著者

Naoki Kaneko Kenichi Sakuta Taichiro Imahori Hannah Gedion Mahsa Ghovvati Satoshi Tateshima

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

vol.17, no.11, pp.257-262, 2023 (Released:2023-11-20)

参考文献数

34

被引用文献数

2

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This extensive review explores the intricacies of the three principal mechanical thrombectomy techniques: the stent retriever technique, contact aspiration technique, and a combined approach, and their application in managing acute ischemic stroke. Each technique operates uniquely on the thrombus, leading to differences in their efficacy. Factors including clot size, clot stiffness, vessel tortuosity, and the angle of interaction between the aspiration catheter and the clot significantly influence these differences. Clinical trials and meta-analyses have shown the overall equivalency of these techniques for the treatments of large vessel occlusion and distal medium vessel occlusions. However, there are nuanced differences that emerge under specific clinical circumstances, highlighting the absence of a one-size-fits-all strategy in acute ischemic stroke management. We emphasize the need for future investigations to elucidate these nuances further, aiming to refine procedural strategies and individualize patient care for optimal outcomes.

著者

Naoki Kaneko Kenichi Sakuta Taichiro Imahori Hannah Gedion Mahsa Ghovvati Satoshi Tateshima

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.ra.2023-0054, (Released:2023-10-06)

参考文献数

34

被引用文献数

2

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This extensive review explores the intricacies of the three principal mechanical thrombectomy techniques: the stent retriever technique, contact aspiration technique, and a combined approach, and their application in managing acute ischemic stroke. Each technique operates uniquely on the thrombus, leading to differences in their efficacy. Factors including clot size, clot stiffness, vessel tortuosity, and the angle of interaction between the aspiration catheter and the clot significantly influence these differences. Clinical trials and meta-analyses have shown the overall equivalency of these techniques for the treatments of large vessel occlusion and distal medium vessel occlusions. However, there are nuanced differences that emerge under specific clinical circumstances, highlighting the absence of a one-size-fits-all strategy in acute ischemic stroke management. We emphasize the need for future investigations to elucidate these nuances further, aiming to refine procedural strategies and individualize patient care for optimal outcomes.

著者

Hiroyuki TAKAO Kenichiro SAKAI Hidetaka MITSUMURA Teppei KOMATSU Ichiro YUKI Kohei TAKESHITA Kenichi SAKUTA Toshihiro ISHIBASHI Teppei SAKANO Yuchih YEH Kostadin KARAGIOZOV Marc FISHER Yasuyuki IGUCHI Yuichi MURAYAMA

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.61, no.4, pp.260-267, 2021 (Released:2021-04-15)

参考文献数

18

被引用文献数

8

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Since smartphone applications are revolutionizing telemedicine, a new application specifically for stroke care (JOIN) was designed. Addition of the JOIN smartphone application to the stroke treatment workflow in our hospital was assessed. JOIN has key functions that may improve the care of stroke patients, including the ability to (1) exchange information such as patient data and medical images in real-time throughout the entire process of patient management; (2) track each step of the protocol from door to discharge; and (3) facilitate real-time interaction of all team members via text, audio, and a video chat system. Two periods, 2.7 years before the implementation of JOIN (Pre-JOIN) with 37 patients and 2.2 years after (Post-JOIN) with 54 patients, were compared, and the workflow for all 91 patients who had a cerebral infarction and were treated with tissue plasminogen activator (tPA) and/or thrombectomy between October 2012 and July 2017 was reviewed. There were noticeable reductions in overall patient management time, including times for door-to-imaging, starting tPA treatment, and endovascular intervention with JOIN. Staff members were unanimously satisfied with JOIN, due to the increased efficiency of information exchange and the ability for real-time discussions with different professionals when needed. No significant changes in patient outcomes (as assessed by modified Rankin Scale [mRS] scores) at 3 months and in the total cost for the treatment were observed. A smartphone-based application with the capability of sharing information instantaneously among healthcare professionals facilitated time-sensitive, acute care of ischemic stroke patients.