Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies
The benefit of mechanical thrombectomy (MT) in acute ischemic stroke (AIS) due to large vessel intracranial occlusions is directly related to the technical success of the procedures in achieving fast and complete reperfusion. While a precise definition of refractoriness is lacking in the literature,...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Stroke Society
2020-05-01
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| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-2020-00227.pdf |
| _version_ | 1830358430656757760 |
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| author | Francisco José Arruda Mont` Alverne Fabricio Oliveira Lima Felipe de Araújo Rocha Diego de Almeida Bandeira Adson Freitas de Lucena Henrique Coelho Silva Jin Soo Lee Raul Gomes Nogueira |
| author_facet | Francisco José Arruda Mont` Alverne Fabricio Oliveira Lima Felipe de Araújo Rocha Diego de Almeida Bandeira Adson Freitas de Lucena Henrique Coelho Silva Jin Soo Lee Raul Gomes Nogueira |
| author_sort | Francisco José Arruda Mont` Alverne |
| collection | DOAJ |
| description | The benefit of mechanical thrombectomy (MT) in acute ischemic stroke (AIS) due to large vessel intracranial occlusions is directly related to the technical success of the procedures in achieving fast and complete reperfusion. While a precise definition of refractoriness is lacking in the literature, it may be considered when there is reperfusion failure, long procedural times, or high number of passes with the MT devices. Detailed knowledge about the causes for refractory MT in AIS is limited; however, it is most likely a multifaceted problem including factors related to the vascular anatomy and the underlying nature of the occlusive lesion amongst other factors. We aim to review the impact of several key unfavorable anatomical factors that may be encountered during endovascular AIS treatment and discuss potential bail-out strategies to these challenging situations. |
| first_indexed | 2024-12-20T02:40:56Z |
| format | Article |
| id | doaj.art-e8aef79c130c4550a6174f78d0226a87 |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-12-20T02:40:56Z |
| publishDate | 2020-05-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-e8aef79c130c4550a6174f78d0226a872022-12-21T19:56:19ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052020-05-0122218520210.5853/jos.2020.00227316Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout StrategiesFrancisco José Arruda Mont` Alverne0Fabricio Oliveira Lima1Felipe de Araújo Rocha2Diego de Almeida Bandeira3Adson Freitas de Lucena4Henrique Coelho Silva5Jin Soo Lee6Raul Gomes Nogueira7 Interventional Neuroradiology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil Neurology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil Interventional Neuroradiology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil Interventional Neuroradiology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil Interventional Neuroradiology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil Interventional Neuroradiology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea Department of Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USAThe benefit of mechanical thrombectomy (MT) in acute ischemic stroke (AIS) due to large vessel intracranial occlusions is directly related to the technical success of the procedures in achieving fast and complete reperfusion. While a precise definition of refractoriness is lacking in the literature, it may be considered when there is reperfusion failure, long procedural times, or high number of passes with the MT devices. Detailed knowledge about the causes for refractory MT in AIS is limited; however, it is most likely a multifaceted problem including factors related to the vascular anatomy and the underlying nature of the occlusive lesion amongst other factors. We aim to review the impact of several key unfavorable anatomical factors that may be encountered during endovascular AIS treatment and discuss potential bail-out strategies to these challenging situations.http://www.j-stroke.org/upload/pdf/jos-2020-00227.pdfstrokebrain ischemiareperfusionthrombectomy |
| spellingShingle | Francisco José Arruda Mont` Alverne Fabricio Oliveira Lima Felipe de Araújo Rocha Diego de Almeida Bandeira Adson Freitas de Lucena Henrique Coelho Silva Jin Soo Lee Raul Gomes Nogueira Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies Journal of Stroke stroke brain ischemia reperfusion thrombectomy |
| title | Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies |
| title_full | Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies |
| title_fullStr | Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies |
| title_full_unstemmed | Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies |
| title_short | Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies |
| title_sort | unfavorable vascular anatomy during endovascular treatment of stroke challenges and bailout strategies |
| topic | stroke brain ischemia reperfusion thrombectomy |
| url | http://www.j-stroke.org/upload/pdf/jos-2020-00227.pdf |
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