Endovascular Treatment Effective with Carotid Disease
|
By HospiMedica International staff writers Posted on 12 Jun 2017 |
|
Image: Research shows clearing blood clots in stroke patients is effective even those with blocked carotid arteries (Photo courtesy of FotoSearch).
Intra-arterial treatment (IAT) for acute ischemic stroke caused by intracranial proximal occlusion is effective even in patients with extracranial carotid disease (ECD), according to a new study.
Researchers at Academic Medical Center (AMC; Amsterdam, The Netherlands), Leiden University Medical Center (LUMC, The Netherlands), and other institutions conducted a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment (MR CLEAN) study to examine if the presence of ECD--defined as cervical internal carotid artery stenosis higher than 50%, or occlusion--modified the effect of IAT for intracranial proximal anterior circulation occlusion. The MR CLEAN IAT protocol included intra-arterial thrombolysis, mechanical treatment, or both as treatment for acute ischemic stroke.
The primary measure was functional outcome, as measured by modified Rankin Scale at 90 days and reported as adjusted common odds ratio (acOR) for a shift in direction of a better outcome. The results showed that functional outcome was associated with an acOR of 1.67 in favor of the IAT intervention. In the analysis of the pre-specified subgroup of patients with ECD, acOR was 3.1, compared to an acOR of 1.3 in patients presenting without ECD. The study was published on May 23, 2017, in Annals of Internal Medicine.
“The presence of ECD is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion, and acute IAT in the setting of extracranial and intracranial lesions is considered challenging,” concluded lead author Olvert Berkhemer, MD, PhD, of AMC, and colleagues. “IAT may be at least as effective in patients with ECD as in those without ECD, and it should not be withheld in these complex patients with acute ischemic stroke.”
Based on the Framingham Heart Study and Cardiovascular Health Study populations, the prevalence of ECD is approximately 9% in men and 6–7% in women, and it accounts for up to 15–20% of all ischemic strokes. Several possible mechanisms are involved, including atheroembolism of cholesterol crystals or other debris, artery-to-artery embolism of thrombus, dissection, acute thrombotic occlusion, and reduced cerebral perfusion with plaque growth.
Related Links:
Academic Medical Center
Leiden University Medical Center
Researchers at Academic Medical Center (AMC; Amsterdam, The Netherlands), Leiden University Medical Center (LUMC, The Netherlands), and other institutions conducted a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment (MR CLEAN) study to examine if the presence of ECD--defined as cervical internal carotid artery stenosis higher than 50%, or occlusion--modified the effect of IAT for intracranial proximal anterior circulation occlusion. The MR CLEAN IAT protocol included intra-arterial thrombolysis, mechanical treatment, or both as treatment for acute ischemic stroke.
The primary measure was functional outcome, as measured by modified Rankin Scale at 90 days and reported as adjusted common odds ratio (acOR) for a shift in direction of a better outcome. The results showed that functional outcome was associated with an acOR of 1.67 in favor of the IAT intervention. In the analysis of the pre-specified subgroup of patients with ECD, acOR was 3.1, compared to an acOR of 1.3 in patients presenting without ECD. The study was published on May 23, 2017, in Annals of Internal Medicine.
“The presence of ECD is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion, and acute IAT in the setting of extracranial and intracranial lesions is considered challenging,” concluded lead author Olvert Berkhemer, MD, PhD, of AMC, and colleagues. “IAT may be at least as effective in patients with ECD as in those without ECD, and it should not be withheld in these complex patients with acute ischemic stroke.”
Based on the Framingham Heart Study and Cardiovascular Health Study populations, the prevalence of ECD is approximately 9% in men and 6–7% in women, and it accounts for up to 15–20% of all ischemic strokes. Several possible mechanisms are involved, including atheroembolism of cholesterol crystals or other debris, artery-to-artery embolism of thrombus, dissection, acute thrombotic occlusion, and reduced cerebral perfusion with plaque growth.
Related Links:
Academic Medical Center
Leiden University Medical Center
Gold Member
12-Channel ECG
CM1200B
Gold Member
SARS‑CoV‑2/Flu A/Flu B/RSV Sample-To-Answer Test
SARS‑CoV‑2/Flu A/Flu B/RSV Cartridge (CE-IVD)
New
MR Trolley
MR9002
New
Open Stapler
PROXIMATE Linear Cutter
Latest Surgical Techniques News
- Fluorescent Imaging Agent ‘Lights Up’ Nerves for Better Visualization During Surgery
- LED-Based Imaging System Could Transform Cancer Detection in Endoscopy
- New Surgical Microscope Offers Precise 3D Imaging Using 48 Tiny Cameras
- First-Of-Its-Kind Drug Illuminates Nerve Tissue for Faster and Safer Surgery
- Neuroform Atlas Stent-Assisted Coiling Found Effective Even in Smaller Arteries
- New Surgical Technique Safely Removes Giant Nerve Tumors
- Breakthrough Polymer Significantly Improves Safety of Implantable Medical Devices
- First-Ever Technology Makes Blood Translucent During Surgery
- Tibia Nailing System with Novel Side-Specific Nails to Revolutionize Fracture Surgery
- New Imaging Probe to Transform Brain Cancer Surgery
- New Technology More Than Doubles Success Rate for Blood Clot Removal
- Surgical Ablation During CABG Improves Survival in Patients with Preexisting Atrial Fibrillation
- New Battery Technology Delivers Additional Power to Implantable Medical Devices
- New Model Reveals Optimal Positioning of Orthopedic Screws in Fractures
- Non-Invasive Tool for Removing Lung Cancer Tumors Reduces Surgical Trauma
- Advanced Imaging Endoscopes to Revolutionize Detection and Treatment of Gastrointestinal Disorders
Channels
Critical Care
view channel
Implantable Device Could Save Diabetes Patients from Dangerously Low Blood Sugar
For individuals with Type 1 diabetes, hypoglycemia (low blood sugar) presents a life-threatening threat, particularly when glucose levels drop too low, which can result in seizures, coma, or even death.... Read more
New Prostate Screening Device Could Replace Traditional Examination Method
Prostate cancer is a leading health concern, with one in seven men being diagnosed with the disease. Early detection is critical for improving patient outcomes, but traditional diagnostic methods, such... Read more
Patient Care
view channel
Revolutionary Automatic IV-Line Flushing Device to Enhance Infusion Care
More than 80% of in-hospital patients receive intravenous (IV) therapy. Every dose of IV medicine delivered in a small volume (<250 mL) infusion bag should be followed by subsequent flushing to ensure... Read more
VR Training Tool Combats Contamination of Portable Medical Equipment
Healthcare-associated infections (HAIs) impact one in every 31 patients, cause nearly 100,000 deaths each year, and cost USD 28.4 billion in direct medical expenses. Notably, up to 75% of these infections... Read more
Portable Biosensor Platform to Reduce Hospital-Acquired Infections
Approximately 4 million patients in the European Union acquire healthcare-associated infections (HAIs) or nosocomial infections each year, with around 37,000 deaths directly resulting from these infections,... Read more
First-Of-Its-Kind Portable Germicidal Light Technology Disinfects High-Touch Clinical Surfaces in Seconds
Reducing healthcare-acquired infections (HAIs) remains a pressing issue within global healthcare systems. In the United States alone, 1.7 million patients contract HAIs annually, leading to approximately... Read moreHealth IT
view channel
Printable Molecule-Selective Nanoparticles Enable Mass Production of Wearable Biosensors
The future of medicine is likely to focus on the personalization of healthcare—understanding exactly what an individual requires and delivering the appropriate combination of nutrients, metabolites, and... Read more
Smartwatches Could Detect Congestive Heart Failure
Diagnosing congestive heart failure (CHF) typically requires expensive and time-consuming imaging techniques like echocardiography, also known as cardiac ultrasound. Previously, detecting CHF by analyzing... Read more
Business
view channel
Bayer and Broad Institute Extend Research Collaboration to Develop New Cardiovascular Therapies
A research collaboration will focus on the joint discovery of novel therapeutic approaches based on findings in human genomics research related to cardiovascular diseases. Bayer (Berlin, Germany) and... Read more
