Alternative Arterial Access Routes for Endovascular Thrombectomy in Patients with Acute Ischemic Stroke: A Study from the MR CLEAN Registry

Review Neurosciences

Transcarotid Access for Mechanical Thrombectomy in Acute Ischemic Stroke: A Meta-Analysis and Systematic Review

Allison J. Zhong et al.

Summary: This study assessed the efficacy and safety of transcarotid access for mechanical thrombectomy, showing it to be a viable alternative with high success rates and low complication rates.

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES (2022)

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Article Medicine, General & Internal

Safety and efficacy of aspirin, unfractionated heparin, both, or neither during endovascular stroke treatment (MR CLEAN-MED): an open-label, multicentre, randomised controlled trial

Wouter van der Steen et al.

Summary: This study aimed to evaluate the safety and efficacy of intravenous aspirin and unfractionated heparin during endovascular treatment, as well as their impact on functional outcomes in patients. The results showed that both medications were associated with an increased risk of symptomatic intracranial hemorrhage without any significant improvement in functional outcomes.

LANCET (2022)

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Review Neuroimaging

Rescue carotid puncture for ischemic stroke treated by endovascular therapy: a multicentric analysis and systematic review

Julien Allard et al.

Summary: The study found that rescue carotid puncture (RCP) is a feasible alternative for elderly patients with acute ischemic stroke, especially when supra-aortic tortuosity is present. However, outcomes at 3 months post-procedure are generally unfavorable. RCP should be performed under general anesthesia to ensure patient safety and to minimize life-threatening complications.

JOURNAL OF NEUROINTERVENTIONAL SURGERY (2021)

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Article Clinical Neurology

Direct carotid puncture for mechanical thrombectomy in acute ischemic stroke patients with prohibitive vascular access

Branden J. Cord et al.

Summary: This study evaluated the safety and effectiveness of using direct carotid puncture (DCP) for mechanical thrombectomy (MT) in stroke patients with anterior circulation acute ischemic stroke with large-vessel occlusion and prohibitive vascular access. The results showed that DCP was associated with higher recanalization rates, smaller infarct volumes, and improved functional outcomes compared to patients with failed transfemoral access, suggesting that DCP should be considered in this patient population.

JOURNAL OF NEUROSURGERY (2021)

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Article Medicine, General & Internal

Safety and efficacy of the transbrachial approach for endovascular thrombectomy in patients with acute large vessel occlusion stroke

Chi-Ju Lu et al.

Summary: This study evaluated the safety and efficacy of transbrachial approach (TBA) for endovascular thrombectomy (EVT) in patients with acute large vessel occlusion stroke. The results suggest that TBA is a suitable alternative, particularly when transfemoral approach (TFA) is difficult or impossible to adopt.

JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION (2021)

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Article Medicine, Research & Experimental

MR CLEAN-LATE, a multicenter randomized clinical trial of endovascular treatment of acute ischemic stroke in The Netherlands for late arrivals: study protocol for a randomized controlled trial

F. A. V. ( Anne) Pirson et al.

Summary: This study aims to evaluate the safety and efficacy of EVT for patients treated between 6 and 24 hours from time last known well after selection based on the presence of collateral flow on CTA.

TRIALS (2021)

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Review Clinical Neurology