Interventional Revolution in Treatment of Stroke
|
|
|
- Ann Nicholson
- 5 years ago
- Views:
Transcription
1 TCT RUSSIA 2018 XX Moscow s International Course on Endovascular Therapies Moscow, Russia, May 18-20, 2018 Interventional Revolution in Treatment of Stroke Horst Sievert, Ilona Hofmann, Laura Vaskelyte, Sameer Gafoor, Stefan Bertog, Predrag Matić, Markus Reinartz, Bojan Jovanovic, Kolja Sievert, Iris Grunwald, Nalan Schnelle CardioVascular Center Frankfurt - CVC, Frankfurt, Germany
2 Intracranial Clot Retrieval A new era of interventional medicine - New devices have made a major progress - Huge evidence by randomized trials Much more important than any other intervention I did in the cath lab over the last 35 yrs Much more rewarding than PCI, TAVI,. Cardiologists can and should be involved So if there is one lecture during this congress where you should not fall asleep - This is the one!
3 Break through: Stent Retrievers
4 Penumbra aspiration catheter Stand alone or in combination with stent retrievers
5 2013: 3 negative trials SYNTHESIS MR RESCUE IMS-III
6 Everything changed in positive randomized trials
7 In positive randomized trials
8 Imaging Simple CT: large vessel occlusion? Advanced CT Perfusion, collaterals,. Wait for response to lytics Embolectomy ASAP Select optimal candidates KW Muir et al MR CLEAN, REVASC PISTE ESCAPE, EXTEND-IA, SWIFT- Prime, THRACE, THERAPY, REVASC
9 Vidale S, Agostoni E, Vascular and Endovascular Surgery, 2017, Vol. 51(4)
10 Metaanalysis of 9 randomized trials Modified Rankin scale Vidale S, Agostoni E, Vascular and Endovascular Surgery, 2017, Vol. 51(4)
11 Odds Ratio 2 for the mrs Vidale S, Agostoni E, Vascular and Endovascular Surgery, 2017, Vol. 51(4)
12 No increase in cerebral hemorrhage Vidale S, Agostoni E, Vascular and Endovascular Surgery, 2017, Vol. 51(4)
13 Conclusion from randomized trials Mechanical thrombectomy significantly increases the benefit of thrombolysis in patients with large vessel occlusion There is no increased bleeding risk No other safety issues The evidence for thrombectomy in acute stroke is stronger than for any other cardiovascular intervention
14 Nine randomized trials have proven that mechanical thrombectomy is superior to standard of care There is no other interventional technique which has that level of evidence But this evidence coming from randomized trials is nothing against the evidence coming from individual patients
15 Case Example
16 The case: R.O., born yrs old girl Lives in a small village close to Frankfurt with her parents and a dog named "Buzzi" Goes to high school, 10th grade Would like to study medicine - but she is not sure whether she can make it Tuesday, Aug 11, 2015 was her destiny day
17 R.O., born 1998 In the evening of Aug 11, she suffered from sudden weakness of her right arm followed by complete hemiparesis Awake but could not speak Her mother with the help of neighbors managed to bring her to the ER of the Sankt Katharinen Hospital
18 R.O., born 1998 Complete hemiplegic at the time of arrival Could not speak CT showed (still) normal findings CT angio: left MCA occluded Door to lysis time 22 min But no improvement Discussion with the mother about the options.
19 Neuro called me at 10:09pm: "Big stroke, 16 yrs old! Can you help? "Please wait here - I will come to you later "
20 10:12pm Arrival in the cath lab
21 In this case it was a really difficult femoral puncture! First angio of left carotid - Carotid angiography is not much different from cannulating the subclavian artery for IMA angio! - MCA occluded
22 Exchange for an 8F Cello balloon tipped guide Groin hematoma due to difficult puncture + lytics Someone had to compress
23 Microcatheter REBAR-027 Coronary Whisper wire MS 0.014" Like a very tortious right coronary artery, vessels are very fragile like an ulcerated plaque "Please do not move your head, look straight ahead"
24 10:34pm 25min after the initial call Whisper wire inside of a microcatheter in front of the MCA occlusion
25 Preparation of a 6x30 mm Solitaire
26 Tip of the microcatheter is in a distal branch Deployment of 6x30 mm Solitaire Like unsheathing a selfexpanding stent
27 10:43pm After deployment of the Solitaire
28 33 min after the initial call "Ich kann wieder sprechen!!!!" "I can speak again!!!!"
29 10:45pm 36 min after the initial call Please move your right hand! Yes, very good!
30 Aspiration with a big syringe and Solitaire retrieval Deflation of the Cello balloon
31 Small clot big event
32 Final angio
33 before after
34 45 min after the initial call Hands up again, straight up! Now turn your hands upwards like this! Close your eyes! I can not do it because this hurts me! That was very good!
35 R.O., born 1998 Complete recovery! We do not know whether she will make it into medical school But if not, it will not be due to her stroke In any case, she will have an otherwise normal life
36 Thank you for your time!
Avoiding and Managing Complications During CAS: Lessons Learned
LINC 2019 Leipzig, Germany, Jan 22-25, 2019 Avoiding and Managing Complications During CAS: Lessons Learned Horst Sievert, Ilona Hofmann, Kolja Sievert, Laura Vaskelyte, Sameer Gafoor, Stefan Bertog, Predrag
UPDATES IN INTRACRANIAL INTERVENTION Jordan Taylor DO Metro Health Neurology 2015
UPDATES IN INTRACRANIAL INTERVENTION Jordan Taylor DO Metro Health Neurology 2015 NEW STUDIES FOR 2015 MR CLEAN ESCAPE EXTEND-IA REVASCAT SWIFT PRIME RECOGNIZED LIMITATIONS IV Alteplase proven benefit
Mechanical Thrombectomy of Large Vessel Occlusions Using Stent Retriever Devices
Mechanical Thrombectomy of Large Vessel Occlusions Using Stent Retriever Devices Joey English MD, PhD Medical Director, Neurointerventional Services California Pacific Medical Center Hospitals, San Francisco,
Mechanical thrombectomy in Plymouth. Will Adams. Will Adams
Mechanical thrombectomy in Plymouth Will Adams Will Adams History Intra-arterial intervention 1995 (NINDS) iv tpa improved clinical outcome in patients treated within 3 hours of ictus but limited recanalisation
Mechanical Thrombectomy: Where Are We Now? T. Adam Oliver, MD Tallahassee Neurological Clinic Tallahassee, Florida TMH Neurosymposium June 11, 2016
Mechanical Thrombectomy: Where Are We Now? T. Adam Oliver, MD Tallahassee Neurological Clinic Tallahassee, Florida TMH Neurosymposium June 11, 2016 none DISCLOSURES Where did we come from? Spiotta, et
Endovascular Treatment for Acute Ischemic Stroke
ular Treatment for Acute Ischemic Stroke Vishal B. Jani MD Assistant Professor Interventional Neurology, Division of Department of Neurology. Creighton University/ CHI health Omaha NE Disclosure None 1
Endovascular Neurointervention in Cerebral Ischemia
Endovascular Neurointervention in Cerebral Ischemia Beyond Thrombolytics Curtis A. Given II, MD Co-Director, Neurointerventional Services Baptist Physician Lexington 72 y/o female with a recent diagnosis
BGS Spring Conference 2015
Neuroradiology in hyperacute stroke: what is the UK position? Dr Shelley Renowden Bristol NICE HIS July, 2013 The current evidence on mechanical clot retrieval for treating acute ischaemic stroke shows
Strokecenter Key lessons of MR CLEAN study
Strokecenter Key lessons of MR CLEAN study Diederik Dippel Disclosures Funded by the Dutch Heart Foundation Nominal, unrestricted grants from AngioCare BV Medtronic/Covidien/EV3 MEDAC Gmbh/LAMEPRO Penumbra
Preliminary Results of RETREAT
LINC 2015 Leipzig, Germany, Jan 27-30, 2015 Preliminary Results of RETREAT (Renal Denervation with Ultrasound After Failed Radiofrequency Denervation) Horst Sievert, Jan Philipp Kulow, Stefan Bertog, Predrag
Endovascular Stroke Therapy
Endovascular Stroke Therapy Update with Emphasis on Practical Clinical and Imaging Considerations Sachin Kishore Pandey, MD, FRCPC Disclosures I have no relevant financial disclosures or conflict of interest
Neuro-vascular Intervention in Stroke. Will Adams Consultant Neuroradiologist Plymouth Hospitals NHS Trust
Neuro-vascular Intervention in Stroke Will Adams Consultant Neuroradiologist Plymouth Hospitals NHS Trust Stroke before the mid 1990s Swelling Stroke extension Haemorrhagic transformation Intravenous thrombolysis
Stroke Update Elaine J. Skalabrin MD Medical Director and Neurohospitalist Sacred Heart Medical Center Stroke Center
Stroke Update 2015 Elaine J. Skalabrin MD Medical Director and Neurohospitalist Sacred Heart Medical Center Stroke Center Objectives 1. Review successes in systems of care approach to acute ischemic stroke
Acute Stroke Treatment: Current Trends 2010
Acute Stroke Treatment: Current Trends 2010 Helmi L. Lutsep, MD Oregon Stroke Center Oregon Health & Science University Overview Ischemic Stroke Neuroprotectant trials to watch for IV tpa longer treatment
A case of mislabeled textbooks: misnomer of the traditional "bicaval" view.
Providence St. Joseph Health Providence St. Joseph Health Digital Commons Journal Articles and Abstracts 8-1-2018 A case of mislabeled textbooks: misnomer of the traditional "bicaval" view. Laura Vaskelyte
Disclosure. Advances in Interventional Neurology. Disclosure. Natural History of Disease 3/15/2018. Vishal B. Jani MD
Advances in Interventional Neurology Disclosure Vishal B. Jani MD Medical Director Vascular Neurology Consultant Interventional Neurology CHI Health Assistant Professor, Creighton University School of
Endovascular Treatment for Acute Ischemic Stroke: Curtis A. Given II, MD Co-Director, Neurointerventional Services Baptist Physician Lexington
Endovascular Treatment for Acute Ischemic Stroke: Curtis A. Given II, MD Co-Director, Neurointerventional Services Baptist Physician Lexington Disclosures: SWIFT PRIME site (Medtronic) Physician Proctor
Interventional Stroke Treatment
Interventional Stroke Treatment Vishal B. Jani MD Medical Director Vascular Neurology Consultant Interventional Neurology CHI Health Assistant Professor, Creighton University School of Medicine Omaha,
How to Interpret CT/CTA for Acute Stroke in the Age of Endovascular Clot Retrieval
How to Interpret CT/CTA for Acute Stroke in the Age of Endovascular Clot Retrieval Peter Howard MD FRCPC Disclosures No conflicts to disclose How to Interpret CT/CTA for Acute Stroke in the Age of Endovascular
Patient selection for i.v. thrombolysis and thrombectomy
3 rd Congress of the European Academy of Neurology Amsterdam, The Netherlands, June 24 27, 2017 Teaching Course 8 Acute treatment and early secondary prevention of stroke Level 2 Patient selection for
Distal Mechanical Thrombectomy in Acute Ischemic Stroke Method and Benefit. Hans Henkes, Wiebke Kurre Stuttgart, Germany
Distal Mechanical Thrombectomy in Acute Ischemic Stroke Method and Benefit Hans Henkes, Wiebke Kurre Stuttgart, Germany 1 Thrombectomy... with stent-retrievers is an evidence based therapy for intracranial
Latest Advances in the Neurointerventional Treatment of Ischemic Stroke P A C I F I C N E U R O. O R G
Latest Advances in the Neurointerventional Treatment of Ischemic Stroke Neurointerventional Management of Ischemic Stroke 1. Thrombectomy for acute ischemic stroke 2. Carotid artery stenting 3. Management
5/31/2018. Interventional Therapies that Expand Time Windows for Acute Ischemic Stroke Treatment. Disclosures. Impact of clot burden
Good Outcome (%) Rankin 0-2 at 90 days 5/31/2018 Interventional Therapies that Expand Time Windows for Acute Ischemic Stroke Treatment Disclosures Cerenovus: I am on Executive Committee for ARISE2 Trial
Broadening the Stroke Window in Light of the DAWN Trial
Broadening the Stroke Window in Light of the DAWN Trial South Jersey Neurovascular and Stroke Symposium April 26, 2018 Rohan Chitale, MD Assistant Professor of Neurological Surgery Vanderbilt University
Mechanical thrombectomy beyond the 6 hours. Mahmoud Rayes, MD Medical Director, Stroke program Greenville Memorial Hospital
Mechanical thrombectomy beyond the 6 hours Mahmoud Rayes, MD Medical Director, Stroke program Greenville Memorial Hospital Disclosures None Worldwide statistics 1 IN 6 people will have a stroke at some
Endovascular Treatment Updates in Stroke Care
Endovascular Treatment Updates in Stroke Care Autumn Graham, MD April 6-10, 2017 Phoenix, AZ Endovascular Treatment Updates in Stroke Care Autumn Graham, MD Associate Professor of Clinical Emergency Medicine
Stroke Clinical Trials Update Transitioning to an Anatomic Diagnosis in Ischemic Stroke
Stroke Clinical Trials Update Transitioning to an Anatomic Diagnosis in Ischemic Stroke Alexander A. Khalessi MD MS Director of Endovascular Neurosurgery Surgical Director of NeuroCritical Care University
Case 1 5/26/2017 ENDOVASCULAR MECHANICAL THROMBECTOMY IN PATIENTS WITH ACUTE ISCHEMIC STROKE
ENDOVASCULAR MECHANICAL THROMBECTOMY IN PATIENTS WITH ACUTE ISCHEMIC STROKE Rhonda Whiteman Racing Against the Clock Workshop June 1, 2017 Objectives To discuss the hyperacute ischemic stroke management
Parameter Optimized Treatment for Acute Ischemic Stroke
Heart & Stroke Barnett Memorial Lectureship and Visiting Professorship Parameter Optimized Treatment for Acute Ischemic Stroke December 2, 2016, Thunder Bay, Ontario Adnan I. Qureshi MD Professor of Neurology,
ENDOVASCULAR THERAPIES FOR ACUTE STROKE
ENDOVASCULAR THERAPIES FOR ACUTE STROKE Cerebral Arteriogram Cerebral Anatomy Cerebral Anatomy Brain Imaging Acute Ischemic Stroke (AIS) Therapy Main goal is to restore blood flow and improve perfusion
Drano vs. MR CLEAN Review of New Endovascular Therapy for Acute Ischemic Stroke Patients
Drano vs. MR CLEAN Review of New Endovascular Therapy for Acute Ischemic Stroke Patients Peter Panagos, MD, FACEP, FAHA Associate Professor Emergency Medicine and Neurology Washington University School
Creation of an Arteriovenous Fistula to Treat Hypertension
Creation of an Arteriovenous Fistula to Treat Hypertension Horst Sievert, Ilona Hofmann, Laura Vaskelyte, Sameer Gafoor, Stefan Bertog, Predrag Matić, Markus Reinartz, Bojan Jovanovic, Kolja Sievert CardioVascular
Mechanical Endovascular Reperfusion Therapy
Get With the Guidelines Stroke Mechanical Endovascular Reperfusion Therapy February 1, 2017 Speaker Lee H. Schwamm, MD Executive Vice Chairman and Director of Stroke/TeleStroke Services, Department of
Comparison of Five Major Recent Endovascular Treatment Trials
Comparison of Five Major Recent Endovascular Treatment Trials Sample size 500 # sites 70 (100 planned) 316 (500 planned) 196 (833 estimated) 206 (690 planned) 16 10 22 39 4 Treatment contrasts Baseline
Interventional Neuroradiology. & Stroke INR PROCEDURES INR PROCEDURES. Dr Steve Chryssidis. 25-Sep-17. Interventional Neuroradiology
Interventional Neuroradiology Interventional Neuroradiology & Stroke Dr Steve Chryssidis Interventional Neuroradiology (INR) is a subspecialty within Radiology INR -- broadly defined as treatment by endovascular
Endovascular Treatment for Acute Ischemic Stroke: Considerations from Recent Randomized Trials
Published online: March 13, 2015 1664 9737/15/0034 0115$39.50/0 Review Endovascular Treatment for Acute Ischemic Stroke: Considerations from Recent Randomized Trials Manabu Shirakawa a Shinichi Yoshimura
The DAWN of a New Era for Wake-up Stroke
The DAWN of a New Era for Wake-up Stroke Alan H. Yee, D.O. Stroke and Critical Care Neurology Department of Neurology University of California Davis Medical Center Objectives Review Epidemiology and Natural
Significant Relationships
Opening Large Vessels During Acute Ischemic Stroke Significant Relationships Wade S Smith, MD, PhD Director UCSF Neurovascular Service Professor of Neurology Daryl R Gress Endowed Chair of Neurocritical
Role of Imaging in Complex LAA Closure Anatomies
Role of Imaging in Complex LAA Closure Anatomies Sameer Gafoor 1,2 1 Swedish Heart and Vascular: Ming Zhang, Paul Huang, Darryl Wells, Adam Zivin, John Petersen II, Madalena Petrescu, Nimish Muni, Eric
Advances in Neuro-Endovascular Care for Acute Stroke
Advances in Neuro-Endovascular Care for Acute Stroke Ciarán J. Powers, MD, PhD, FAANS Associate Professor Program Director Department of Neurological Surgery Surgical Director Comprehensive Stroke Center
SEE IT. BELIEVE IT. THE CONFIDENCE OF CLARITY. Solitaire Platinum. Revascularization Device
SEE IT. BELIEVE IT. THE CONFIDENCE OF CLARITY. Revascularization THE CONFIDENCE OF CLARITY. The key features that make the device effective have been retained including our unique Parametric overlapping
Size Matters: Differentiating Large Vessel Occlusion (LVO) and Small Vessel Occlusion (SVO) in Stroke
Size Matters: Differentiating Large Vessel Occlusion (LVO) and Small Vessel Occlusion (SVO) in Stroke Charles E. Romero, M.D. UPMC Hamot Great Lakes Neurosurgery & Neurointervention Case 1 83 yo RH F with
Acute Stroke Management What is State of the Art?
Acute Stroke Management What is State of the Art? Karl-Titus Hoffmann Department of Neuroradiologie University of Leipzig / University Hospital Leipzig Disclosure Speaker name: Karl-Titus Hoffmann I have
A DIRECT ASPIRATION FIRST PASS TECHNIQUE (ADAPT) IN PATIENTS WITH ACUTE ISCHEMIC STROKE
A DIRECT ASPIRATION FIRST PASS TECHNIQUE (ADAPT) IN PATIENTS WITH ACUTE ISCHEMIC STROKE Hocine REDJEM Raphaël BLANC Bertrand LAPERGUE Gabriele CICCIO Stanislas SMAJDA Mikael MAZIGHI Georges RODESCH Michel
ACUTE STROKE INTERVENTION: THE ROLE OF THROMBECTOMY AND IA LYSIS
Associate Professor of Neurology Director of Neurointerventional Services University of Louisville School of Medicine ACUTE STROKE INTERVENTION: THE ROLE OF THROMBECTOMY AND IA LYSIS Conflict of Interest
New Stroke Interventions. Scott L. Zuckerman M.D. Vanderbilt Neurosurgery
New Stroke Interventions Scott L. Zuckerman M.D. Vanderbilt Neurosurgery Agenda Clot Retrieval Devices Merci Penumbra Stent Retrievers Solitaire Trevo New Technology Funnel ReCover MERCI Retriever (2004)
Vivek R. Deshmukh, MD Director, Cerebrovascular and Endovascular Neurosurgery Chairman, Department of Neurosurgery Providence Brain and Spine
Vivek R. Deshmukh, MD Director, Cerebrovascular and Endovascular Neurosurgery Chairman, Department of Neurosurgery Providence Brain and Spine Institute The Oregon Clinic Disclosure I declare that neither
From interventional cardiology to cardio-neurology. A new subspeciality
From interventional cardiology to cardio-neurology. A new subspeciality in the future? Prof. Andrejs Erglis, MD, PhD Pauls Stradins Clinical University Hospital University of Latvia Riga, LATVIA Disclosure
Single Pass MCA Revascularization with Trevo
Single Pass MCA Revascularization with Trevo By Concentric Medical ProVueTM Retriever Case Reported By Sascha Prothmann, MD Klinikum rechts der Isar, Munich, Germany Images contained herein courtesy of
Early Clinical Experience with 5 MAX ACE- A New Clot Extrac8on Device
Early Clinical Experience with 5 MAX ACE- A New Clot Extrac8on Device Sophia Janjua, Jeffrey Farkas, Karthekiyan Arcot, Rajesh Kumar, Jean Delbrune, Nikolaos Papamitsakis, Yevgeny Margulis, Kenneth A.
Evidence for Mechanical ThrombectomyFor Acute Ischemic Stroke. Kenneth V Snyder MD PhD SUNY Buffalo, NY
Evidence for Mechanical ThrombectomyFor Acute Ischemic Stroke Kenneth V Snyder MD PhD SUNY Buffalo, NY Disclosure Speaker name:... I have the following potential conflicts of interest to report: Honorarium
Acute Stroke Identification and Treatment
Acute Stroke Identification and Treatment James S. McKinney, MD, FAHA Medical Director, NHRMC Stroke Center SE NC is located in the buckle of the Stroke Belt, seeing the highest stroke incidence and mortality
Update on Early Acute Ischemic Stroke Interventions
Update on Early Acute Ischemic Stroke Interventions Diana Goodman MD Lead Neurohospitalist Maine Medical Center Assistant Professor of Neurology, Tufts University School of Medicine I have no disclosures
Endovascular Treatment of Ischemic Stroke
Endovascular Treatment of Ischemic Stroke William Thorell, MD Associate Professor Neurosurgery UNMC Co-Director Stroke and Neurovascular Center Nebraska Medicine Overview Definitions of terms Review basic
ESCAPE Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times
ESCAPE Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times Michael D Hill, Mayank Goyal on behalf of the ESCAPE Trial
Supplementary Online Content
Supplementary Online Content Badhiwala JH, Nassiri F, Alhazzani W, et al. Endovascular Thrombectomy for Acute Ischemic Stroke: A Meta-analysis. JAMA. doi:10.1001/jama.2015.13767. etable 1. The modified
Solitaire FR Revascularization Device
Solitaire FR Revascularization Device FEATURING PARAMETRIC DESIGN Restore. Retrieve. Revive. 5 Revolutionizing Mechanical Thrombectomy with Parametric Design Solitaire FR Device The Solitaire FR revascularization
ACUTE ISCHEMIC STROKE. Current Treatment Approaches for Acute Ischemic Stroke
ACUTE ISCHEMIC STROKE Current Treatment Approaches for Acute Ischemic Stroke EARLY MANAGEMENT OF ACUTE ISCHEMIC STROKE Rapid identification of a stroke Immediate EMS transport to nearest stroke center
Code Stroke Intervention: Endovascular Therapies for Stroke J. DIEGO LOZANO MD INTERVENTIONAL NEURORADIOLOGY
Code Stroke Intervention: Endovascular Therapies for Stroke J. DIEGO LOZANO MD INTERVENTIONAL NEURORADIOLOGY Disclosures None Part A. Objectives Epidemiology of AIS and of ELVO Concept: Acute Ischemic
Acute Stroke Rescue and Recovery
Acute Stroke Rescue and Recovery Qaisar A. Shah, MD Director, Neurointerventional and Neurocritical care Nancy Arena Gogal,, RN Manager Cath/EPS/Neuro lab AMH Stroke Program Evolution 1997: Stroke Program
Stroke: The First Critical Hour. Alina Candal, RN, PCC, MICN Kevin Andruss, MD, FACEP
Stroke: The First Critical Hour Alina Candal, RN, PCC, MICN Kevin Andruss, MD, FACEP Disclosures We have no actual or potential conflicts of interest in relation to this presentation. Objectives Discuss
Acute stroke update 2016 innovations in managing ischemic and hemorrhagic disease
Acute stroke update 2016 innovations in managing ischemic and hemorrhagic disease Christopher Koebbe, MD Endovascular Neurosurgeon Florida Spine Institute Director of Neurosciences Northside Hospital Overview
MEET 2007: Evaluation and treatment of the stroke and TIA patient for the non-neurointerventionist. neurointerventionist
MEET 2007: Evaluation and treatment of the stroke and TIA patient for the non-neurointerventionist neurointerventionist Steve Ramee, MD Ochsner Medical Center New Orleans DISCLOSURE Nothing Nothing to
ORIGINAL RESEARCH. Gabriel A. Vidal, MD, 1,2 James M. Milburn, MD 3
ORIGINAL RESEARCH Ochsner Journal 16:486 491, 2016 Ó Academic Division of Ochsner Clinic Foundation The Penumbra 5MAX ACE Catheter Is Safe, Efficient, and Cost Saving as a Primary Mechanical Thrombectomy
57y WRH woman, controlled HTN only, presents with sudden LOC, fixed and dilated, quadraplegic Intubated on arrival and CT is negative CTA and CTP
Case # 1 Hx 57y WRH woman, controlled HTN only, presents with sudden LOC, fixed and dilated, quadraplegic Intubated on arrival and CT is negative CTA and CTP show left PCA occlusion, some basilar stenosis,
Devices and Long-Term Outcomes of Renal Denervation for Hypertension
18th ANGIOPLASTY SUMMIT-TCTAP 2013 Seoul, Korea, April 23-26, 2013 Devices and Long-Term Outcomes of Renal Denervation for Hypertension Horst Sievert, Ilona Hofmann, Laura Vaskelyte, Stefan Bertog, Simon
Better identification of patients who may benefit from therapy
Jon Jui MD, MPH Large Vessel Occlusion Low rates of re-canalization after tpa Only 25 % of large vessel strokes re-canalization after tpa Newer invasive techniques Solitaire vs Merci Better identification
Acute Management of Stroke due to Intracranial Steno-occlusion. Joon-Tae Kim, MD, PhD Department of Neurology Chonnam National University Hospital
Acute Management of Stroke due to Intracranial Steno-occlusion Joon-Tae Kim, MD, PhD Department of Neurology Chonnam National University Hospital None Disclosure Contents Current status of acute management
Quality Metrics. Stroke Related Procedure Outcomes
Quality Metrics Stroke Related Procedure Outcomes Below is a description of some of the stroke-related procedures performed at St. Dominic Hospital in Jackson, with quality information on the complication
Further Pragmatic Trials of Thrombectomy are Needed
Further Pragmatic Trials of Thrombectomy are Needed Prof Keith W Muir Institute of Neuroscience & Psychology University of Glasgow Institute of Neurological Sciences Queen Elizabeth University Hospital
Interventional Treatment of Stroke
Interventional Treatment of Stroke Andrew F. Ducruet, MD Barrow Neurological Institute 2018 BNI Stroke Rehab Symposium October 13, 2018 Disclosures Consultant: Medtronic, Penumbra, Cerenovus Lecture Overview
AHA/ASA Guideline. Downloaded from by on November 7, 2018
AHA/ASA Guideline 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular
ICCA Carotid Angioplasty and Other Cerebrovascular Interventions. Preliminary Scientific Program as of September 2011
ICCA 2011 Carotid Angioplasty and Other Cerebrovascular Interventions October 21 22, 2011 Wiesbaden Germany With Live Cases Preliminary Scientific Program as of September 2011 www.iccaonline.org Scientific
Endovascular Clot Retrieval. Teddy Wu Neurologist (and Stroke enthusiast) Christchurch Hospital
Endovascular Clot Retrieval Teddy Wu Neurologist (and Stroke enthusiast) Christchurch Hospital Something you can do tomorrow Melbourne half marathon 2016 In 2009 Simple approach to stroke - blocked artery,
Advances in Acute stroke Management
Advances in Acute stroke Management Sandra Ripper-Brown, DNP Neuroscience Nurse Practitioner St. Mary s Medical Center WPB, FL Palm Beach County Nurse Practitioner Council Annual Conference APRNs: Agents
Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, Munich, Germany 2
The Scientific World Journal Volume 212, Article ID 19763, 7 pages doi:1.11/212/19763 The cientificworldjournal Clinical Study The Phenox Clot Retriever as Part of a Multimodal Mechanical Thrombectomy
Acute Stroke Treatment KPNC Stroke EXPRESS
Acute Stroke Treatment 2018 KPNC Stroke EXPRESS EXpediting the PRocess of Evaluating & Stopping Stroke 1 Jeffrey G. Klingman, MD The Permanente Medical Group Stroke Treatment in the old days Prior to 1996:
Pr Roman Sztajzel Service de Neurologie HUG
Pr Roman Sztajzel Service de Neurologie HUG Conflict of interest: none IV THROMBOLYSIS AND ENDOVASCULAR THROMBECTOMY approved treatments of acute stroke main criteria time (delay) IV thrombolysis radiological
Basilar artery stenosis with bilateral cerebellar strokes on coumadin
Qaisar A. Shah, MD Patient Profile 68 years old female with a history of; Basilar artery stenosis with bilateral cerebellar strokes on coumadin Diabetes mellitus Hyperlipidemia Hypertension She developed
ACUTE ISCHEMIC STROKE
ENDOVASCULAR MECHANICAL THROMBECTOMY IN PATIENTS WITH ACUTE ISCHEMIC STROKE HHS Stroke Annual Review March 7 and March 8, 2018 Objectives To review the stroke endovascular mechanical thrombectomy evidence
Managing the Measures: A Serious Look at Key Abstraction Concepts for the Comprehensive Stroke (CSTK) Measure Set Session 2
Managing the Measures: A Serious Look at Key Abstraction Concepts for the Comprehensive Stroke (CSTK) Measure Set Session 2 January 28, 2015 1 to 3 PM Central Time Continuing Education Credit This course
UNIVERSITY HOSPITAL UDINE/ITALY A SINGLE CENTRE EXPERIENCE IN STROKE TREATMET WITH EMBOTRAP II. TECHNOLOGY BASE ON CLOT RESEARCH
UNIVERSITY HOSPITAL UDINE/ITALY A SINGLE CENTRE EXPERIENCE IN STROKE TREATMET WITH EMBOTRAP II. TECHNOLOGY BASE ON CLOT RESEARCH Massimo Sponza, Vladimir Gavrilović RIPERFUSION THERAPY Intraovenous thrombolysis
ANGIOPLASTY AND STENTING
ANGIOPLASTY AND STENTING What is angioplasty and stenting? During an angioplasty, your vascular surgeon inflates a small balloon inside a narrowed blood vessel. This balloon helps to widen your blood vessel
2017 Cardiology Survival Guide
2017 Cardiology Survival Guide Chapter 2: Angioplasty/Atherectomy/Stent The term angioplasty literally means "blood vessel repair." During an angioplasty procedure, the physician inserts a catheter, with
Supplementary Online Content
Supplementary Online Content Lapergue B, Blanc R, Gory B, et al; ASTER Trial Investigators. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic
Endovascular Therapy for Acute Ischaemic Stroke in Northern Ireland. Ian Rennie Interventional Neurologist On behalf of the Belfast trust stroke team
Endovascular Therapy for Acute Ischaemic Stroke in Northern Ireland Ian Rennie Interventional Neurologist On behalf of the Belfast trust stroke team Belfast Team Evidence base we rely on ESCAPE trial Acute
Figures for Draft Response to IMS III, MR RESCUE, and SYNTHSESIS Trials
Figures for Draft Response to IMS III, MR RESCUE, and SYNTHSESIS Trials Figure 1: Lay Press Judgment May Belie a Deeper Examination of the Data. Truman ultimately defeated Dewey for the Presidency Subject
Why I m afraid of occlusive devices
Why I m afraid of occlusive devices Cannes 28.06.2008 Carlo Cernetti Cardiology Department Mirano (Venice) MEET 2008 CANNES I HAVE NOT FINACIAL INTEREST/ARRANGEMENT OR AFFILIATION CONFLICT Obstructive
Extra- and intracranial tandem occlusions in the anterior circulation - clinical outcome of endovascular treatment in acute major stroke.
Extra- and intracranial tandem occlusions in the anterior circulation - clinical outcome of endovascular treatment in acute major stroke. Poster No.: C-1669 Congress: ECR 2014 Type: Scientific Exhibit
Volume 13 - Issue 3, Interventions
Volume 13 - Issue 3, 2013 - Interventions Interventional Radiology And Stroke Therapy Authors Dr. Leo Lawler Dr. Matt Crockett Dr. Eoin Kavanagh Prof. Sean Murphy Stroke Physician Mater Misericordiae University
Disclosures. Current Management of Acute Ischemic Stroke. Overview. Focal brain ischemia. Nerissa U. Ko, MD, MAS Professor of Neurology May 8, 2015
Disclosures Current Management of Acute Ischemic Nerissa U. Ko, MD, MAS Professor of Neurology May 8, 2015 Nothing to disclose Research Funding: American Heart Association NIH/NINDS Selected slides courtesy
Acute Ischemic Stroke Imaging. Ronald L. Wolf, MD, PhD Associate Professor of Radiology
Acute Ischemic Stroke Imaging Ronald L. Wolf, MD, PhD Associate Professor of Radiology Title of First Slide of Substance An Illustrative Case 2 Disclosures No financial disclosures Off-label uses of some
Endovascular therapy using mechanical thrombectomy devices for treatment of patients with ischaemic stroke
Evidence Note 87 December 2018 In response to enquiry from the Thrombectomy Advisory Group Endovascular therapy using mechanical thrombectomy devices for treatment of patients with ischaemic stroke Questions
Limitations of thrombolysis, including low recanalization
ORIGINAL RESEARCH Solitaire Flow-Restoration Device for Treatment of Acute Ischemic Stroke: Safety and Recanalization Efficacy Study in a Swine Vessel Occlusion Model R. Jahan BACKGROUND AND PURPOSE: The
Disclosures. Anesthesia for Endovascular Treatment of Acute Ischemic Stroke. Acute Ischemic Stroke. Acute Stroke = Medical Emergency!
Disclosures Anesthesia for Endovascular Treatment of Acute Ischemic Stroke I have nothing to disclose. Chanhung Lee MD, PhD Associate Professor Anesthesia and perioperative Care Acute Ischemic Stroke 780,000
1/19/2018. Endovascular Therapy for Stroke
Endovascular Therapy for Stroke 1 PROACT II (1999, IA urokinase)first to demonstrate benefit of EST Newer trials (including MERCI in 2005) demonstrated vessel recanalization but no clinical benefit 2 Based
RadRx Your Prescription for Accurate Coding & Reimbursement Copyright All Rights Reserved.
Interventional Radiology Coding Case Studies Prepared by Stacie L. Buck, RHIA, CCS-P, RCC, CIRCC, AAPC Fellow President & Senior Consultant Week of June 4, 2018 Thrombolysis, Thrombectomy & Angioplasty
MR RESCUE: Primary Results
MR RESCUE: Primary Results (Mechanical Retrieval and REcanalization of Stroke Clots Using Embolectomy) Funded by NIH-NINDS UCLA SPOTRIAS Grant: P50 NS044378 Clinical Trials.gov Number NCT00389467 FDA IDE
Thrombectomy with the preset stent-retriever. Insights from the ARTESp* trial
Thrombectomy with the preset stent-retriever Insights from the ARTESp* trial Wiebke Kurre, MD Klinikum Stuttgart - Germany * Acute Recanalization of Thrombo-Embolic Ischemic Stroke with preset (ARTESp)
Stroke Imaging Basics. Jeremy Hopkin M.D.
Stroke Imaging Basics Jeremy Hopkin M.D. Goals Introduce the basic physical properties of imaging used in stroke. Understand why each modality is used in the setting of stroke. Understand some strengths