Cerebrovascular

Read the latest cerebrovascular clinical findings in Neurosurgery Watch and improve your practice with new approaches and techniques.

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ESCAPE: Rapid endovascular treatment improves functional outcomes in stroke

February 26, 2015
Cerebrovascular
By: 
Alexander A. Khalessi, MD
Source: 
PubMed

The ESCAPE Trial aimed to assess the role for thrombectomy for patients with stroke due to anterior circulation proximal vessel occlusion. The study randomized 316 patients across 22 centers worldwide who presented within 12 hours with an acute stroke syndrome...

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MR CLEAN: A Randomized Trial of Intra-arterial Treatment for Acute Ischemic Stroke

January 29, 2015
Cerebrovascular
By: 
Alexander A. Khalessi, MD
Source: 
New England Journal of Medicine

The MR CLEAN trial was 16 center, randomized trial conducted in the Netherlands on subjects presenting within 6 hours after onset of acute stroke syndrome, and confirmed large vessel occlusion in the anterior circulation.  Subjects received endovascular thrombectomy (81.5% received...

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Change in CT appearance over time correlates with outcomes more than initial CT findings in ischemic stroke

January 5, 2015
Cerebrovascular
By: 
Michelle J. Smith, MD
Source: 
Pub Med

Sun et al. performed a retrospective cohort study assessing the rate of pretreatment Alberta Stroke Program Early CT Scores (ASPECTS) decay and its ability to predict good outcome. ASPECTS scores <8 have been associated with worse functional outcomes in patients...

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Efficacy of combined direct and indirect revascularization for Moya Moya disease

November 4, 2014
Cerebrovascular
By: 
Robert M. Starke, MD MSC
Source: 
Pub Med

Reports of long-term outcomes following combined direct and indirect bypass for moyamoya disease are sparse.  Cho and colleagues report on 77 treated hemispheres in 60 patients with a mean follow up of approximately 6 years.  Karnofsky Performance and modified Rankin...

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Stent Retriever for Acute Stroke: Post-market validation of revascularization and outcomes

November 4, 2014
Cerebrovascular
By: 
Michelle J. Smith, MD
Source: 
Pubmed

The North American Solitaire Stent Retriever Acute Stroke (NASA) registry is the largest post-marketing study to date assessing radiographic and clinical outcomes of a stent retriever device, including 354 patients treated for acute ischemic stroke secondary to large vessel occlusion...

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Urokinase reduces clot volume without increasing edema in patients with spontaneous intracerebral hemorrhage

September 30, 2014
Cerebrovascular
By: 
Justin F. Fraser, MD
Source: 
Pub Med

New data increasingly support the potential role for minimally invasive surgery (MIS) methods for evacuation of intracerebral hemorrhage (ICH).  The authors retrospectively studied patients with ICH, evaluating nonsurgical patients (N=30), patients undergoing MIS evacuation alone(N=20), and those undergoing MIS with...

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Endarterectomy associated with less peri-procedural strokes than stenting for symptomatic carotid stenosis

September 4, 2014
Cerebrovascular
By: 
Robert M. Starke, MD MSC
Source: 
PubMed

Long-term follow-up results of the randomized controlled trial “Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis” (EVA-3S) of 527 patients randomized to carotid stenting or endarterectomy at 30 French centers reported primary endpoints of ipsilateral stroke or procedural...

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Early hemicraniectomy improves survival of elderly MCA stroke patients, but with substantial disability

September 4, 2014
Cerebrovascular
By: 
Alexander A. Khalessi, MD
Source: 
The New England Journal of Medicine

Previous trials showed the substantial survival benefit of decompressive hemicraniectomy and duroplasty within 48 hours of malignant MCA strokes (29% versus 78% at 1 year), and achieve a severe disability of 4% versus 5% in controls. The randomized DESTINY II...

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ADAPT FAST is a fast, effective, versatile mechanical embolectomy technique for acute stroke

September 4, 2014
Cerebrovascular
By: 
Michelle J. Smith, MD
Source: 
Journal of NeuroIntervent Surgery

The multi-institutional prospective data on ADAPT (a direct aspiration first pass technique)-treated stroke patients was reported. ADAPT advances a large guide catheter into ICA for clot aspiration with a large caliber catheter. Other mechanical embolectomy devices are used if first...

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New stent retrievers may be superior to previous-generation mechanical thrombectomy devices for ischemic strokes

July 31, 2014
Cerebrovascular
By: 
Stacey Quintero Wolfe, MD
Source: 
Journal of Neurosurgery

Deshaies, et al report a single-center review of 102 consecutive cases of acute stroke patients treated with mechanical thrombectomy devices from 2007-2013. The type of thrombectomy device used was significantly associated with functional independence (mRS score ≤ 2) at discharge...

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