IMPORTANCEWhether intravenous thrombolysis is needed in combination with mechanical thrombectomy in patients with acute large vessel occlusion stroke is unclear.OBJECTIVE To examine whether mechanical thrombectomy alone is noninferior to combined intravenous thrombolysis plus mechanical thrombectomy for favorable poststroke outcome. Investigator-initiated, multicenter, randomized, open-label, noninferiority clinical trial in 204 patients with acute ischemic stroke due to large vessel occlusion enrolled at 23 hospital networks in DESIGN, SETTING, AND PARTICIPANTS

Gallbladder infarction developing after transcatheter arterial embolization (TAE) in patients with malignant hepatic tumors was studied by comparing preoperative angiographic and postoperative macroscopic and histological findings. Eight patients demonstrated occlusion of the cystic artery or its branches by embolic materials on post-TAE angiograms. Surgery revealed infarction of the gallbladder in 6 patients; no infarction was noted in the other 2, although branches of the cystic artery were occluded on the post-TAE angiogram. Due to recanalization of the occluded artery, the infarcted area could be assessed only by follow-up angiography. No patient experienced perforation of the gallbladder as a result of infarction. The authors suggest that patients with post-TAE infarction of the gallbladder can be treated conservatively if they are kept under close observation.

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We here report the methods for and efficacy of C-arm cone-beam CT (CBCT) with diluted contrast medium during the recanalization therapy in acute ischemic stroke patients with middle cerebral artery occlusion. Case Presentation: The subjects were 30 patients who underwent recanalization therapy for acute ischemic stroke with occlusion of the middle cerebral artery at our hospital between January 2015 and December 2016. Utilizing leptomeningeal anastomosis (LMA), 20-second CBCT with fourfold diluted contrast medium was performed, and 3D image processing was subsequently conducted. In 25 (83.3%) of the 30 patients, a blood vessel distal to the site of occlusion and the extent of thrombus were favorably visualized. Conclusion: This procedure may be useful as an auxiliary examination that provides more detailed information to safely perform recanalization therapy for acute occlusion of the middle cerebral artery through the visualization of a blood vessel distal to the site of the occlusion.