Gadolinium to the rescue for mechanical thrombectomy in acute ischemic stroke

Male, Shailesh; Mehta, Tapan; Töre, Hüseyin Gürkan; Quinn, Coridon; Grande, Andrew W.; Tummala, Ramachandra P.; Jagadeesan, Bharathi

doi:10.1177/1591019918815298

Cited by 3 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The segments such as entering and leaving the operating room, anesthesia and surgery, and entering and leaving the resuscitation room were displayed timely by controlling the important links and nodes in the perioperative period to provide information and data for ensuring the normal movement of surgery. At the same time, the application of anesthesia resuscitation room, induction room, and preoperative waiting room should be clarified, so as to ensure the sufficient materials and reasonable storage of goods [ 8 ]…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

Gong¹,

Wang

2022

Disease Markers

View full text Add to dashboard Cite

Objective. To explore the application value of standardized perioperative management in mechanical thrombectomy for acute cerebral infarction. Methods. 98 patients with acute cerebral infarction admitted to our hospital from January 2019 to January 2022 were selected as the study sample in this study, and all patients were given the standardized perioperative management. According to the interventional methods, they were divided into the thrombolytic treatment group (arteriovenous combined thrombolysis, n = 49 ) and mechanical thrombectomy group (mechanical thrombectomy, n = 49 ) to compare the nerve function, limb function, thrombolysis in myocardial infarction (TIMI) flow grade, symptomatic intracranial hemorrhage within 24 hours, acute vascular reocclusion, and the death status within 1 year and incidence of adverse events in 90 days of the two groups after treatment. Results. After treatment, the values of brain symmetry index (BSI) and power ratio indices (DTABR) in the two groups were obviously lower than those before treatment ( P < 0.05 ), and the values of BSI and DTABR in the mechanical thrombectomy group were lower than those in the thrombolytic treatment group ( P < 0.05 ). According to the statistical data of National Institutes of Health Stroke Scale (NIHSS) score in patients, the NIHSS scores of the two groups after treatment were visibly decreased ( P < 0.05 ), while the NIHSS score in the mechanical thrombectomy group after treatment was lower than that in the thrombolytic treatment group ( P < 0.05 ). The proportion of modified Rankin scale (mRS) score < 3 in the mechanical thrombectomy group was distinctly higher than that in the thrombolytic treatment group ( P < 0.05 ). The proportion of TIMI flow grade ≥ 2 in the mechanical thrombectomy group was significantly higher than that in the thrombolytic treatment group ( P < 0.05 ). The rate of symptomatic intracranial hemorrhage within 24 hours in the mechanical thrombectomy group was lower than that in the thrombolytic treatment group ( P < 0.05 ), with the indistinctive difference between the two groups ( P > 0.05 ). The incidence of acute vascular reocclusion in the mechanical thrombectomy group was markedly lower than that in the thrombolytic treatment group ( P < 0.05 ). There was no significant difference in 1-year mortality between the two groups ( P > 0.05 ). In the mechanical thrombectomy group, there were 1 case of gingiva bleeding, 1 case of hemorrhinia, and 2 cases of recurrent cerebral infarction in 90 days, with a total of 4 cases (8.16%), while in the thrombolytic treatment group, there were 4 cases of gingiva bleeding, 4 cases of hemorrhinia, and 15 cases of recurrent cerebral infarction in 90 days, with a total of 23 cases (46.94%), indicating that the incidence of adverse events in 90 days in the mechanical thrombectomy group was significantly lower than that in the thrombolytic treatment group ( P < 0.05 ). Conclusion. The standardized perioperative management is effective in patients with acute cerebral infarction who were treated with arteriovenous combined thrombolysis or mechanical thrombectomy, which can improve the neurological function and physical function of patients. However, the mechanical thrombectomy has a better improvement effect on the neurological function and physical function of patients, with the relatively better safety, thrombolytic effect, and long-term prognosis.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Disease Markers resuscitation room, induction room, and preoperative waiting room should be clarified, so as to ensure the sufficient materials and reasonable storage of goods [8] 2.4.2. Arteriovenous Combined Thrombolysis.…”

Section: Standardized Perioperative Managementmentioning

confidence: 99%

Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

Gong¹,

Wang

2022

Disease Markers

View full text Add to dashboard Cite

show abstract

Adverse Events Associated with Intra-Arterial Administration of Gadolinium-Based Contrast Agents: A Systematic Review and Meta-Analysis

Macleod

Gauthier

Davenport

et al. 2023

Journal of Vascular and Interventional Radiology

View full text Add to dashboard Cite

Adrenal Vein Sampling With Gadolinium Contrast Medium in a Patient With Florid Primary Aldosteronism and Iodine Allergy

Yoshida

Nagai

Shibuta

et al. 2022

Journal of the Endocrine Society

View full text Add to dashboard Cite

We describe a 35-year-old woman who was allergic to iodine contrast medium and was diagnosed with primary aldosteronism (PA) based on functional confirmatory tests. She was suspected to have unilateral PA because of marked hypertension, spontaneous hypokalemia, high plasma aldosterone, reduced plasma renin activity, and a right hypodense adrenal tumor. She wanted to become pregnant and requested adrenalectomy instead of medical treatment with mineralocorticoid receptor antagonists. Localization of PA by adrenal vein sampling (AVS) was necessary, but angiography with iodine contrast medium was not possible because of her allergy. AVS was performed using gadolinium contrast agent (gadoterate meglumine) instead of iodine, in combination with computed tomography angiography (CTA). In AVS, before and after adrenocorticotropic hormone (ACTH) loading, 12 blood samples were drawn from the right adrenal vein, left adrenal central vein, left adrenal common duct, left and right renal veins, and the lower inferior vena cava with only 5 mL of gadolinium medium. There were no complications during AVS. Examination revealed an elevated aldosterone/cortisol ratio on the right side, lateralized ratio of 7.4, and contralateral ratio of 0.76; the patient was diagnosed with right unilateral PA. She underwent right adrenalectomy and showed improvements in aldosterone level from 312.4 pg/mL to 83.0 pg/mL, potassium from 3.0 mEq/L to 3.9 mEq/L, and systolic blood pressure from 138 mmHg to 117 mmHg. In conclusion, in PA patients with iodine allergy, AVS can be performed safely and precisely using gadolinium contrast combined with CTA.

show abstract

Gadolinium to the rescue for mechanical thrombectomy in acute ischemic stroke

Cited by 3 publications

References 20 publications

Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

Adverse Events Associated with Intra-Arterial Administration of Gadolinium-Based Contrast Agents: A Systematic Review and Meta-Analysis

Adrenal Vein Sampling With Gadolinium Contrast Medium in a Patient With Florid Primary Aldosteronism and Iodine Allergy

Contact Info

Product

Resources

About