Microcatheter contrast injections during intra-arterial thrombolysis increase intracranial hemorrhage risk.

Abstract:

BACKGROUND AND PURPOSE:Combined analysis of the Interventional Management of Stroke I and II trials demonstrated a significant association between microcatheter contrast injections and both intracranial hemorrhage (ICH) and contrast extravasation following combined intravenous (IV) and intra-arterial (IA) thrombolysis. The reliability of these observations was tested in our local registry of IA cases. DESIGN/METHODS:Treatment angiograms and post-procedure CTs of patients treated with combined IV/IA or IA only recombinant tissue plasminogen activator for ICA-T, M1 or M2 occlusions (n=77) were reviewed. The number of microcatheter injections (MCIs) within/distal to the target occlusion was assigned for every case. The association of MCIs to total ICH, total parenchymal hematoma (PH1+PH2) and PH2 after adjusting for significant covariates was tested. RESULTS:MCIs were used in 21 (27%) cases (range MCI 0-6). Any ICH occurred in 38 (49%) cases, including eight (10%) PH1s and eight (10%) PH2s. The use of MCIs was associated with increased PH (p=0.04), PH2 (p=0.07) and total ICH (p=0.03). MCIs were associated with increased contrast extravasation (CEx) (p=0.02). ICH was observed in all CEx cases (n=5, 100% vs 46% non-CEx; p=0.03), and four (80%) CEx cases developed PH2s (p<0.01). MCIs remained associated with total ICH after adjustment for significant covariates of Thromolysis in Cerebral Infarction score, glucose level and presence of atrial fibrillation (OR 3.60; 95% CI 1.12 to 11.49, p=0.03). MCI use was the only significantly associated covariate for total PHs. CONCLUSIONS:MCI use was associated with ICH and with clinically significant PHs in this cohort, providing further evidence that MCIs be reduced during IA thrombolysis.

journal_name

J Neurointerv Surg

authors

Khatri R,Khatri P,Khoury J,Broderick J,Carrozzella J,Tomsick T

doi

10.1136/jnis.2009.000794

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

115-9

issue

2

eissn

1759-8478

issn

1759-8486

pii

jnis.2009.000794

journal_volume

2

pub_type

杂志文章
  • Creation of sidewall aneurysm in rabbits: aneurysm patency and growth follow-up.

    abstract:INTRODUCTION:To explore the patency and growth of surgical sidewall aneurysms in rabbits. MATERIALS AND METHODS:Forty sidewall aneurysms were created in the right common carotid artery (RCCA). Intravenous digital subtraction angiography (DSA) through the ear vein was performed immediately after creation. Three weeks l...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2012-010575

    authors: Ding YH,Tieu T,Kallmes DF

    更新日期:2014-01-01 00:00:00

  • Transvenous embosurgery of a left sigmoid sinus dural arteriovenous fistula via a retrograde approach from the superior ophthalmic vein, cavernous and inferior petrosal sinuses.

    abstract::The efficacy and safety of transvenous embosurgery for sigmoid sinus dural arteriovenous fistula (DAVF) using the internal jugular vein approach is well known. Embosurgery of cavernous sinus DAVF has also been described utilizing a superior ophthalmic vein approach. The first report of a sigmoid sinus DAVF endosurgica...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/jnis.2010.003848

    authors: Patel DV,Rangaswamy R,Lesley WS,Hester JL,McDonald DK,Tsai JH

    更新日期:2011-09-01 00:00:00

  • Rates of local procedural-related structural injury following clipping or coiling of anterior communicating artery aneurysms.

    abstract:BACKGROUND:Surgical clipping and endovascular coiling yield similar functional outcomes for the treatment of saccular aneurysms of the anterior communicating (ACOM) artery. However, surgical treatment may be associated with greater rates of cognitive impairment due to injury of adjacent structures. We aimed to quantify...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1136/neurintsurg-2014-011620

    authors: Mortimer AM,Steinfort B,Faulder K,Erho T,Scherman DB,Rao PJ,Harrington T

    更新日期:2016-03-01 00:00:00

  • Endovascular treatment of extracranial atherosclerotic disease involving the vertebral artery origins: a comparison of drug-eluting and bare-metal stents.

    abstract:OBJECTIVE:To determine whether drug-eluting (DE) stents offer any advantage over bare-metal (BM) stents in terms of restenosis rates and to identify indications for vertebral artery stenting (VAS) based on the current literature. METHODOLOGY:A retrospective analysis was performed for patients who underwent extracrania...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2011-010051

    authors: Raghuram K,Seynnaeve C,Rai AT

    更新日期:2012-05-01 00:00:00

  • The bihemispheric posterior interior cerebellar artery: anatomic variations and clinical relevance in 11 cases.

    abstract:PURPOSE:Although the anatomic course of the posterior interior cerebellar artery (PICA) is variable, it is thought to be very rare for the artery to cross midline, with an estimated incidence of 0.1%. Bihemispheric PICA crosses midline and typically serves both PICA territories. METHODS:We present 11 cases of bihemisp...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2012-010527

    authors: Carlson AP,Alaraj A,Dashti R,Aletich VA

    更新日期:2013-11-01 00:00:00

  • Correlation of AOL recanalization, TIMI reperfusion and TICI reperfusion with infarct growth and clinical outcome.

    abstract:OBJECTIVE:To understand how three commonly used measures of endovascular therapy correlate with clinical outcome and infarct growth. METHODS:Prospectively enrolled patients underwent baseline MRI and started endovascular therapy within 12 h of stroke onset. The final angiogram was given a primary arterial occlusive le...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2013-010973

    authors: Marks MP,Lansberg MG,Mlynash M,Kemp S,McTaggart R,Zaharchuk G,Bammer R,Albers GW,DEFUSE 2 Investigators.

    更新日期:2014-12-01 00:00:00

  • Early carotid angioplasty and stenting may offer non-inferior treatment for symptomatic cases of carotid artery stenosis.

    abstract:OBJECTIVE:Early intervention is desirable in patients presenting with stroke or transient ischemic attack (TIA) referable to carotid artery stenosis because of the high incidence of recurrent ischemic events within 48 h post-ictus. However, the optimal timing of performing carotid angioplasty and stenting (CAS) in thes...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2013-010744

    authors: Wach MM,Dumont TM,Mokin M,Kass-Hout T,Snyder KV,Hopkins LN,Levy EI,Siddiqui AH

    更新日期:2014-05-01 00:00:00

  • Stent assisted coiling of the ruptured wide necked intracranial aneurysm.

    abstract:BACKGROUND:Stent assisted coiling of unruptured wide necked intracranial aneurysms require antiplatelets to prevent stent thrombosis. The effect of the loading dose of antiplatelets prior to the stent coiling procedure in an unsecured wide necked ruptured intracranial aneurysm is not known. OBJECTIVE:To report any pot...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2011-010035

    authors: Lodi YM,Latorre JG,El-Zammar Z,Swarnkar A,Deshaies E,Fessler RD

    更新日期:2012-07-01 00:00:00

  • Emergency medical systems education may improve knowledge of pre-hospital stroke triage protocols.

    abstract:BACKGROUND:Following the results of randomized clinical trials supporting the use of mechanical thrombectomy (MT) with tissue plasminogen activator for emergent large vessel occlusion (ELVO), our state Stroke Task Force convened to: update legislation to recognize differences between Primary Stroke Centers (PSCs) and C...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2018-014108

    authors: DiBiasio EL,Jayaraman MV,Oliver L,Paolucci G,Clark M,Watkins C,DeLisi K,Wilks A,Yaghi S,Hemendinger M,Baird GL,Oostema JA,McTaggart RA

    更新日期:2020-04-01 00:00:00

  • CT perfusion-guided patient selection for endovascular treatment of acute ischemic stroke is safe and effective.

    abstract:BACKGROUND:Traditional treatment in acute ischemic stroke is based on time criteria when administering intravenous and intra-arterial therapies. However, recent evidence suggests that image-based criteria may be useful for selecting patients for intra-arterial interventions. The use of CT perfusion (CTP)-based criteria...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2011-010067

    authors: Turk A,Magarik JA,Chaudry I,Turner RD,Nicholas J,Holmstedt CA,Chalela J,Hays A,Lazaridis C,Jauch E,Chimowitz M,Turan T,Adams R

    更新日期:2012-07-01 00:00:00

  • Endovascular management of torcular dural sinus malformations in children: the role of straight sinus occlusion.

    abstract:BACKGROUND:Torcular dural sinus malformations (tDSMs) with arteriovenous shunts are rare congenital intracranial vascular malformations that carry a high rate of neurologic impairment and death in the neonatal, infant and young pediatric population. Their impact on brain venous drainage, especially the deep venous syst...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2020-016888

    authors: Smajda S,Söderman M,Dorfmüller G,Dorison N,Nghe MC,Rodesch G

    更新日期:2020-11-16 00:00:00

  • Transfundal stent placement for treatment of complex basilar tip aneurysm: technical note.

    abstract::We describe a case where a complex unruptured basilar tip aneurysm was treated with a unique method of stent-assisted coil embolization. The aneurysm was considered to have a complex anatomy since both the left posterior cerebral artery and left superior cerebellar artery originated from the dome of the aneurysm. Also...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2014-011288.rep

    authors: Vasquez C,Hubbard M,Jagadeesan BD,Tummala RP

    更新日期:2015-10-01 00:00:00

  • Mechanical thrombectomy performs similarly in real world practice: a 2016 nationwide study from the Czech Republic.

    abstract:BACKGROUND:Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. METHODS:Available nationwide data for the CR ...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,meta分析

    doi:10.1136/neurintsurg-2017-013534

    authors: Volny O,Krajina A,Belaskova S,Bar M,Cimflova P,Herzig R,Sanak D,Tomek A,Köcher M,Rocek M,Padr R,Cihlar F,Nevsimalova M,Jurak L,Havlicek R,Kovar M,Sevcik P,Rohan V,Fiksa J,Menon BK,Mikulik R

    更新日期:2018-08-01 00:00:00

  • Improved outcomes with direct percutaneous CT guided lumbar synovial cyst treatment: advanced approaches and techniques.

    abstract:PURPOSE:To determine if lumbar synovial cyst rupture in symptomatic patients results in improved clinical outcome when using direct tandem and/or coaxial percutaneous CT guided techniques. MATERIALS AND METHODS:20 patients with unilateral lower extremity radiculopathy and/or low back pain underwent CT guided percutane...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2013-010891

    authors: Ortiz AO,Tekchandani L

    更新日期:2014-12-01 00:00:00

  • Republished: Intracranial pellet embolization: an endovascular endeavor.

    abstract::A 44-year-old man was referred to the neurointerventionalist 6 hours after sustaining a shotgun wound to the left chest, shoulder, and neck from 4 feet away. Physical examination of the chest showed a 5 cm × 5 cm gunshot entry wound on the anterior-superior aspect of the chest involving the supraclavicular and infracl...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2019-015301.rep

    authors: Hassan AE,Rabah RR,Tekle W

    更新日期:2020-02-01 00:00:00

  • The modified 'no touch' technique in the antegrade endovascular approach for left common carotid artery ostial stenosis stenting.

    abstract:BACKGROUND:Open surgery and the retrograde endovascular approach via the distal left common carotid artery (LCCA) have some limitations in LCCA ostial stenosis treatment. The 'no touch' technique used in the renal artery was modified for this situation. METHODS:Fifteen selective LCCA stenosis patients were treated by ...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2016-012544

    authors: Tang X,Long WA,Hu C,Tang F,Wang Q,Li L

    更新日期:2017-02-01 00:00:00

  • Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling.

    abstract:BACKGROUND AND PURPOSE:Microcatheterization is an important, but also difficult, technique used for the embolization of intracranial aneurysms. The purpose of this study was to investigate the application of three-dimensional (3D) printing technology in microcatheter shaping. METHODS:Nine cases of internal carotid art...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2019-015346

    authors: Xu Y,Tian W,Wei Z,Li Y,Gao X,Li W,Dong B

    更新日期:2020-03-01 00:00:00

  • Carotid revascularization treatment is shifting to low volume centers.

    abstract:BACKGROUND:Expansion of the endovascular and surgical workforce in the USA might lead to carotid revascularization procedures being carried out at low volume centers. OBJECTIVE:To evaluate trends in the treatment of carotid stenosis at high volume centers in the USA and compare outcomes by hospital volume. METHODS:Us...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2014-011180

    authors: Brinjikji W,Kallmes DF,Lanzino G,Cloft HJ

    更新日期:2015-05-01 00:00:00

  • Hemodynamic characteristics of stable and unstable vertebrobasilar dolichoectatic and fusiform aneurysms.

    abstract:BACKGROUND AND PURPOSE:Vertebrobasilar dolichoectatic and fusiform aneurysms (VBDAs) are known to have a poor natural history, with high rates of growth, rupture, and stroke. The purpose of this study was to identify hemodynamic characteristics that differ between VBDAs associated with growth, rupture, and stroke. MAT...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2018-013756

    authors: Brinjikji W,Chung B,Yong-Hong D,Wald JT,Mut F,Kadirvel R,Kallmes DF,Rouchaud A,Lanzino G,Cebral JR

    更新日期:2018-11-01 00:00:00

  • Venous sinus stenting for idiopathic intracranial hypertension: a review of the literature.

    abstract::Idiopathic intracranial hypertension (IIH) is characterized by headache, papilledema, visual field changes and tinnitus with elevated cerebral spinal fluid opening pressures on lumbar puncture. Left untreated, this condition can lead to permanent visual loss. Previous treatment modalities include medical management, t...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,评审

    doi:10.1136/neurintsurg-2012-010468

    authors: Puffer RC,Mustafa W,Lanzino G

    更新日期:2013-09-01 00:00:00

  • Endovascular reconstruction of unruptured intradural vertebral artery dissecting aneurysms with the Pipeline embolization device.

    abstract:BACKGROUND:Dissecting aneurysms of the vertebral artery (VA) are difficult to treat using current surgical and endovascular techniques. OBJECTIVE:To analyze retrospectively the efficacy and safety of flow diverters in the treatment of dissecting aneurysms of the vertebral artery. METHODS:We identified six patients wi...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2015-012028

    authors: Kühn AL,Kan P,Massari F,Lozano JD,Hou SY,Howk M,Gounis MJ,Wakhloo AK,Puri AS

    更新日期:2016-10-01 00:00:00

  • Endovascular treatment for ruptured and unruptured vertebral artery dissecting aneurysms: a meta-analysis.

    abstract:BACKGROUND:Different endovascular modalities have been applied to the treatment of vertebral artery dissecting aneurysms, the most commonly used being internal trapping and stent-assisted coiling, although the ideal treatment remains controversial. OBJECTIVE:To perform a meta-analysis to study clinical outcomes of pat...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,meta分析

    doi:10.1136/neurintsurg-2016-012309

    authors: Guan J,Li G,Kong X,He C,Long J,Qin H,Zhang H,Wang R

    更新日期:2017-06-01 00:00:00

  • De novo pseudoaneurysm formation after angioplasty and stenting of posterior circulation intracranial atherosclerotic disease: mechanism, characterization with intravascular ultrasound and management considerations.

    abstract:BACKGROUND:The formation of de novo pseudoaneurysms after stent implantation has not been well characterized after stenting of intracranial vessels. Its clinical significance is unknown, resulting in a difficult decision making process with regard to its treatment. METHODS:The database of patients treated at the Bapti...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2012-010443

    authors: Dabus G,Linfante I,Samaniego EA

    更新日期:2013-09-01 00:00:00

  • Transradial approach for diagnostic cerebral angiograms in the elderly: a comparative observational study.

    abstract:BACKGROUND:The transradial approach (TRA) reduces mortality, morbidity, access site complications, hospital cost, and length of stay while maximizing patient satisfaction. We aimed to assess the technical success and safety of TRA for elderly patients (aged ≥75 years). METHODS:A retrospective chart review and comparat...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2020-016140

    authors: Sweid A,Das S,Weinberg JH,E L Naamani K,Kim J,Curtis D,Joffe D,Hiranaka CG,Vijaywargiya D,Sioka C,Oneissi M,El Hajjar AH,Gooch MR,Herial N,Tjoumakaris SI,Rosenwasser RH,Jabbour P

    更新日期:2020-12-01 00:00:00

  • Reporting standards for endovascular repair of saccular intracranial cerebral aneurysms.

    abstract:BACKGROUND AND PURPOSE:The goal of this article is to provide consensus recommendations for reporting standards, terminology, and written definitions when reporting on the radiological evaluation and endovascular treatment of intracranial, cerebral aneurysms. These criteria can be used to design clinical trials, to pro...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,实务指引

    doi:10.1136/jnis.2010.002337

    authors: Meyers PM,Schumacher HC,Higashida RT,Derdeyn CP,Nesbit GM,Sacks D,Wechsler LR,Bederson JB,Lavine SD,Rasmussen P,Joint Writing Group of the Technology Assessment Committee, Society of Neurolnterventional Surgery, Society of Interventi

    更新日期:2010-12-01 00:00:00

  • Intracranial bailout stenting with the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter after failed thrombectomy in acute ischemic stroke: a multicenter experience.

    abstract:BACKGROUND AND PURPOSE:To report on the feasibility, safety, and outcome of acute intracranial stenting (ICS) with the Acclino (Flex) Stent and NeuroSpeed Balloon Catheter in cases of failed mechanical thrombectomy (MT) for acute ischemic stroke (AIS). METHODS:We retrospectively reviewed the data of patients treated w...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1136/neurintsurg-2019-014957

    authors: Stracke CP,Meyer L,Fiehler J,Leischner H,Bester M,Buhk JH,Thomalla G,Krause LU,Lowens S,Rothaupt J,Chapot R,Hanning U

    更新日期:2020-01-01 00:00:00

  • Endovascular therapy for acute basilar artery occlusion: a review of the literature.

    abstract::Basilar artery occlusion is an infrequent form of acute stroke; clinical outcomes are heterogeneous, but the condition can be fatal. There is a lack of randomized controlled trial data in this field. Case series suggest that patients who are recanalized have much better outcomes than those who are not, and it is gener...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,评审

    doi:10.1136/neurintsurg-2011-010090

    authors: Mortimer AM,Bradley M,Renowden SA

    更新日期:2012-07-01 00:00:00

  • Onyx embolization of an extensive mandibular arteriovenous malformation via a dual lumen balloon catheter: a technical case report.

    abstract:SUMMARY:The first known use of Onyx delivered via a dual lumen balloon catheter is reported. A mandibular arteriovenous malformation was successfully embolized with Onyx via an Ascent balloon catheter. CASE PRESENTATION:A teenage girl presented with facial deformity and episodes of oral bleeding. Angiogram showed an e...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2011-010179

    authors: Fifi J,Niimi Y,Berenstein A

    更新日期:2013-03-01 00:00:00

  • Infundibular dilations of the posterior communicating arteries: pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage.

    abstract:BACKGROUND:Cerebrovascular infundibular dilations (IDs) are triangular-shaped widenings less than 3 mm in diameter, which are most commonly found at the posterior communicating artery (PCoA). The aims of this systematic review are to elucidate the natural histories of IDs, determine their risk of progression to signifi...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章,评审

    doi:10.1136/neurintsurg-2015-011827

    authors: Chen CJ,Moosa S,Ding D,Raper DM,Burke RM,Lee CC,Chivukula S,Wang TR,Starke RM,Crowley RW,Liu KC

    更新日期:2016-08-01 00:00:00

  • The safety of anticoagulation in patients with intracranial aneurysms.

    abstract:BACKGROUND AND PURPOSE:Little is known about the safety of long-term anticoagulation in patients with unruptured saccular intracranial aneurysms, although case reports of anticoagulation in patients with fusiform and saccular aneurysms have been published. The goal of this study was to estimate the rate of subarachnoid...

    journal_title:Journal of neurointerventional surgery

    pub_type: 杂志文章

    doi:10.1136/neurintsurg-2012-010359

    authors: Tarlov N,Norbash AM,Nguyen TN

    更新日期:2013-09-01 00:00:00