Mechanical Thrombectomy in Acute Occlusion of the Carotid-T: A Retrospective Single Centre Study in 51 Patients.

BACKGROUND AND PURPOSE: Acute occlusion of the carotid-T is associated with large ischemic lesions, poor outcome and up to 53 % mortality with conservative therapy. Endovascular mechanical thrombectomy (EMT) is a promising alternative treatment of large vessel occlusion. Here, we examine feasibility, safety and efficiency of EMT in acute ischemic stroke due to carotid-T-occlusion. METHODS: Single centre, retrospective analysis of 51 consecutive patients with acute occlusion of the carotid-T, treated by EMT within 6 h after symptom onset. Most patients (42/51) were treated with stentretrievers, 33 with stentretrievers only. Recanalization was assessed by the Thrombolysis in Cerebral Infarction (TICI) score. Early and mid-term clinical outcome was evaluated by National Institutes of Health Stroke Scale (NIHSS)- and modified Rankin Scale mRS-scores, respectively. RESULTS: Successful recanalization (TICI 2b/3) was achieved in 78.4 % (40/51). Good clinical outcome (mRS 0-2) was observed in 24.4 % of patients, and only in patients treated successfully (TICI 2b/3). Stentretrievers yielded higher recanalization rates and better clinical outcomes than non-stentretriever devices. A total of 12 patients died (29.3 %) during the 90-day observation period. Clinically relevant procedure-related complications occurred in two patients, consisting in one vessel perforation with a microwire, and one symptomatic parenchymal haemorrhage after initiation of antiplatelet therapy following the inadvertent detachment of a stentretriever. Another symptomatic haemorrhage, not directly procedure-related, occurred in one additional patient. CONCLUSION: EMT in acute carotid-T-occlusion is efficient, yielding high recanalization rates, and reasonably safe, with a low rate of clinically relevant complications. Successful recanalization seems to be a prerequisite for good clinical outcome in this severe condition.

An interpenetrated metal-organic framework and its gas storage behavior: simulation and experiment.

A new metal-organic framework, called UHM-6 (UHM: University of Hamburg Materials), based on the copper paddle wheel motif and a novel organosilicon linker, 4',4″-(dimethylsilanediyl)bis(biphenyl-3,5-dicarboxylic acid) (sbbip), has been synthesized and characterized with regard to its gas storage behavior up to 1 bar for hydrogen, methane, and carbon dioxide. The 2-fold interpenetrated microporous framework of UHM-6 is isoreticular to PMOF-3 (Inorg. Chem.2009, 48, 11507) and is composed of cuboctahedral cages of Cu(2) paddle wheels connected via nonlinear organosilicon units. The structure (SG I422, No. 97) is characterized by straight channels running along the [001] and [110] direction. UHM-6 reveals a specific surface area of S(BET) ~ 1200 m(2) g(-1) and a specific micropore volume of V(micropore) ~ 0.48 cm(3) g(-1). At 1 bar the activated form of UHM-6 shows a hydrogen uptake of 1.8 wt % (77 K), a methane uptake of 0.8 mmol g(-1) (293 K), and a carbon dioxide uptake of 3.3 mmol g(-1) (273 K). Accompanying theoretical grand-canonical Monte Carlo (GCMC) simulations show an overall good agreement with the experimental results. Furthermore, GCMC adsorption simulations for three binary equimolar mixtures (CH(4)/H(2), CO(2)/H(2), and CO(2)/CH(4)) were carried out (T = 298 K) to assess the potential for gas separation/purification applications.