Aggressive revascularization of acute internal carotid artery occlusion in patients with NIHSS&gt;20 and poor collateral circulation: Preliminary report

Li, Ai-Hsien; Wang, Yao Hung; Kao, Hsiang‐Fong; Yang, Lin; Chan, Lung; Chu, Shu‐Hsun; Liu, Hon‐Man

doi:10.1016/j.ijcard.2011.05.004

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…We used the combination of Navien aspiration, thrombolysis, and anticoagulation therapy for this case for several reasons. Compared to other microcatheters, the Navien catheters have the minimal outer diameter but greatest inner diameter, [14] with strengths of self-anchoring at curved vessels and maintaining a circular shape without altering to an oval shape in the procedure. These characteristics and the relatively big inner diameter can ensure removal of large clot fragments at aspiration and maintain patent catheter lumen in tortuous vessels for good manipulation and stability of the catheter.…”

Section: Discussionmentioning

confidence: 99%

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Zhang

Gao

et al. 2022

Medicine

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Rationale: The incidence of pregnancy-related cerebral venous sinus thrombosis (CVST) is rare, and cerebral hemorrhage caused by CVST in the early pregnancy period is even rarer. Only 3 cases of cerebral hemorrhage caused by CVST had been reported in the early pregnancy period in the literature. In this study, we reported successful endovascular treatment of such a case.Patient concerns: A 27-year-old woman presented with rapidly progressive neurologic decline in her second pregnancy for 8 weeks. She was afebrile and completely conscious, without neurological deficits. She did not have any previous history of venous thrombosis, hematologic, or autoimmune diseases.Diagnosis: Urgent brain computed tomography demonstrated parietal-occipital hemorrhage surrounded by a large hypodense area and full brain swelling. Magnetic resonance venography showed complete occlusion of the right sigmoid sinus, transverse sinus, and two-thirds of the superior sagittal sinus. Transvaginal sonography demonstrated early intrauterine pregnancy, with the size of gestation sac being 6 × 7 × 6 mm and the fetal heart not being detected. CVST-related cerebral hemorrhage was confirmed based on the clinical and imaging data. Interventions:The CVST in this pregnant woman was treated endovascularly with a 6 Fr Navien catheter for aspiration, thrombolysis, and anticoagulation.Outcomes: Ten days after treatment, the cerebral hemorrhage had gradually been absorbed. Follow-up angiography performed 2 weeks later demonstrated complete recanalization of her cortical veins and sinuses. Two months later, the patient was completely recovered without cognitive or neurological dysfunction.Lessons: Pregnancy-related CVST can be successfully treated with a combined endovascular approach of aspiration, thrombolysis, and anticoagulation to complete recovery.

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Section: Discussionmentioning

confidence: 99%

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Zhang

Gao

et al. 2022

Medicine

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“…Literature addressing the aggressive alternatives aimed at revascularization of the acutely symptomatic internal carotid artery is plagued by several controversial issues [ 5 , 6 ]. Technically feasible surgical intervention in the form of emergency carotid endarterectomy with distal thrombectomy has an elusive benefit and is not widely accepted [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Milrinone Salvage Therapy in Acute Internal Carotid Artery Occlusion: Case Report

Al-Jehani

Angle

2019

Neurol Ther

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Introduction Acute internal carotid artery occlusion is a devastating form of ischemic accident with significant morbidity and possible mortality. The “threatened hemisphere” is allowed limited access to collateral circulation further worsening the ischemic burden and the overall prognosis. Methods We present the details of a case of a 38-year-old woman who suffered from an ischemic stroke. The clinical course of which showed a hemodynamic dependence to preserve her neurological function, prompting the use of the phosphodiesterase inhibitor milrinone to maintain her neurological function. Result This case represents the first case in the literature in which a medical therapy is used to salvage brain tissue in the site of acute symptomatic large vessel occlusion. This has spared the patient from a potential significant morbidity and even mortality if a revascularization procedure had been attempted. Conclusion This innovative use of milrinone, if applied in more captured patients with internal carotid occlusion or those with reversible hemodynamic failure, would improve our understanding of the ischemic thresholds and cerebral vascular reserves and would improve the clinical outcome of this significant ischemic insult.

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Urgent Carotid Artery Stenting for Carotid-Related Stroke-in-Evolution

Nakagawa

Fukawa²,

Tsuji³

et al. 2017

ONSURG

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Aggressive revascularization of acute internal carotid artery occlusion in patients with NIHSS>20 and poor collateral circulation: Preliminary report

Cited by 4 publications

References 18 publications

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Intravenous Milrinone Salvage Therapy in Acute Internal Carotid Artery Occlusion: Case Report

Urgent Carotid Artery Stenting for Carotid-Related Stroke-in-Evolution

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