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Jeffrey Forris Beecham Chick - One of the best experts on this subject based on the ideXlab platform.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients
CardioVascular and Interventional Radiology, 2019Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:Purpose To report the technical success and complications following sharp recanalization of chronic venous Occlusions. Materials and Methods A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis ( n = 43; 35.0%), prior central venous access ( n = 39; 31.7%), indwelling cardiac leads ( n = 21; 17.1%), and occluded venous stents ( n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Results Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare ( n = 92; 74.8%), partially deployed Wallstent ( n = 21; 17.1%), partially deployed Amplatzer vascular plug ( n = 8; 6.5%), and an angioplasty balloon ( n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Conclusion Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients.
CardioVascular and Interventional Radiology, 2018Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:To report the technical success and complications following sharp recanalization of chronic venous Occlusions. A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis (n = 43; 35.0%), prior central venous access (n = 39; 31.7%), indwelling cardiac leads (n = 21; 17.1%), and occluded venous stents (n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare (n = 92; 74.8%), partially deployed Wallstent (n = 21; 17.1%), partially deployed Amplatzer vascular plug (n = 8; 6.5%), and an angioplasty balloon (n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
Ravi N. Srinivasa - One of the best experts on this subject based on the ideXlab platform.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients
CardioVascular and Interventional Radiology, 2019Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:Purpose To report the technical success and complications following sharp recanalization of chronic venous Occlusions. Materials and Methods A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis ( n = 43; 35.0%), prior central venous access ( n = 39; 31.7%), indwelling cardiac leads ( n = 21; 17.1%), and occluded venous stents ( n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Results Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare ( n = 92; 74.8%), partially deployed Wallstent ( n = 21; 17.1%), partially deployed Amplatzer vascular plug ( n = 8; 6.5%), and an angioplasty balloon ( n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Conclusion Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients.
CardioVascular and Interventional Radiology, 2018Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:To report the technical success and complications following sharp recanalization of chronic venous Occlusions. A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis (n = 43; 35.0%), prior central venous access (n = 39; 31.7%), indwelling cardiac leads (n = 21; 17.1%), and occluded venous stents (n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare (n = 92; 74.8%), partially deployed Wallstent (n = 21; 17.1%), partially deployed Amplatzer vascular plug (n = 8; 6.5%), and an angioplasty balloon (n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
Joseph L. Mcdevitt - One of the best experts on this subject based on the ideXlab platform.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients
CardioVascular and Interventional Radiology, 2019Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:Purpose To report the technical success and complications following sharp recanalization of chronic venous Occlusions. Materials and Methods A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis ( n = 43; 35.0%), prior central venous access ( n = 39; 31.7%), indwelling cardiac leads ( n = 21; 17.1%), and occluded venous stents ( n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Results Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare ( n = 92; 74.8%), partially deployed Wallstent ( n = 21; 17.1%), partially deployed Amplatzer vascular plug ( n = 8; 6.5%), and an angioplasty balloon ( n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Conclusion Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients.
CardioVascular and Interventional Radiology, 2018Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:To report the technical success and complications following sharp recanalization of chronic venous Occlusions. A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis (n = 43; 35.0%), prior central venous access (n = 39; 31.7%), indwelling cardiac leads (n = 21; 17.1%), and occluded venous stents (n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare (n = 92; 74.8%), partially deployed Wallstent (n = 21; 17.1%), partially deployed Amplatzer vascular plug (n = 8; 6.5%), and an angioplasty balloon (n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
V. Costalat - One of the best experts on this subject based on the ideXlab platform.
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Anterior Circulation Acute Ischemic Stroke Associated with Atherosclerotic Lesions of the Cervical ICA: A Nosologic Entity Apart
American Journal of Neuroradiology, 2017Co-Authors: O. F. Eker, P. Panni, C. Dargazanli, G. Marnat, C. Arquizan, P. Machi, I. Mourand, G. Gascou, E. Le Bars, V. CostalatAbstract:BACKGROUND AND PURPOSE: Mechanical thrombectomy for patients with acute ischemic stroke with tandem Occlusions has been shown to present varying reperfusion successes and clinical outcomes. However, the heterogeneity of tandem Occlusion etiology has been strongly neglected in previous studies. We retrospectively investigated patients with acute ischemic stroke atherothrombotic tandem Occlusion. MATERIALS AND METHODS: All consecutive patients with acute ischemic stroke with atherothrombotic tandem Occlusions treated with mechanical thrombectomy in our center between September 2009 and April 2015 were analyzed. They were compared with patients with acute ischemic stroke with dissection-related tandem Occlusion and isolated intracranial Occlusion treated during the same period. Comparative univariate and multivariate analyses were conducted, including demographic data, safety, and rates of successful recanalization and good clinical outcome. RESULTS: Despite comparable baseline severity of neurologic deficits and infarct core extension, patients with atherothrombotic tandem Occlusions were older (P\textless .001), were more frequently smokers (P\textless .001), and had globally more cardiovascular risk factors (P\textless .001) than the other 2 groups of patients. The patients with atherothrombotic tandem Occlusions had significantly longer procedural times (P\textless .001), lower recanalization rates (P= .004), and higher global burden of procedural complications (P\textless .001). In this group, procedural complications (OR = 0.15,P= .02) and the TICI 2b/3 reperfusion scores (OR = 17.76,P= .002) were independently predictive factors of favorable clinical outcome. CONCLUSIONS: Our study suggests that atherothrombotic tandem Occlusions represent a peculiar and different nosologic entity compared with dissection-related tandem Occlusions. This challenging cause of acute ischemic stroke should be differentiated from other etiologies in patient management in future prospective studies.
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Endovascular Management of Tandem Occlusion Stroke Related to Internal Carotid Artery Dissection Using a Distal to Proximal Approach: Insight from the RECOST Study
American Journal of Neuroradiology, 2016Co-Authors: G. Marnat, C. Arquizan, P. Machi, I. Mourand, O. Eker, C. Riquelme, X. Ayrignac, A. Bonafé, V. CostalatAbstract:BACKGROUND AND PURPOSE: Internal carotid artery dissection is a common cause of stroke in young adults. It may be responsible for tandem Occlusion defined by a cervical steno-occlusive carotid wall hematoma associated with an intracranial large-vessel stroke. Intravenous thrombolysis is associated with a poor clinical outcome in these cases, and endovascular treatment has not been specifically evaluated to date. Our aim was to evaluate endovascular treatment technical and clinical efficiency in this specific Occlusion topography, in comparison with treatment of isolated anterior circulation stroke. MATERIALS AND METHODS: As part of our ongoing prospective stroke data base started in August 2009 (Prognostic Factors Related to Clinical Outcome Following Thrombectomy in Ischemic Stroke [RECOST] Study), we analyzed all carotid artery dissection tandem Occlusion strokes and isolated anterior circulation Occlusions. All patients were selected for endovascular treatment according to clinical-radiologic mismatch, NIHSS ≥ 7 and DWI-ASPECTS ≥5, within 6 hours after onset. For carotid artery dissection, the revascularization procedure consisted first of distal recanalization by a stent retriever in the intracranial vessel. Following assessment of the circle of Willis, internal carotid artery stent placement was only performed in case of insufficiency. Carotid artery dissection treatment efficacy, safety, and clinical outcome were compared with the results of the isolated anterior circulation Occlusion cohort. RESULTS: Two hundred fifty-eight patients with an anterior circulation stroke were analyzed, including 57 with tandem Occlusions (22%); among them, 20 were carotid artery dissection-related Occlusions (7.6%). The median age of patients with tandem Occlusions with internal carotid dissection was 52.45 versus 66.85 years for isolated anterior circulation Occlusion (P < .05); the mean initial NIHSS score was 17.53 ± 4.11 versus 17.55 ± 4.8 (P = .983). The median DWI-ASPECTS was 6.05 versus 6.64 (P = .098), and the average time from onset to puncture was 4.38 for tandem Occlusions versus 4.53 hours in isolated anterior circulation Occlusion (P = .704). Complication rates and symptomatic intracranial hemorrhage were comparable in both groups (5% versus 3%, P = .49). The duration of the procedure was significantly prolonged in case of tandem Occlusion (80.69 versus 65.45 minutes, P = .030). Fourteen patients with carotid artery dissection (70%) had a 3-month mRS of ≤ 2, without a significant difference from patients with an isolated anterior circulation Occlusion (44%, P = .2). Only 5 carotid artery dissections (25%) necessitated cervical stent placement. No early ipsilateral stroke recurrence was recorded, despite the absence of stent placement in 15 patients (75%) with carotid artery dissection. CONCLUSIONS: Mechanical endovascular treatment of carotid artery dissection tandem Occlusions is safe and effective compared with isolated anterior circulation Occlusion stroke therapy. Hence, a more conservative approach with stent placement only in cases of circle of Willis insufficiency may be a reliable and safe strategy.
Anthony N. Hage - One of the best experts on this subject based on the ideXlab platform.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients
CardioVascular and Interventional Radiology, 2019Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:Purpose To report the technical success and complications following sharp recanalization of chronic venous Occlusions. Materials and Methods A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis ( n = 43; 35.0%), prior central venous access ( n = 39; 31.7%), indwelling cardiac leads ( n = 21; 17.1%), and occluded venous stents ( n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Results Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare ( n = 92; 74.8%), partially deployed Wallstent ( n = 21; 17.1%), partially deployed Amplatzer vascular plug ( n = 8; 6.5%), and an angioplasty balloon ( n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Conclusion Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
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Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients.
CardioVascular and Interventional Radiology, 2018Co-Authors: Joseph L. Mcdevitt, Ravi N. Srinivasa, Joseph J. Gemmete, Anthony N. Hage, Jacob J. Bundy, Jeffrey Forris Beecham ChickAbstract:To report the technical success and complications following sharp recanalization of chronic venous Occlusions. A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous Occlusions. The etiologies of Occlusion were chronic deep venous thrombosis (n = 43; 35.0%), prior central venous access (n = 39; 31.7%), indwelling cardiac leads (n = 21; 17.1%), and occluded venous stents (n = 20; 16.3%). The sites of venous Occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of Occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm). Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare (n = 92; 74.8%), partially deployed Wallstent (n = 21; 17.1%), partially deployed Amplatzer vascular plug (n = 8; 6.5%), and an angioplasty balloon (n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter Occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent. Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous Occlusions.
