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During the last decade, the management of acute ischemic stroke has changed dramatically, from an expectant bedside "wait and see" attitude towards active treatment, thanks to the continuous improvement of new therapeutic options. In addition to the use of intravenous (IV) thrombolysis in emergent large vessel occlusion (ELVO), endovascular therapy (EVT) has proven to be very efficient in selected acute stroke patients. The indications for EVT have progressed from the era of thrombolysis to individual patient profiling. Recently, several indication parameters, e.g., "treatment time window" or "more distal vessel occlusion," are under debate for adjustment. In this article, we review the imaging strategies in acute stroke and discuss several EVT indication dogmas, which are subject to change.
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http://dx.doi.org/10.1186/s13244-019-0744-4 | DOI Listing |
Atherosclerosis
September 2025
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China; State Key Laboratory of Frigid Zone Cardiovascular Diseases, Harbin Medical University, Harbin, China. Electronic address
Background And Aims: Cold weather is associated with an increased risk of cardiovascular events, but its impact on culprit plaque characteristics in ST-segment elevation myocardial infarction (STEMI) remains unclear.
Methods: This study included 647 STEMI patients who underwent optical coherence tomography (OCT) to assess untreated culprit lesions. Participants were grouped based on ambient temperature on the day of admission or mean ambient temperatures over the preceding 7-, 14-, 21-, and 28-day periods.
J Neurointerv Surg
September 2025
Neurology Department, Lariboisière Hospital, APHP, Université Paris Cité, Paris, France.
Background And Purpose: Cervicocephalic artery dissection (CCAD) is a well-recognized cause of ischemic stroke. However, complex forms of CCAD, characterized by a wide intimal inlet without a visible intramural hematoma, pose diagnostic challenges and complicate endovascular access to the true lumen when recanalization is required. We aimed to analyze the clinical presentation, outcomes, and feasibility of endovascular treatment of complex CCAD and to propose a novel morphological classification.
View Article and Find Full Text PDFJ Am Coll Cardiol
September 2025
Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France.
Background: The hemodynamic effects of femoro-femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) on pulmonary capillary wedge pressure (PCWP) remain poorly defined. High ECMO flow is believed to increase PCWP and the risk of pulmonary edema; yet, supporting in vivo physiological data are lacking.
Objectives: The purpose of this study was to evaluate the impact of incremental femoro-femoral VA-ECMO flow variations on PCWP, hemodynamic, and echocardiographic parameters in patients with cardiogenic shock during the early phase of VA-ECMO support, after stabilization.
BMJ Open
September 2025
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
Introduction: Intracranial atherosclerosis is the main cause of stroke globally, with acute large vessel occlusive (LVO) stroke being a predominant contributor to stroke-related mortality. In recent years, aspiration thrombectomy (AT) has emerged as a novel therapeutic method for treating acute LVO stroke. The purpose of this study aims to investigate the safety and efficacy of AT alone or combined with stent retriever thrombectomy (SRT) in the treatment of acute LVO stroke METHODS AND ANALYSIS: This is a multicentre and observational real-world study involving patients diagnosed with acute LVO stroke.
View Article and Find Full Text PDFObjectives: This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients' COVID-19 infection status.
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