy ◽  
Significant Risk ◽  
Artery Occlusion ◽  
Posterior Circulation ◽  
Morbidity And Mortality ◽  
Basilar Artery Occlusion ◽  
Posterior Circulation Stroke ◽  
Endovascular Mechanical Thrombectomy

Posterior circulation strokes are potentially devastating events that carry a significant risk of morbidity and mortality. Acute basilar artery occlusion stroke is a rare posterior circulation stroke that needs emergent management. We report the case of a 67-year-old woman who developed an acute basilar artery occlusion. We achieved complete recanalization of the occluded basilar artery and its branches with endovascular mechanical thrombectomy. It is possible to achieve excellent results with mechanical thrombectomy in acute basilar artery occlusion if timely diagnosis and reperfusion can be done. We are not aware of any previous publication from Nepal describing this technique in acute basilar artery occlusion.

Factors Associated with 90-Day Outcomes of Patients with Acute Posterior Circulation Stroke Treated By Mechanical Thrombectomy

2018 ◽  
Vol 109 ◽  
pp. e318-e328 ◽  
Author(s):  
Gang Luo ◽  
Dapeng Mo ◽  
Xu Tong ◽  
David S. Liebeskind ◽  
Ligang Song ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Posterior Circulation ◽  
Factors Associated ◽  
Posterior Circulation Stroke

A Meta-Analysis of Prognostic Factors in Patients with Posterior Circulation Stroke after Mechanical Thrombectomy

2020 ◽  
pp. 1-15
Author(s):  
Kai Xun ◽  
Jiahang Mo ◽  
Shunyi Ruan ◽  
Jinyao Dai ◽  
Wenting Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Prognostic Factors ◽  
Mechanical Thrombectomy ◽  
Time Window ◽  
Meta Analysis ◽  
Primary Outcome Measure ◽  
Posterior Circulation ◽  
Posterior Circulation Stroke ◽  
Previous Stroke ◽  
Outcome Differences

<b><i>Background:</i></b> Posterior circulation stroke is characterized by poor prognosis because its optimal thrombolysis “time window” is always missed. After mechanical thrombectomy (MT), the recanalization rate of posterior circulation obstruction is significantly increased, but prognosis remains poor. To best manage patients, prognostic factors are needed to inform MT triaging after posterior circulation stroke. <b><i>Methods:</i></b> A systematic literature search was done for the period through April 2020. Studies included those with posterior circulation stroke cases that underwent MT. The primary outcome measure in this study was the modified Rankin Scale on day 90. <b><i>Results:</i></b> No outcome differences were found in gender, atrial fibrillation, smoking, and coronary artery disease (OR = 1.07, 95% CI: 0.90–1.28; OR = 1.02, 95% CI: 0.82–1.26; OR = 1.26, 95% CI: 0.94–1.68; and OR = 0.84, 95% CI: 0.58–1.22, respectively). Hypertension, diabetes mellitus, and previous stroke correlated with poorer prognosis (OR = 0.61, 95% CI: 0.48–0.77; OR = 0.60, 95% CI: 0.50–0.73; and OR = 0.74, 95% CI: 0.55–0.99, respectively). However, hyperlipidemia correlated with better prognosis (OR = 1.28, 95% CI: 1.04–1.58). <b><i>Conclusion:</i></b> Our analysis indicates that hypertension, diabetes mellitus, or previous stroke correlate with poorer outcomes. Intriguingly, hyperlipidemia correlates with better prognosis. These factors may help inform triage decisions when considering MT for posterior circulation stroke patients. However, large, multicenter, randomized controlled trials are needed to validate these observations.

Posterior circulation stroke: an easily overlooked complication of catheter ablation of atrial fibrillation

2020 ◽  
Vol 13 (8) ◽  
pp. e234661
Author(s):  
Tahir Nazir ◽  
Mohiuddin Sharief ◽  
James Farthing ◽  
Irfan M Ahmed
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Treatment Options ◽  
Posterior Circulation ◽  
Diagnosis And Treatment ◽  
Neurological Deficits ◽  
Cerebellar Infarction ◽  
Af Ablation ◽  
Posterior Circulation Stroke ◽  
Ventricular Response

Catheter ablation of atrial fibrillation (AF) has established itself as a safe and proven rhythm control strategy for selected patients with AF over the past decade. Thromboembolic complications of catheter ablation are becoming rare in anticoagulated patients with a risk of stroke reported as 0.3%. A particular challenge is posed by clinical presentation due to ischaemic stroke involving the posterior circulation following catheter ablation because of its substantial differences from the carotid territory stroke, making the timely diagnosis and treatment very difficult. It is crucial to keep an index of clinical suspicion in patients presenting with neurological deficits related to vertebrobasilar circulation following ablation. We describe the case of a man who presented with dizziness and palpitations after radiofrequency catheter ablation of AF. He was found to be in AF with a rapid ventricular response. His dizziness was initially attributed to the cardiac dysrhythmia. As his symptoms continued despite heart rate control, he underwent further investigations and was eventually diagnosed with a posterior circulation stroke resulting in left cerebellar infarction. He was treated with antiplatelet therapy and improved significantly over the following few days. We review and present an up-to-date brief literature review on the complications of catheter ablation of AF and describe pathophysiology, clinical features, diagnosis and treatment options for posterior circulation stroke after AF ablation. This case aims to raise awareness among clinicians about posterior circulation stroke after AF ablation.

APICAL PLEURAL ASPERGILLOSIS WITH PANCOAST'S SYNDROME AND POSTERIOR CIRCULATION STROKE: A CASE REPORT

2021 ◽  
pp. 101154
Author(s):  
Y Muralidhar Reddy ◽  
Subhendu Parida ◽  
Premchand Gupta ◽  
Shyam K Jaiswal ◽  
Ganjisreenivasa Gnaneswar ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Circulation ◽  
Posterior Circulation Stroke
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