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RISS 인기검색어
- 검색키워드
- 저자 : Seby John (검색결과 3 건)
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Seby John,Muhammad S. Hussain,Gabor Toth,Mark Bain,Ken Uchino,Ferdinand K. Hui 대한뇌혈관외과학회 2014 Journal of Cerebrovascular and Endovascular Neuros Vol.16 No.4
Objectives : The 5MAX ACE is a new large bore aspiration catheter availablefor vessel recanalization for treatment of acute ischemic stroke (AIS). We report our initial experience with its use. Methods : A retrospective analysis of patients undergoing intra-arterialtherapy for AIS using the 5MAX ACE reperfusion catheter at our institutionwas performed. Patient demographics, clinical characteristics andprocedural data were obtained from chart review. Successful recanlizationwas defined as achievement of Thrombolysis in Cerebral Infarction score(TICI) 2b-3 and time to recanalization was defined as time from groinpuncture to achievement of at least TICI 2b recanalization. Results : The 5MAX ACE was used in 15 patients from July-October2013. Direct aspiration was used as the primary technique in 10/15(67%) patients. Out of these, aspiration alone was sufficient for recanalizationin 3 (20%) patients. In the remaining 7 (47%) patients, additionaldevices were used. In 5/15 (33%) patients, combined aspiration/stentrieverthrombectomy using Solitaire™ (3/5 patients) and Penumbra 3DSeparator™ (2/5 patients) were used as the primary technique. Successfulrecanlization (TICI 2b-3) was achieved in 11/15 (73%) patients. Averagetime from groin puncture to successful recanalization was 46 +/- 30 minutes(range 14-98 minutes). There were no procedural complications. Conclusion : The 5MAX ACE is a useful recanalization tool, either by directaspiration or combined stentriever/aspiration. It may be most advantageouswith large clots in the internal carotid artery. The potentialfor effective and faster recanalization using this device alone or in combinationmay be a good topic for future study.
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Seby John,Syed Irteza Hussain,Bartlomiej Piechowski,Mohammad Asif Dogar 대한뇌혈관외과학회 2020 Journal of Cerebrovascular and Endovascular Neuros Vol.22 No.1
Objective: Mechanical thrombectomy (MT) is now an established treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO) within 6 hours. Since 2018, MT is also recommended from 6-24 hours after selecting with additional multimodal imaging including perfusion imaging. We sought to investigate patients with significant discrepancy in core infarct between computed tomography (CT) and CT perfusion (CTP). Methods: In this retrospective study, patients with AIS who were evaluated for MT using the RAPID software (IschemaView, Redwood City, CA, USA) from February 2018 to March 2019 were included. Cases with discrepancy between infarct volume on non-contrast CT and core volume (cerebral blood flow <30%) as analyzed by RAPID on CTP were analyzed. Results: In the study period, 635 patients were evaluated for acute stroke symptoms. Non-contrast head CT was performed in 635 patients, and CTP with RAPID software post processing was performed in 134 patients. Among the 134 patients, 8 (5.9%) patients had gross discrepancy in core infarct between CT and CTP, with underestimation of infarct by CTP. Evaluation of these cases shows that the likely reason for this discrepancy is recanalization of a LVO, which then leads to erroneously normal or gross underestimate of the core infarct volume determined from CTP post processing analysis. Conclusions: Recanalization of a LVO can lead to erroneously normal or gross underestimation of the core infarct as determined by post processing software analysis of CTP data. The whole composite of hyperacute CT imaging should be examined while making decisions. This caveat of perfusion imaging interpretation has not been reported previously.
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Seby John,Tanmoy Kumar Maiti,Praveen Kesav,Ashna Arif,Syed Irteza Hussain 대한뇌혈관외과학회 2024 Journal of Cerebrovascular and Endovascular Neuros Vol.26 No.1
Intracranial non-galenic pial arteriovenous fistula (PAVF) is an extremely rare vascular malformation, where one or more pial arteries feeds directly into a cortical vein without any intervening nidus. Though occasionally they can be asymptomatic, neurological symptoms such as headache, seizure, or focal neurological deficit are more common presenting features. Life threatening or fatal hemorrhage is not uncommon, hence needed to be treated more often than not. Spontaneous occlusion of PAVF is reported only four times before. We report a 49-year-old gentleman, who was diagnosed to have a PAVF, possibly secondary to trauma. He presented 5 months and 22 days from initial digital subtraction angiography (DSA) for treatment, and follow-up angiogram showed complete obliteration. He denied any significant event, medication or alternate treatment during this period. His clinical symptoms were stable as well. We postulate iodinated contrast medium induced vasculopathy as a possible cause, which has been described for other vascular pathologies, but never for PAVF.
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