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[Complications of mechanical thrombectomy].

CLINICAL PROBLEM: Ischemic stroke is the most common cause of disability in adults and an important disease for society; therefore, the prevention, diagnosis, and treatment play an important role. Endovascular mechanical recanalization to reopen large occlusions of the intracerebral vessels has established itself as the gold standard in therapy, which is why knowledge of the most important complications and their management is essential for interventionalists. PRACTICAL RECOMMENDATIONS: Intracranial hemorrhages, which include intracerebral and subarachnoid hemorrhages, are dreaded complicatio

Young stroke, cardiac myxoma, and multiple emboli: a case report and literature review.

Cardiac myxoma is a source of emboli to the vascular tree, especially to the central nervous system. Although it is rare, its early recognition is particularly important because of its unique clinical features of subsequently leading to intracerebral or subarachnoid hemorrhage, even brain metastases, and its potential for surgical cure. Missing the diagnosis may lead to devastating results, including stroke, even sudden death. A 40-year-old male with no other conventional vascular risk factors such as hypertension, diabetes or hyperlipidemia presented with right hemiplegia, global aphasia, vom

Shotgun pellet embolization to the posterior cerebral circulation.

The embolization of missiles to the intracranial circulation is a rare event. We describe here a case of a man shot by a shotgun, presenting with a posterior fossa stroke and occlusion of the superior cerebellar artery by a metallic pellet. To our knowledge, this is the third case of posterior fossa circulation pellet emboli.

Dangerous Extracranial-Intracranial Anastomoses: What the Interventionalist Must Know.

The extracranial and intracranial circulations are richly interconnected at numerous locations, a functional connectivity which underlies their impressive capacity for adaptive plasticity in the setting of vasoocclusive disease. While evolutionarily beneficial, these connections can also result in inadvertent communication with the intracranial circulation during embolization of extracranial vessels, potentially resulting in stroke or cranial nerve palsy. While these anastomoses are always present to a certain extent, flow through them occurs under predictable circumstances, and thus embolizat

A traveler in transit: A case of an impending thrombus entrapped in a patent foramen ovale.

Thrombus across a patent foramen ovale (PFO), also referred to as a pending paradoxical embolus is a rare condition. We report a case of a 50-year-old male taxi driver who was diagnosed with a massive saddle pulmonary embolism, leg deep venous thromboembolism, and pending paradoxical embolus through a PFO with systemic embolization. The patient had an inferior vena cava (IVC) filter inserted immediately followed by surgical thromboembolectomy and closure of PFO. He was discharged home 1 month after surgery. Surgery is the treatment of choice for preventing systemic embolization particularly cr

The Clot Strikes Thrice: Case Report of a Patient with 3 Concurrent Embolic events.

PURPOSE: Concurrent cerebral and systemic embolism are unusual occurrences. Acute myocardial infarction secondary to coronary embolism are particularly rare with only isolated reports in the literature. CASE REPORT: A 49-year old Chinese man presented with right posterior cerebral artery infarction to our hospital. He developed chest pain and ST-elevation on ECG the next morning. Urgent cardiac catheterization showed a right coronary artery as well as a right profunda femoris artery occlusion. The cause of these 3 concurrent emboli was a large mobile left ventricular thrombus seen on echocard

Thrombus-in-transit causing paradoxical embolism in cerebral and coronary arterial circulation.

We describe the case of an elderly man who was admitted to our hospital with the diagnosis of an acute anterior myocardial infarction, together with an acute bioccipital ischaemic stroke. Coronary angiography revealed embolization of the distal left anterior descendens and the first septal branch. The definite diagnosis of paradoxical embolism was made by means of a transoesophageal echocardiography which demonstrated a large snake-like floating thrombus crossing a patent foramen ovale. This diagnosis was also supported by the presence of deep venous thrombosis as a probable origin of the intr

Fulminant brain necrosis from atrial myxoma showers.

BACKGROUND: Atrial myxoma is uncommon and may be associated with brief isolated ischemic events. We describe a patient with atrial myxoma and an incompletely evaluated ischemic stroke followed 1 year later with almost complete brain necrosis. SUMMARY OF REPORT: A 63-year-old woman presented with a rapidly progressive illness resulting in coma within 24 hours from multiple myxomatous emboli. Cranial computed tomographic scan demonstrated multiple hypodensities in both cerebellar and cerebral hemispheres. Postmortem examination revealed virtually complete brain necrosis, multiple peripheral art

Long-Term Outcomes and Natural Course of Giant Cerebral Arteriovenous Malformations (> 6 cm): Insights From a National Multicenter Propensity Score-Matched Cohort.

OBJECTIVES: This study evaluated the natural history of giant cerebral arteriovenous malformations (AVMs) over 6 cm and compared long-term outcomes of interventional treatment versus conservative management. MATERIALS AND METHODS: Patients with AVMs > 6 cm were identified from a national multicenter prospective registry (MATCH). Rupture risk factors were analyzed with uni- and multivariate models. Propensity score matching balanced intervention and conservative groups. The primary outcome was long-term hemorrhagic stroke or death; secondary outcomes included obliteration rates and neurologica

Cerebrovascular and Bleeding Outcomes of Warfarin versus Direct Oral Anticoagulants Therapy for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVES: To compare the effects on cerebral health in atrial fibrillation patients receiving either warfarin or direct oral anticoagulants (DOACs). Atrial fibrillation is linked to a higher likelihood of both stroke and cognitive impairment. While warfarin has historically served as the leading anticoagulant treatment, DOACs are now more frequently viewed as alternatives with an improved safety profile. METHODS: The methodology involved an extensive search of multiple databases, completed up to June 2024. This search yielded randomized controlled trials, which together enrolled over 60,000

Left atrial appendage closure vs oral anticoagulation for stroke prevention in atrial fibrillation: Long-term outcomes from 4 randomized trials.

BACKGROUND: Left atrial appendage closure (LAAC) is primarily indicated for stroke prevention in patients with atrial fibrillation (AF) who have contraindications to long-term oral anticoagulants (OACs). However, the long-term comparative benefits of LAAC vs OACs in the broader AF population remain unclear. OBJECTIVE: To study aimed to assess the long-term efficacy and safety of LAAC compared with OACs in patients with AF, we conducted a meta-analysis of randomized controlled trials (RCTs). METHODS: We systematically searched PubMed, Embase, and Cochrane Library for eligible RCTs. Risk ratio

Safety and effectiveness of edoxaban in Japanese patients with nonvalvular atrial fibrillation: Final report of a two-year postmarketing surveillance study (ETNA-AF-Japan).

BACKGROUND: Direct oral anticoagulants (DOACs) are the recommended first-line therapy for ischemic stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). However, the safety and effectiveness of edoxaban for this indication requires monitoring over the long term in real-world settings. METHODS: ETNA-AF-Japan (trial no. UMIN000017011) was a prospective, multicenter observational study (part of postmarketing surveillance in Japan). NVAF patients due to receive edoxaban to prevent ischemic stroke were enrolled between 13 April 2015 and 30 September 2017. RESULTS: A total of

Caudal paramedian midbrain infarction: a clinical study of imaging, clinical features and stroke mechanisms.

Caudal paramedian midbrain infarction (CPMI) is an extremely rare form of ischemic stroke and related clinical studies are scarce. Our aim is to investigate the clinical features, neuroradiological findings and stroke etiology of CPMI. We conducted a retrospective study of 12 patients with CPMI, confirmed by diffusion-weighted MRI from 6820 cerebral infarction patients at our stroke center from January 2012 to August 2018. Experienced neurologists evaluated the clinical manifestations, neuroimaging findings and stroke mechanisms. Twelve patients (11 men, 1 woman) aged 42-81 years old met the s

Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial.

BACKGROUND: Anticoagulants are more effective than antiplatelet agents at reducing stroke risk in patients with atrial fibrillation, but whether this benefit outweighs the increased risk of bleeding in elderly patients is unknown. We assessed whether warfarin reduced risk of major stroke, arterial embolism, or other intracranial haemorrhage compared with aspirin in elderly patients. METHODS: 973 patients aged 75 years or over (mean age 81.5 years, SD 4.2) with atrial fibrillation were recruited from primary care and randomly assigned to warfarin (target international normalised ratio 2-3) or

Эндоваскулярная тромбектомия у молодой пациентки с дефектом септальной системы: отчет по делу.

Крупноразмерный окклюз (LVO) у молодого пациента в возрасте до 30 лет является весьма редким явлением. При приближении к симптомам, похожим на инсульт, в молодом поколении, инсульт имитирует такие симптомы, как эпилепсия, хроническая субдуральная гематома, сжатие спинного мозга из-за грызуна диска или аутоиммунная нейропатия, как синдром Гильен-Барре или множественный склероз, безусловно, являются серьезным препятствием на пути быстрого диагностики. Такое состояние, вероятно, усугубит трудности с точным диагностикой и замедлит лечение инсульта в сочетании с редкостью инсультов у молодых людей.

Совпадение в полном тексте источника
… Among them, transcranial Doppler is most useful and least invasive in the diagnosis of PFO-associated embolic stroke because it has a sensitivity of 91-100% and specificity of 78-100% [ 22 ]. …

Cardiac arrhythmias in acute stroke.

Cardiac arrhythmias were more frequent (p less than 0.001) in 312 stroke patients admitted to an intensive care stroke unit, than in 92 patients admitted to the unit and subsequently found not to have strokes. This significant difference remained when a stroke subgroup and the non-stroke group were matched for age, sex and duration of stay in the unit (P less than 0.005). Hypertension and hypertensive cardiac disease were more common in the stroke than in the non-stroke patients (P less than 0.001). Ectopic beats and atrial fibrillation, as well as other arrhythmias, were most frequent in pati

Efficacy of Cerebral Embolic Protection Device in Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.

Transcatheter aortic valve replacement (TAVR) is widely used to treat severe aortic stenosis; however, periprocedural stroke remains a significant concern. This systematic review and meta-analysis evaluate whether the use of cerebral embolic protection devices (CEPDs) during TAVR reduces the risk of stroke and other complications. To conduct a network meta-analysis of relevant trials to assess the efficacy of CEPDs currently used in TAVR. PubMed, Embase, and Scopus were systematically searched through April 2025 to identify studies comparing TAVR performed with and without CEPDs. Primary outco

Effectiveness and Safety of Direct Oral Anticoagulants in the Secondary Stroke Prevention of Elderly Patients: Ljubljana Registry of Secondary Stroke Prevention.

BACKGROUND AND OBJECTIVES: The results of randomised clinical trials (RCTs) on direct oral anticoagulants (DOACs) for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) can mostly be applied to primary prevention in relatively young patients, since only a minority of patients included in these trials were receiving DOACs for secondary prevention. The real-life secondary prevention subgroup, comprising mostly elderly and high-risk patients, remains a point of interest where further exploration is needed. Our objective was to explore the effectiveness and safety of DOACs f