AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Apr 2013
Predictors of functional outcome after emergency carotid artery stenting and intra-arterial thrombolysis for treatment of acute stroke associated with obstruction of the proximal internal carotid artery and tandem downstream occlusion.
Patients who develop severe stroke symptoms due to acute internal carotid artery occlusion eventually in combination with a thromboembolic obstruction of the middle cerebral artery incur a major risk of developing extensive MCA infarction with a poor outcome. The purpose of this study was to evaluate the outcome for patients with tandem occlusions in the MCA and/or distal ICA, retrospectively, who had undergone stent implantation in the proximal segment of the ICA in addition to intra-arterial thrombolysis. ⋯ Initial stroke severity, degree of successful revascularization, and the side of ischemia were found to independently predict the functional outcome at 3 months after treatment.
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AJNR Am J Neuroradiol · Apr 2013
Clopidogrel resistance is associated with thromboembolic complications in patients undergoing neurovascular stenting.
Antiplatelet drug resistance has been associated with thromboembolic complications in patients after coronary stent placement. It has not been well-studied in patients who have neurovascular stent-placement procedures. This study aimed to analyze the relationship between antiplatelet drug resistance and neurovascular stent-placement complications. ⋯ In our series, clopidogrel resistance was associated with increased periprocedural thromboembolic complications from neurovascular stent-placement procedures. Targeting the clopidogrel dose to platelet inhibition assays may improve clinical outcomes and requires further study.
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AJNR Am J Neuroradiol · Apr 2013
Traumatic intracranial hematomas: prognostic value of contrast extravasation.
Contrast extravasation within spontaneous intracranial hemorrhage is a well-described predictor of hematoma growth, poor clinical outcome, and mortality. The purpose of this study was to assess the prognostic value of contrast extravasation in acute traumatic intracranial hematomas. ⋯ Contrast extravasation within intracranial hematomas predicts poor in-hospital outcome in the setting of acute traumatic intracranial injuries.
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AJNR Am J Neuroradiol · Apr 2013
Multisociety Consensus Quality Improvement Guidelines for Intraarterial Catheter-directed Treatment of Acute Ischemic Stroke, from the American Society of Neuroradiology, Canadian Interventional Radiology Association, Cardiovascular and Interventional Radiological Society of Europe, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, European Society of Minimally Invasive Neurological Therapy, and Society of Vascular and Interventional Neurology.
In this international multispecialty document, quality benchmarks for processes of care and clinical outcomes are defined. It is intended that these benchmarks be used in a quality assurance program to assess and improve processes and outcomes in acute stroke revascularization. ⋯ Quality improvement guidelines are provided for endovascular acute ischemic stroke revascularization procedures.