Your browser doesn't support javascript.
loading
Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee.
Al-Mufti, Fawaz; Schirmer, Clemens M; Starke, Robert M; Chaudhary, Neeraj; De Leacy, Reade; Tjoumakaris, Stavropoula I; Haranhalli, Neil; Abecassis, Isaac Josh; Amuluru, Krishna; Bulsara, Ketan R; Hetts, Steven W.
Afiliação
  • Al-Mufti F; Department of Neurology and Neurosurgery, Westchester Medical Center, Valhalla, New York, USA.
  • Schirmer CM; Department of Neurosurgery, Geisinger Health System, Wilkes-Barre, Pennsylvania, USA.
  • Starke RM; Department of Neurosurgery & Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Chaudhary N; Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA.
  • De Leacy R; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Tjoumakaris SI; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Haranhalli N; Department of Neurosurgery, Montefiore Hospital and Medical Center, Bronx, New York, USA.
  • Abecassis IJ; Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.
  • Amuluru K; Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
  • Bulsara KR; Department of Interventional Neuroradiology, Goodman Campbell Brain and Spine, Carmel, Indiana, USA.
  • Hetts SW; Division of Neurosurgery, University of Connecticut, Farmington, Connecticut, USA.
J Neurointerv Surg ; 14(10): 1033-1041, 2022 Oct.
Article em En | MEDLINE | ID: mdl-34244337
ABSTRACT

BACKGROUND:

The purpose of this guideline is to summarize the data available for performing mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) stroke in special populations not typically included in large randomized controlled clinical trials, including children, the elderly, pregnant women, patients who have recently undergone surgery, and patients with thrombocytopenia, collagen vascular disorders, and endocarditis.

METHODS:

We performed a literature review for studies examining the indications, efficacy, and outcomes for patients undergoing MT for ischemic stroke aged <18 years and >80 years, pregnant patients, patients who have recently undergone surgery, and those with thrombocytopenia, collagen vascular diseases, or endocarditis. We graded the quality of the evidence.

RESULTS:

MT can be effective for the treatment of ELVO in ischemic stroke for patients over age 80 years and under age 18 years, thrombocytopenic patients, pregnant patients, and patients with endocarditis. While outcomes are worse compared to younger patients and those with normal platelet counts (respectively), there is still a benefit in the elderly (in both mRS and mortality). Data are very limited for patients with collagen vascular diseases; although diagnostic cerebral angiography carries increased risks, MT may be appropriate in carefully selected patients in whom untreated ELVO would likely result in disabling or fatal outcome.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Arteriopatias Oclusivas / Trombocitopenia / Isquemia Encefálica / Acidente Vascular Cerebral / Endocardite / AVC Isquêmico Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Aged80 / Child / Female / Humans / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Arteriopatias Oclusivas / Trombocitopenia / Isquemia Encefálica / Acidente Vascular Cerebral / Endocardite / AVC Isquêmico Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Aged80 / Child / Female / Humans / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article