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132 results of 16 texts with exact phrase : 'thrombectomy'.

1. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 2 , , ,

Mechanical Thrombectomy Following Intravenous Thrombolysis in the Treatment of Acute Stroke.
Lansberg MG, Fields JD, Albers GW, Jayaraman MV, Do HM, Marks MP. Mechanical Thrombectomy Following Intravenous Thrombolysis in the Treatment of Acute Stroke.
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2. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 2 , , ,

Еndovascular Thrombectomy and Thrombolysis for Severe Cerebral Sinus Thrombosis: A Prospective Study.
Stam J, Majoie C. B.L.M, van Delden OM, van Lienden KP, Reekers JA. Еndovascular Thrombectomy and Thrombolysis for Severe Cerebral Sinus Thrombosis: A Prospective Study.
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3. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 1 , , ,

creation of IA devises for mechanical or ultrasound thrombectomy [15];
creation of IA devises for mechanical or ultrasound thrombectomy [15];
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4. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 1 , , ,

In both cases an urgent thrombectomy and endarterectomy with patch closure was performed.
During the hospitalization patients were treated with anticoagulation and two antiaggregants. In both cases an urgent thrombectomy and endarterectomy with patch closure was performed. Patients were discharged on the second postoperative day without any complications. Treatment with Aspirin and Clopidogrel was prescribed.
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Duplex-scanning of LICA after thrombectomy (arrow marks the patch).
Duplex-scanning of LICA after thrombectomy (arrow marks the patch).
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Patients were examined longitudinally at the end of the first and third month after the thrombectomy with no evidence of recurrence (fig.
During their stay in the hospital both patients were treated with low molecular weight Heparin and two antiplatelets. They were discharged on the second postoperative day with no change in their preoperative neurogical status and were given therapy with Aspirin and Clopidogrel. Patients were examined longitudinally at the end of the first and third month after the thrombectomy with no evidence of recurrence (fig. 1C, fig. 2C)
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5. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2012, No. 2 , , ,

J. Endovascular thrombectomy and thrombolysis for severe cerebral sinus thrombosis: a prospective study.
J. Endovascular thrombectomy and thrombolysis for severe cerebral sinus thrombosis: a prospective study.
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The scientific program is devoted to new directions in Neurosonology focusing on Fourdimensional ultrasound imaging, progress in modern Neurorehabilitation, applying thrombectomy and / or therapeutic hypothermia in acute ischemic stroke.
The scientific program is devoted to new directions in Neurosonology focusing on Fourdimensional ultrasound imaging, progress in modern Neurorehabilitation, applying thrombectomy and / or therapeutic hypothermia in acute ischemic stroke. Participants will learn about the latest developments in these areas and the possibilities of their applications worldwide and in Bulgaria.
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Thrombectomy in Acute Stroke
Thrombectomy in Acute Stroke
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6. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 2 , , ,

Early Hemodynamic Changes Post Intracranial Thrombectomy: a Sign of Vessel Wall Injury?
Early Hemodynamic Changes Post Intracranial Thrombectomy: a Sign of Vessel Wall Injury?
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EARLY HEMODYNAMIC CHANGES POST INTRACRANIAL THROMBECTOMY: A SIGN OF VESSEL WALL INJURY?
EARLY HEMODYNAMIC CHANGES POST INTRACRANIAL THROMBECTOMY: A SIGN OF VESSEL WALL INJURY?
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Stent retrievers are new devices that can be also used to perform mechanical intracranial thrombectomy.
Stent retrievers are new devices that can be also used to perform mechanical intracranial thrombectomy. They have revolutionized endovascular treatment of acute ischemic stroke with good recanalization and acceptable safety. However, previous animal studies have shown that mechanical thrombectomy may cause endothelial injury of the arterial wall leading to myointimal hyperplasia.
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However, previous animal studies have shown that mechanical thrombectomy may cause endothelial injury of the arterial wall leading to myointimal hyperplasia.
Stent retrievers are new devices that can be also used to perform mechanical intracranial thrombectomy. They have revolutionized endovascular treatment of acute ischemic stroke with good recanalization and acceptable safety. However, previous animal studies have shown that mechanical thrombectomy may cause endothelial injury of the arterial wall leading to myointimal hyperplasia.
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Acute ischemic stroke patients suffering from acute intracranial single large artery occlusion in which mechanical thrombectomy using stent retrievers was performed were studied.
Acute ischemic stroke patients suffering from acute intracranial single large artery occlusion in which mechanical thrombectomy using stent retrievers was performed were studied. Only those with complete vessel recanalization as assessed by post-procedural DSA and in whom MRA and transcranial duplex sonography (TDS) were performed were retained. Complete revascularization was defined as modified TICI 2b or 3. Patients treated with intra-arterial thrombolysis or stenting of these arteries were excluded.
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20 acute ischemic stroke patients (10 women; mean age 63.7 years) due to arterial occlusion (19MCA;1BA) showed complete recanalization post thrombectomy.
20 acute ischemic stroke patients (10 women; mean age 63.7 years) due to arterial occlusion (19MCA;1BA) showed complete recanalization post thrombectomy. All of them received acetylsalicylic acid. DSA post thrombectomy and post acute MRA confirmed complete recanalization without residual stenosis or vasospasm. However, in 18/20 patients TDS (mean 3.8 days after thrombectomy) showed segmental acceleration of blood flow velocities in the affected segments of these arteries (MCA PSVmax at least > 35% as compared at same depth with the controlateral side; BA PSVmax > 40% as compared to velocities measured in the same vessel). None of them showed clinical deterioration.
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DSA post thrombectomy and post acute MRA confirmed complete recanalization without residual stenosis or vasospasm.
20 acute ischemic stroke patients (10 women; mean age 63.7 years) due to arterial occlusion (19MCA;1BA) showed complete recanalization post thrombectomy. All of them received acetylsalicylic acid. DSA post thrombectomy and post acute MRA confirmed complete recanalization without residual stenosis or vasospasm. However, in 18/20 patients TDS (mean 3.8 days after thrombectomy) showed segmental acceleration of blood flow velocities in the affected segments of these arteries (MCA PSVmax at least > 35% as compared at same depth with the controlateral side; BA PSVmax > 40% as compared to velocities measured in the same vessel). None of them showed clinical deterioration.
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However, in 18/20 patients TDS (mean 3.8 days after thrombectomy) showed segmental acceleration of blood flow velocities in the affected segments of these arteries (MCA PSVmax at least > 35% as compared at same depth with the controlateral side; BA PSVmax > 40% as compared to velocities measured in the same vessel).
20 acute ischemic stroke patients (10 women; mean age 63.7 years) due to arterial occlusion (19MCA;1BA) showed complete recanalization post thrombectomy. All of them received acetylsalicylic acid. DSA post thrombectomy and post acute MRA confirmed complete recanalization without residual stenosis or vasospasm. However, in 18/20 patients TDS (mean 3.8 days after thrombectomy) showed segmental acceleration of blood flow velocities in the affected segments of these arteries (MCA PSVmax at least > 35% as compared at same depth with the controlateral side; BA PSVmax > 40% as compared to velocities measured in the same vessel). None of them showed clinical deterioration.
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Thispilot study isthe first showing with transcranial duplex sonography early very focal acceleration of blood flow velocities in intracranial arteries after thrombectomy with stent retrievers.
Thispilot study isthe first showing with transcranial duplex sonography early very focal acceleration of blood flow velocities in intracranial arteries after thrombectomy with stent retrievers. In the absence of residual stenosis or vasospasms, this might be a sign of vessel wall i.e. intimal injury in humans. Whether this is due to local inflammatory agents, neothrombosis or myointimal hyperplasia is not yet clear.
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acute ischemic stroke, stent retrievers, thrombectomy, transcranial duplex ultrasound.
acute ischemic stroke, stent retrievers, thrombectomy, transcranial duplex ultrasound.
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7. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 2 , , ,

Present State of Thrombectomy in Acute Stroke.
Present State of Thrombectomy in Acute Stroke.
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It is possible to consider endovascular recanalization by thrombectomy in the acute stroke anticoagulated patient.
It is possible to consider endovascular recanalization by thrombectomy in the acute stroke anticoagulated patient.
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8. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 1 , , ,

SITS-OPEN is an international, multicentre controlled study for the safety and efficacy of thrombectomy in acute occlusive stroke following intravenous thrombolysis with Alteplase, compared to patients treated with venous thrombolysis alone [Lorenzano S.
SITS-OPEN is an international, multicentre controlled study for the safety and efficacy of thrombectomy in acute occlusive stroke following intravenous thrombolysis with Alteplase, compared to patients treated with venous thrombolysis alone [Lorenzano S. and all, 2013; Topakian
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Vida Demarin (Croatia) had a speech on Stroke and Neuroplasticity and Professor Kurt Niederkorn (Austria) talked about the Present state of thrombectomy in acute stroke. Prof.
her research on How to face the burden of AF with aging to prevent stroke and vascular dementia. Prof. Vida Demarin (Croatia) had a speech on Stroke and Neuroplasticity and Professor Kurt Niederkorn (Austria) talked about the Present state of thrombectomy in acute stroke. Prof. Lachezar Traykov (Bulgaria) gave talk on the Classification and early diagnosis of cognitive impairments. The workshops in the afternoon were also very interesting and useful to the delegates.
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9. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 2 , , ,

Thrombectomy in Acute Stroke – Now an Evidence Based Method.
Thrombectomy in Acute Stroke – Now an Evidence Based Method.
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THROMBECTOMY IN ACUTE STROKE – NOW AN EVIDENCE BASED METHOD
THROMBECTOMY IN ACUTE STROKE – NOW AN EVIDENCE BASED METHOD
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Mechanical thrombectomy (TE) devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years.
Mechanical thrombectomy (TE) devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years. The initial results were based on case reports, case series and in the last several years on registries mainly concerning stent retrievers.
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acute stroke, thrombectomy.
acute stroke, thrombectomy.
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10. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 1 , , ,

Mechanical Thrombectomy in the Treatment
Mechanical Thrombectomy in the Treatment
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Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke
Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke
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acute ischemic stroke, mechanical thrombectomy, reperfusion
acute ischemic stroke, mechanical thrombectomy, reperfusion
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The application of mechanical thrombectomy in acute ischemic stroke (AIS) aims recanalization by removing thrombus in a large arterial vessel occlusion (intracranial occlusion of the distal internal carotid artery (ICA), and/or middle cerebral artery (MCA) or the M2).
The application of mechanical thrombectomy in acute ischemic stroke (AIS) aims recanalization by removing thrombus in a large arterial vessel occlusion (intracranial occlusion of the distal internal carotid artery (ICA), and/or middle cerebral artery (MCA) or the M2). The review summarizes the experience of experimental and clinical application of this method and presents the international consensus adopted in 2014 by the European Stroke Conference. The use of mechanical thrombectomy in patients with AIS allows to increase the therapeutic window for recanalization which in intravenous thrIombolysis (IVT) is limited to 4.5 hours.
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The use of mechanical thrombectomy in patients with AIS allows to increase the therapeutic window for recanalization which in intravenous thrIombolysis (IVT) is limited to 4.5 hours.
The application of mechanical thrombectomy in acute ischemic stroke (AIS) aims recanalization by removing thrombus in a large arterial vessel occlusion (intracranial occlusion of the distal internal carotid artery (ICA), and/or middle cerebral artery (MCA) or the M2). The review summarizes the experience of experimental and clinical application of this method and presents the international consensus adopted in 2014 by the European Stroke Conference. The use of mechanical thrombectomy in patients with AIS allows to increase the therapeutic window for recanalization which in intravenous thrIombolysis (IVT) is limited to 4.5 hours.
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Mechanical thrombectomy is a surgical removal of a blood clot from a blood vessel in the brain and is used to treat strictly selected patients with AIS.
Mechanical thrombectomy is a surgical removal of a blood clot from a blood vessel in the brain and is used to treat strictly selected patients with AIS.
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Mechanical thrombectomy in the treatment of acute ischemic stroke
Mechanical thrombectomy in the treatment of acute ischemic stroke
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The original version of the Consensus on mechanical thrombectomy in AIS was approved by the European Stroke Organization (ESO) in 2014.
The original version of the Consensus on mechanical thrombectomy in AIS was approved by the European Stroke Organization (ESO) in 2014. In 2015 this Consensus was updated with new clinical trials data. The MRCLEAN trial (Multicenter Randomized Clinical trial of Endovascular Treatment in the Netherlands), the SWIFT PRIME trial (Solitaire TM With the Intention For Thrombectomy as PRIMary treatment for acute ischemic stroke), the ESCAPE trial (Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times), the REVASCAT trial (Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset) are the biggest ones and give answers to many questions related to the treatment of acute stroke [8, 16].
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The MRCLEAN trial (Multicenter Randomized Clinical trial of Endovascular Treatment in the Netherlands), the SWIFT PRIME trial (Solitaire TM With the Intention For Thrombectomy as PRIMary treatment for acute ischemic stroke), the ESCAPE trial (Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times), the REVASCAT trial (Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset) are the biggest ones and give answers to many questions related to the treatment of acute stroke [8, 16].
The original version of the Consensus on mechanical thrombectomy in AIS was approved by the European Stroke Organization (ESO) in 2014. In 2015 this Consensus was updated with new clinical trials data. The MRCLEAN trial (Multicenter Randomized Clinical trial of Endovascular Treatment in the Netherlands), the SWIFT PRIME trial (Solitaire TM With the Intention For Thrombectomy as PRIMary treatment for acute ischemic stroke), the ESCAPE trial (Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times), the REVASCAT trial (Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset) are the biggest ones and give answers to many questions related to the treatment of acute stroke [8, 16].
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The clinical efficacy associated with the outcome of the disease has been analyzed in 240 patients treated from 2005 to 2011 by mechanical thrombectomy (initially using Merci system and later stent retrievers) alone or in addition to intravenous thrombolysis (IVT).
The clinical efficacy associated with the outcome of the disease has been analyzed in 240 patients treated from 2005 to 2011 by mechanical thrombectomy (initially using Merci system and later stent retrievers) alone or in addition to intravenous thrombolysis (IVT). Three months after the symptoms onset an improvement in the stroke outcome by using the Rankin scale (mRS 0-2) was reported in 50% of patients [6].
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In a retrospective single-center cohort of 176 patients focusing on mechanical thrombectomy complications, it was shown that prolonged over one hour endovascular procedure was associated with higher complication rate (spontaneous intracerebral hematoma, embolism to new territories, dissection, vasospasm, stent dislocation/occlusion).
In a retrospective single-center cohort of 176 patients focusing on mechanical thrombectomy complications, it was shown that prolonged over one hour endovascular procedure was associated with higher complication rate (spontaneous intracerebral hematoma, embolism to new territories, dissection, vasospasm, stent dislocation/occlusion). Post interventional subarachnoid hyperdensities were not shown to in
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It is shown that a lot of factors influence the stroke outcome – the process of recanalization, time to the beginning of the thrombectomy, presence of combined cerebrovascular pathology (thrombosis of MCA and ipsilateral occlusion of the BCA), patient's age and type of anesthesia during the intervention.
uence outcomes [4, 14]. It is shown that a lot of factors influence the stroke outcome – the process of recanalization, time to the beginning of the thrombectomy, presence of combined cerebrovascular pathology (thrombosis of MCA and ipsilateral occlusion of the BCA), patient's age and type of anesthesia during the intervention.
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Проучванията MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment in the Netherlands), SWIFT PRIME (SolitaireTM With the Intention For Thrombectomy), ESCAPE (Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times), REVASCAT (Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset) са най – мащабните, които дават отговор на много от въпросите, свързани с лечението на острия исхемичен мозъчен инсулт [8, 16].
Проведени са редица проучвания, на базата на които през 2014 г. е приет консенсус за механична тромбектомия при остър исхемичен мозъчен инсулт. Същият е обновен през 2015 г., въз основа на допълнително получени данни. Проучванията MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment in the Netherlands), SWIFT PRIME (SolitaireTM With the Intention For Thrombectomy), ESCAPE (Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times), REVASCAT (Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset) са най – мащабните, които дават отговор на много от въпросите, свързани с лечението на острия исхемичен мозъчен инсулт [8, 16].
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in performing thrombectomy up to 3.5 hours from the symptoms onset and decreasing with time.
in performing thrombectomy up to 3.5 hours from the symptoms onset and decreasing with time. The increased time to reperfusion was associated with a decreased probability of good functional outcome (mRS 0-2). These
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In the MR CLEAN trial, 146 (29%) patients had an additional extracranial ICA occlusion (combined pathology), with treatment effect in favor of thrombectomy.
ndings underline the necessity to treat as early as possible and justify the time window of treatment within 6h from symptoms onset [8]. In the MR CLEAN trial, 146 (29%) patients had an additional extracranial ICA occlusion (combined pathology), with treatment effect in favor of thrombectomy. Acute stenting of the extracranial ICA occlusions resulted in a higher recanalization rate (87% vs. 48%) and favorable outcomes (68% vs. 15%) as well as lower mortality (18% vs. 41%) compared to intraarterial thrombolysis [8, 9]. In MR CLEAN trial 16% of the patients were 80 years old or older.
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t for all subgroups including the elderly, who should thus be considered for thrombectomy [7, 15].
t for all subgroups including the elderly, who should thus be considered for thrombectomy [7, 15]. For the vertebrobasilar circulation a retrospective analysis from a US nationwide database from 2006 to 2010 showed that the age had an impact on in-hospital mortality of patients undergone mechanical thrombectomy but not IVT [3].
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For the vertebrobasilar circulation a retrospective analysis from a US nationwide database from 2006 to 2010 showed that the age had an impact on in-hospital mortality of patients undergone mechanical thrombectomy but not IVT [3].
t for all subgroups including the elderly, who should thus be considered for thrombectomy [7, 15]. For the vertebrobasilar circulation a retrospective analysis from a US nationwide database from 2006 to 2010 showed that the age had an impact on in-hospital mortality of patients undergone mechanical thrombectomy but not IVT [3].
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The choice of anesthesia in mechanical thrombectomy is also important for the disease outcome.
The choice of anesthesia in mechanical thrombectomy is also important for the disease outcome. A retrospective analysis of patients received either general anesthesia or conscious sedation showed that conscious sedation had a better clinical outcome [19]. Patients received general anesthesia had signi
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The analysis of the thrombectomy patients in MR CLEAN showed better functional three-month outcome in the absence of general anesthesia, but the patients were not randomized to the type of anesthesia.
cantly higher inhospital mortality (25%) and pneumonia (17%) compared to patients received conscious sedation (12% and 9.3%, respectively) but similar rates of SICH [14, 19]. The analysis of the thrombectomy patients in MR CLEAN showed better functional three-month outcome in the absence of general anesthesia, but the patients were not randomized to the type of anesthesia. The issue of general anesthesia vs. sedation has been currently studied in four randomized trials [8]. An expert consensus of the Neurointerventional Surgery and the Neurocritical Care Society recommends the use of general anesthesia for patients with severe agitation, low level of consciousness (GCS
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Mechanical thrombectomy in the treatment of acute ischemic stroke
Mechanical thrombectomy in the treatment of acute ischemic stroke
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less than 100 patients have shown good functional outcomes after thrombectomy of the basilar artery, ranging from 30% to 48% [2, 3].
less than 100 patients have shown good functional outcomes after thrombectomy of the basilar artery, ranging from 30% to 48% [2, 3]. The experience at the Karolinska Hospital shows a 57% rate of good functional outcome, with about 21% mortality [12].
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The indications for selecting patients suitable for mechanical thrombectomy are associated with changes in imaging studies (computed tomography /CT/ and/or CT-angiography or magnetic resonance imaging /MRI/ of the head and/or MR angiography of cerebral arteries) [6].
The indications for selecting patients suitable for mechanical thrombectomy are associated with changes in imaging studies (computed tomography /CT/ and/or CT-angiography or magnetic resonance imaging /MRI/ of the head and/or MR angiography of cerebral arteries) [6]. If non-invasive arterial imaging cannot be performed, the patient has NIHSS > 9 points within the
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In most studies an ASPECTS scale to evaluate the effectiveness and safety of conducting mechanical thrombectomy was used.
In most studies an ASPECTS scale to evaluate the effectiveness and safety of conducting mechanical thrombectomy was used. This scale is a 10-point quantitative computer tomography topographic scale and was developed as a replicable system with standard head CT exam for evaluation of early ischemic changes in patients with acute ischemic stroke in the anterior circulation territory.
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t of thrombectomy for patients with ASPECTS scores of 5 or more points (5–7 points) but not with ASPECTS scores 0–4 [8].
t of thrombectomy for patients with ASPECTS scores of 5 or more points (5–7 points) but not with ASPECTS scores 0–4 [8]. In the ESCAPE and SWIFT-PRIME trials a lower ASPECTS threshold was applied – 5 and 6 points respectively [16].
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Mechanical thrombectomy in the treatment of acute ischemic stroke
Mechanical thrombectomy in the treatment of acute ischemic stroke
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Mechanical thrombectomy in addition to intravenous thrombolysis within 4.5 hours when eligible, is recommended to treat acute stroke patients with large artery occlusions in the anterior circulation up to 6h after symptoms onset (Level 1, Grade A);
Mechanical thrombectomy in addition to intravenous thrombolysis within 4.5 hours when eligible, is recommended to treat acute stroke patients with large artery occlusions in the anterior circulation up to 6h after symptoms onset (Level 1, Grade A);
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Mechanical thrombectomy should not prevent the initiation of intravenous thrombolysis where this is indicated, and intravenous
Mechanical thrombectomy should not prevent the initiation of intravenous thrombolysis where this is indicated, and intravenous
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thrombolysis should not delay mechanical thrombectomy (Level 1, Grade A);
thrombolysis should not delay mechanical thrombectomy (Level 1, Grade A);
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Mechanical thrombectomy should be performed as soon as possible after its indication (Level 1, Grade A);
Mechanical thrombectomy should be performed as soon as possible after its indication (Level 1, Grade A);
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For mechanical thrombectomy stent retrievers approved by local health authorities should primarily be considered (Level 1, Grade A);
For mechanical thrombectomy stent retrievers approved by local health authorities should primarily be considered (Level 1, Grade A);
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Other thrombectomy or aspiration devices approved by local health authorities may be used if rapid, complete and safe revascularization of the target vessels can be achieved (Level 2, Grade C);
Other thrombectomy or aspiration devices approved by local health authorities may be used if rapid, complete and safe revascularization of the target vessels can be achieved (Level 2, Grade C);
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Warfarin-treated with therapeutic INR) mechanical thrombectomy is recommended as
If intravenous thrombolysis is contraindicated (e.g. Warfarin-treated with therapeutic INR) mechanical thrombectomy is recommended as
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Patients with acute basilar artery occlusion should be evaluated in centers with multimodal imaging and treated with mechanical thrombectomy in addition to intravenous thrombolysis when indicated (Level 4, Grade C); alternatively they may be treated within a randomized controlled trial for thrombectomy approved by local ethical committees;
Patients with acute basilar artery occlusion should be evaluated in centers with multimodal imaging and treated with mechanical thrombectomy in addition to intravenous thrombolysis when indicated (Level 4, Grade C); alternatively they may be treated within a randomized controlled trial for thrombectomy approved by local ethical committees;
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The decision to perform mechanical thrombectomy should be made by a multidisciplinary team comprising at least a stroke physician and a neurointerventionist and performed in experienced centers providing comprehensive stroke care and expertise in neuroanesthesiology (Level 4, Grade C);
The decision to perform mechanical thrombectomy should be made by a multidisciplinary team comprising at least a stroke physician and a neurointerventionist and performed in experienced centers providing comprehensive stroke care and expertise in neuroanesthesiology (Level 4, Grade C);
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Mechanical thrombectomy should be performed by a trained and experienced neurointerventionist who meets national and/or international requirements (Level 2, Grade B);
Mechanical thrombectomy should be performed by a trained and experienced neurointerventionist who meets national and/or international requirements (Level 2, Grade B);
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The choice of anesthesia depends on the individual situation; regardless of the choice of procedure, all efforts should be made to avoid thrombectomy delay (Level 2, Grade C).
The choice of anesthesia depends on the individual situation; regardless of the choice of procedure, all efforts should be made to avoid thrombectomy delay (Level 2, Grade C).
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Patient selection for mechanical thrombectomy, according to the existing standard [21]
Patient selection for mechanical thrombectomy, according to the existing standard [21]
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Intracranial vessel occlusion must be diagnosed with non-invasive imaging whenever possible before considering treatment with mechanical thrombectomy (Level 1, Grade A);
Intracranial vessel occlusion must be diagnosed with non-invasive imaging whenever possible before considering treatment with mechanical thrombectomy (Level 1, Grade A);
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Mechanical thrombectomy in the treatment of acute ischemic stroke
Mechanical thrombectomy in the treatment of acute ischemic stroke
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infarcts (using the ASPECTS score) may be unsuitable for thrombectomy (Level 2, Grade B);
infarcts (using the ASPECTS score) may be unsuitable for thrombectomy (Level 2, Grade B);
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Imaging techniques for determining infarct and penumbra sizes can be used for patient selection and correlate with functional outcome after mechanical thrombectomy (Level 1, Grade B);
Imaging techniques for determining infarct and penumbra sizes can be used for patient selection and correlate with functional outcome after mechanical thrombectomy (Level 1, Grade B);
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Advanced age alone is not a reason to avoid mechanical thrombectomy as adjunctive treatment (Level 1, Grade A).
Advanced age alone is not a reason to avoid mechanical thrombectomy as adjunctive treatment (Level 1, Grade A).
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Impact of age and baseline NIHSS scores on clinical outcomes in the mechanical thrombectomy using solitaire FR in acute ischemic stroke study.
Almekhlafi MA, Davalos A, Bonafe A. Impact of age and baseline NIHSS scores on clinical outcomes in the mechanical thrombectomy using solitaire FR in acute ischemic stroke study.
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Mechanical thrombectomy as the primary treatment for acute basilar artery occlusion: experience from 5 years of practice.
Andersson T, Kuntze Soderqvist A, Soderman M. Mechanical thrombectomy as the primary treatment for acute basilar artery occlusion: experience from 5 years of practice.
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Acute basilar artery occlusion: Outcome of mechanical thrombectomy with solitaire stent within 8 hours of stroke onset.
Baek JM, Yoon W, Kim SK. Acute basilar artery occlusion: Outcome of mechanical thrombectomy with solitaire stent within 8 hours of stroke onset.
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Complications of mechanical thrombectomy for acute ischemic stroke – a retrospective single-center study of 176 consecutive cases.
Behme D, Gondecki L, Fiethen S. Complications of mechanical thrombectomy for acute ischemic stroke – a retrospective single-center study of 176 consecutive cases.
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Mechanical thrombectomy with stent retrievers in acute basilar artery occlusion.
Mohlenbruch M, Stampfl S, Behrens L. Mechanical thrombectomy with stent retrievers in acute basilar artery occlusion.
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Improved clinical outcome after acute basilar artery occlusion since the introduction of endovascular thrombectomy devices.
Nagel S, Kellert L, Mohlenbruch M. Improved clinical outcome after acute basilar artery occlusion since the introduction of endovascular thrombectomy devices.
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Acute ischaemic stroke outcomes following mechanical thrombectomy in the elderly versus their younger counterpart: a retrospective cohort study.
Villwock MR, Singla A, Padalino DJ. Acute ischaemic stroke outcomes following mechanical thrombectomy in the elderly versus their younger counterpart: a retrospective cohort study.
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Trevo versus merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial.
Nogueira RG, Lutsep HL, Gupta R. Trevo versus merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial.
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Impact of the ASPECT scores and distribution on outcome among patients undergoing thrombectomy for acute ischemic stroke.
Spiotta AM, Vargas J, Hawk H. Impact of the ASPECT scores and distribution on outcome among patients undergoing thrombectomy for acute ischemic stroke.
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Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.
Wahlgren N, Moreira T, Miche P, Steiner TH, Jansen O, Cognard Chr, Mattle H, van Zwam W, Holmin St, Tatlisumak T, Petersson J, Caso V, Hacke W, Mazighi M, Arnold M, Fischer U, Szikora I, Pierot L, Fiehler J, Gralla J, Fazekas Fr; Lees K. Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.
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11. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 2 , , ,

Тhe scientific programme of the Congress is dedicated to the modern diagnosis and differentiated treatment of stroke, focusing endovascular therapy and mechanical thrombectomy.
Тhe scientific programme of the Congress is dedicated to the modern diagnosis and differentiated treatment of stroke, focusing endovascular therapy and mechanical thrombectomy.
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CONSENSUS FOR MECHANICAL THROMBECTOMY IN ACUTE ISCHEMIC STROKE
CONSENSUS FOR MECHANICAL THROMBECTOMY IN ACUTE ISCHEMIC STROKE
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Thrombectomy in Acute Ischemic Stroke – Diagnostic and Treatment Algorhitm.
Thrombectomy in Acute Ischemic Stroke – Diagnostic and Treatment Algorhitm.
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Requirements for conducting thrombectomy in Acute
Requirements for conducting thrombectomy in Acute
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INTERDISCIPLINARY CONSENSUS FOR MECHANICAL THROMBECTOMY
INTERDISCIPLINARY CONSENSUS FOR MECHANICAL THROMBECTOMY
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12. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 1 , , ,

for Mechanical Thrombectomy in Acute Ischemic Stroke
for Mechanical Thrombectomy in Acute Ischemic Stroke
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for Mechanical Thrombectomy in Acute Ischemic Stroke
for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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acute ischemic stroke, endovascular therapy, mechanical thrombectomy, stent retriever, thrombolysis, thrombectomy.
acute ischemic stroke, endovascular therapy, mechanical thrombectomy, stent retriever, thrombolysis, thrombectomy.
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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Endovascular thrombectomy for stroke: current best practice and future goals.
Campbell BCV, Donnan GA, Mitchell PJ, Davis SM. Endovascular thrombectomy for stroke: current best practice and future goals.
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Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.
Wahlgren N et al. Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
National Consensus for Mechanical Thrombectomy in Acute Ischemic Stroke
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The forum was dedicated to the developments in diagnosis and treatment of cerebrovascular diseases with a focus on differentiated stroke treatment (thrombolysis and thrombectomy).
The Second National Congress of the Bulgarian Society of Neurosonology and Cerebral Hemodynamics with international participation was held in the halls of the Bulgarian Red Cross in Sofia from September 30 to October 2, 2016. The event was under the auspices of the Neurosonology Research Group of the World Federation of Neurology, European Society of Neurosonology and Cerebral Hemodynamics, Medical Faculty of Sofia University “St. Kl. Ohridski”, Military Medical Academy, Bulgarian Academy of Sciences and Arts, Bulgarian Society of Neurology, Bulgarian Medical Association and Bulgarian Red Cross. Over 160 delegates from Austria, Bosnia and Herzegovina, Bulgaria, Germany, Israel, Macedonia, Serbia, Sudan and Croatia, medical, nursing, physical therapy, medical rehabilitation and occupational therapy students from various Bulgarian medical universities and the National Sports Academy “V. Levski” were registered for participation. The forum was dedicated to the developments in diagnosis and treatment of cerebrovascular diseases with a focus on differentiated stroke treatment (thrombolysis and thrombectomy). The event was accredited with 12 points by
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thrombectomy in acute ischemic stroke was adopted.
thrombectomy in acute ischemic stroke was adopted. The algorithm was presented by Prof. S. Andonova, a National Consultant for Interventional Neurology of the Department of Health.
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Signature of the National Consensus on Mechanical Thrombectomy in Acute Ischemic Stroke
Signature of the National Consensus on Mechanical Thrombectomy in Acute Ischemic Stroke
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13. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 2 , , ,

Mechanical Thrombectomy in Acute Stroke
Mechanical Thrombectomy in Acute Stroke
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Mechanical Thrombectomy in Acute Stroke.
Mechanical Thrombectomy in Acute Stroke.
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Mechanical Thrombectomy in Acute Stroke
Mechanical Thrombectomy in Acute Stroke
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mechanical thrombectomy, stroke,
mechanical thrombectomy, stroke,
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Mechanical thrombectomy devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years.
Mechanical thrombectomy devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years. The initial results were based on case reports and case series and in the last several years on registries, mainly concerning stent retrievers. The present article presents the findings from recent international trials.
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Mechanical thrombectomy (TE) devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years.
Mechanical thrombectomy (TE) devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years. The initial results were based on case reports and case series and in the last several years on registries, mainly concerning stent retrievers.
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The Austrian Stroke Network Thrombectomy results were published recently [5].
The Austrian Stroke Network Thrombectomy results were published recently [5]. The TE results in Styria (Neurointervention Center Graz, catchment area 1.5 million inhabitants) are comparable to the nationwide data (Table 1).
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Results of Mechanical Thrombectomy in Styria 2011–2014
Results of Mechanical Thrombectomy in Styria 2011–2014
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There was a significant relative risk reduction (73%) in disability in 107 patients receiving mechanical thrombectomy compared to 99 with medical management (OR 2.1, 95% 1.20 – 3.12, p
There was a significant relative risk reduction (73%) in disability in 107 patients receiving mechanical thrombectomy compared to 99 with medical management (OR 2.1, 95% 1.20 – 3.12, p
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In Bulgaria, the percentage of recanalization procedures by intravenous thrombolysis (TL), thrombectomy, etc., remains low as compared to the centers for stroke treatment in the countries of Eastern Europe, where recanalization procedures are implemented in 20% to 30% of the hospitalized acute stroke patients (Fig. 5).
In Bulgaria, the percentage of recanalization procedures by intravenous thrombolysis (TL), thrombectomy, etc., remains low as compared to the centers for stroke treatment in the countries of Eastern Europe, where recanalization procedures are implemented in 20% to 30% of the hospitalized acute stroke patients (Fig. 5).
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To monitor the effect of applied physiotherapy in a patient with complications after aortic valve thrombectomy.
To monitor the effect of applied physiotherapy in a patient with complications after aortic valve thrombectomy.
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A 73-year-old female 24 days after aortic valve thrombectomy is described.
A 73-year-old female 24 days after aortic valve thrombectomy is described. On the 10
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14. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 1 , , ,

The updated results from the mechanical thrombectomy as a relatively new treatment approach in acute stroke, and the workup of cryptogenic stroke were discussed by prof.
The updated results from the mechanical thrombectomy as a relatively new treatment approach in acute stroke, and the workup of cryptogenic stroke were discussed by prof. Kurt Niederkorn (Austria). Assoc. Prof. Dimitre Staykov (Austria/Bulgaria) made a comprehensive review on the recent concept for the quality of stroke units and the importance of unified stroke register. During the interactive workshop he presented the international practical approach to the treatment of intracerebral hemorrhage. Prof. Silva Andonova (Bulgaria) paid attention on the prospective follow-up of thrombolytic versus standard therapy in acute ischemic stroke.
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15. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 2 , , ,

Mechanical thrombectomy in acute ischemic stroke: consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.
Wahlgren N, Moreira T, Michel P et al. Mechanical thrombectomy in acute ischemic stroke: consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.
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Mechanical Thrombectomy in Treatment
Mechanical Thrombectomy in Treatment
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From implementation of public educational programs and stroke protocols for first aid providers to keeping time goals of 45 to 60 min in the hospital for emergency evaluation of the patient for intravenous thrombolysis and/or mechanical thrombectomy are recommended in the guidelines.
From implementation of public educational programs and stroke protocols for first aid providers to keeping time goals of 45 to 60 min in the hospital for emergency evaluation of the patient for intravenous thrombolysis and/or mechanical thrombectomy are recommended in the guidelines.
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For mechanical thrombectomy the use of stent retrievers is the first choice; in selected patients with large vessel occlusion it is recommended to perform the procedure 6 to 24 hours after the stroke onset.
The detailed conditions for intravenous thrombolysis are considered; new recommendations are about the treatment of mild stroke, with small number of cerebral microbleeds or with sickle cell disease. The initial treatment with intraarterial thrombolysis is uncertain. For mechanical thrombectomy the use of stent retrievers is the first choice; in selected patients with large vessel occlusion it is recommended to perform the procedure 6 to 24 hours after the stroke onset.
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Among them mechanical thrombectomy stands out as the most effective method, which is beginning to affirm as standard in the international practice.
Brain stroke is a leading cause of severe invalidation and mortality. Attempts for preventing consequences have led investigators to development of vast majority of techniques for achievement of reperfusion in the super acute phase. Among them mechanical thrombectomy stands out as the most effective method, which is beginning to affirm as standard in the international practice. We report statistical data of the initial experience in Bulgaria in comparison with the achievements of the leading interventional centers. Guidelines for the next steps in the
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acute ischemic stroke, mechanical thrombectomy, reperfusion
acute ischemic stroke, mechanical thrombectomy, reperfusion
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Special treatment is initiated through early recanalization (intravenous and intraarterial thrombolysis, endovascular stenting and/or mechanical thrombectomy) at the acute stage of ischemic stroke (AIS) and its impact on the final outcome of the disease.
In recent decades Bulgaria ranks at one of the top places in the EU on stroke death. The presentation shows the main trends in the course of stroke morbidity and mortality in the country. Special treatment is initiated through early recanalization (intravenous and intraarterial thrombolysis, endovascular stenting and/or mechanical thrombectomy) at the acute stage of ischemic stroke (AIS) and its impact on the final outcome of the disease. Despite the fact that there is a steady tendency to increase the relative part of the specific treatment in AIS, its incidence is still very low
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Mechanical thrombectomy was not attempted due to absence of viability on penumbra imaging.
Surgery at high perioperative risk was offered, but patient refused. 50h post UFH initiation patient became unresponsive, with right sided hemiparesis and NIHSS – 25. The LV thrombus was not seen anymore. Color coded duplex ultrasound showed that both carotids were free of thrombi, but the left one was with diminished flow. MRI-angiography confirmed hemispheric stroke and carotid siphon obstruction. Mechanical thrombectomy was not attempted due to absence of viability on penumbra imaging. Patient expired.
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Patient had emergency thrombectomy for the leg ischaemia.
Left atrial embolism due to poor TTR was presumed. TTE revealed mobile apical thrombus. Patient had emergency thrombectomy for the leg ischaemia. Conservative approach was employed for the LV thrombus, enoxaparin sc, followed by rivaroxaban 20mg. In one week the mobile component was gone and in one year time the LV apex was clear.
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Patient management was discussed by Heart Team and decision to proceed with atrial/pulmonary thrombectomy and PFO closure was made.
Echocardiography revealed severe RA dilation, interatrial septum was bulging towards left atrium (LA), there was a serpingous thrombus protruding from RA into LA via patent foramen ovale (PFO). CT pulmoangiography confirmed massive pulmonary embolism and the atrial thrombus. Compression ultrasound and color coded duplex ultrasound showed proximal lower limb deep vein thrombosis. Patient management was discussed by Heart Team and decision to proceed with atrial/pulmonary thrombectomy and PFO closure was made. Immediately post-op, there were pulmonary bleeding and right
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Protruding thrombus in LA is contraindication for thrombolysis due to risk of brain embolism and the only possible treatment is surgical thrombectomy with PFO closure.
In PE patients right atrial thrombi are rather rare. Increased RA pressures in patients with PE may lead to opening on PFO and right-to-left shunting, which in turn can suck the RA thrombi in transit into LA. First presentation in such patients can be systemic embolism – for example stroke. Protruding thrombus in LA is contraindication for thrombolysis due to risk of brain embolism and the only possible treatment is surgical thrombectomy with PFO closure.
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16. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 15, 2019, No. 1 , , ,

The invasive treatment method includes procedures aim the recanalization of the internal carotid artery (carotid endarterectomy, endovascular stenting and/or mechanical thrombectomy) [12, 15] and the ophthalmic artery through selective intra-arterial thrombolysis.
The invasive treatment method includes procedures aim the recanalization of the internal carotid artery (carotid endarterectomy, endovascular stenting and/or mechanical thrombectomy) [12, 15] and the ophthalmic artery through selective intra-arterial thrombolysis. In treatment with intra-arterial thrombolysis there is a 60-70% visual acuity improvement [19]. In some cases the use of anterior chamber paracentesis followed by aspiration of a small amount of fluid is recommended. Nd YAG laser (Neodymium: yttrium-aluminum-garnet laser) embolectomy and pars plana vitrectomy are not routinely used because of the high risk for vitreous hemorrhage. Late effects occur in 18% of patients with acute thrombosis: neovascularization of the optic papilla (usually between weeks 2 and 16 after the symptoms
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for mechanical thrombectomy in acute ischemic stroke, Koty Ltd, Sofia, 2016.
for mechanical thrombectomy in acute ischemic stroke, Koty Ltd, Sofia, 2016.
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The forum was dedicated to novelties in ultrasound diagnostics of the nervous system, the control of risk factors for cerebrovascular disease, modern treatment of stroke through early recanalization (thrombolysis and/or thrombectomy), new approaches to early and late neurorehabilitation to stimulate the brain neuroplasticity and reorganization after stroke.
The forum was dedicated to novelties in ultrasound diagnostics of the nervous system, the control of risk factors for cerebrovascular disease, modern treatment of stroke through early recanalization (thrombolysis and/or thrombectomy), new approaches to early and late neurorehabilitation to stimulate the brain neuroplasticity and reorganization after stroke.
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Staneva), initial experience in the application of mechanical thrombectomy in ischemic stroke in Bulgaria (Dr. N.
In a separate morning session the novelties in the field of Neurosonology and stroke were presented: Bulgarian experience in carotid revascularization (Prof. M. Staneva), initial experience in the application of mechanical thrombectomy in ischemic stroke in Bulgaria (Dr. N. Alioski and al.), treatment of cerebral and spinal vascular diseases (Assoc. Prof.
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