scholarly journals Impact of Collateral Status Evaluated by Dynamic Computed Tomographic Angiography on Clinical Outcome in Patients With Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (12) ◽  
pp. 3398-3404 ◽  
Author(s):  
Ido R. van den Wijngaard ◽  
Jelis Boiten ◽  
Ghislaine Holswilder ◽  
Ale Algra ◽  
Diederik W.J. Dippel ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals Successful recanalization using the Embolus Retriever with Interlinked Cage for acute stroke due to calcified cerebral emboli

2018 ◽  
Vol 24 (6) ◽  
pp. 674-677 ◽  
Author(s):  
Hyo S Kwak ◽  
Jung S Park
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Thrombolytic Agent ◽  
Mechanical Thrombectomy ◽  
Computed Tomographic Angiography ◽  
Sudden Onset ◽  
Aspiration Thrombectomy ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Left Middle

Mechanical thrombectomy is a safe and effective treatment in patients with acute ischemic stroke caused by large vessel occlusions. However, in rare cases, the procedure may be challenging due to the composition of the embolus. We describe a case of a mechanical thrombectomy with the Embolus Retriever with Interlinked Cage (ERIC) device in a patient with an acute ischemic stroke due to calcified cerebral emboli in the middle cerebral artery. The procedure was done after a failed recanalization attempt with manual aspiration thrombectomy. An 82-year-old woman presented to the emergency department with a sudden onset of right-sided weakness. A computed tomographic angiography showed left middle cerebral (M1 branch) calcified emboli. After the administration of an intravenous thrombolytic agent, the patient was transferred to the angiographic suite for a mechanical thrombectomy. After failure to recanalize the vessel with manual aspiration thrombectomy, successful recanalization was achieved via mechanical thrombectomy using the ERIC device. Mechanical thrombectomy with an ERIC device can be a useful option in cases of acute ischemic stroke caused by calcified cerebral emboli.

Abstract T P177: Non-dominant Vertebral Artery With Higher Resistance Flow Pattern Is A Risk Factor For Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Leonard yeo ◽  
Amit Batra ◽  
Ashley Tan ◽  
Song Majinyang ◽  
Darren Low ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Flow Pattern ◽  
Posterior Inferior Cerebellar Artery ◽  
Computed Tomographic Angiography ◽  
Mean Flow ◽  
Computed Tomographic ◽  
Vertebral Arteries ◽  
Cerebellar Artery ◽  
Intracranial Arteries ◽  
Tomographic Angiography

Background and aims: The diameters of the vertebral arteries (VAs) are very often unequal and the larger artery is called ‘dominant’. We investigated whether the hemodynamic parameters differ between the ‘dominant’ and ‘non-dominant’ variants. Methods: Consecutive patients who underwent computed tomographic angiography (CTA) of cervical and intracranial arteries, cervical duplex (CDU) and transcranial Doppler (TCD) ultrasonography were included. VA diameters (cervical and intracranial segments) were measured on CTA. Flow velocities recorded were peak systolic (PSV), end-diastolic (EDV), mean flow (MFV). Pulsatility index (PI) and ratio of distal-to-proximal VAs were computed. Results: Of the total 501 patients admitted during 2012 with acute ischemic stroke, both CTA and ultrasound data were available for VAs for 161 (32%). The dominant VA was more frequent on the left side (p<0.01). Non-dominant VAs were found to have lower MFV (27cm/s versus 38cm/s; p<0.01) and higher PI (1.27 versus 1.0; p<0.01) as compared to the dominant variant. In most patients, proximal basilar artery was noted to be on the side of non-dominant artery. Posterior inferior cerebellar artery territory infarcts and lateral medullary infarcts were noted in 38 (7.6%) patients. These infarcts were noted more commonly on the same side as the non-dominant intracranial VA side (p<0.01), especially when associated with low MFV (p<0.01) and high PI (p<0.01). Conclusions: The risk of ischemic stroke in VA territory is higher with the non-dominant artery, especially when it is associated with higher-resistance flow pattern.

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