NEVA IN AN I-TYPE ICA OCCLUSION WITH MANY SURPRISES скачать в хорошем качестве

NEVA IN AN I-TYPE ICA OCCLUSION WITH MANY SURPRISES

NEVA IN AN I-TYPE ICA OCCLUSION WITH MANY SURPRISES: Live CaseTransmission at the iCureStroke 2022 featuring Vesalio NeVa™ 4.5 x 37 mm COURTESY OF iCureStroke.org, PROF GEYIK and DR BAJRAMI, AYDIN UNIVERSITY HOSPITAL, ISTANBUL, TURKEY This case was transmitted live during the iCureStroke 2022 meeting. Full of surprises, the case started out with the patient presenting with signs of hemianopsia and relevant PCA-territory DWI restriction, suggesting an acute occlusion of the PCA. Albeit initial presentation, diagnostic angiography revealed an ipsilateral ICA occlusion, mimicking a chronic occlusion, with collateral filling of the ipsilateral MCA from the opposite side. The biggest surprise was the discovery of the fetal-type-PCA anatomic variant and the occlusion of the PCA origin, explaining the initial presentation with PCA-stroke symptoms. The technical challenge was removing the high clot burden from the ICA without jeopardising the downstream MCA-ACA territories, which remained fully intact thanks to the collateral filling. Any fragment loss would have compromised the MCA territory, worsening the patient outcome. Watch the case in real-time as Prof Serdar Geyik and his team forge ahead despite the challenges. Take in the comments a,d recommendations of the the iCureStroke meeting faculty as they discuss relevant evidence and statistics at each step. CHAPTERS 00:00 Introduction 02:14 Groin puncture & discussion on the case presentation 04:28 A chronic ICA occlusion on top of a PCA occlusion? 11:56 Posterior Circulation Angio 14:52 Anterior Circulation Angio 18:30 Is this a pseudo-occlusion? Exploration of the lesion 23:58 A change in access strategy and discussion on the shape and size of the thrombus 26:47 Large clot burden expected: discussion on the ideal technique and stent-retriever 32:30 Intracranial access and further discussion on treatment choices 35:00 Thrombectomy with NeVa 4.5 x 37 mm: navigation, deployment, retrieval 38:04 1st Pass TICI 3 recanalization & what is specific about NeVa 41:46 Thrombus inside NeVa 43:14 What I love the most about the case… 47:24 Revision of the material emploed, further comments and closure Vesalio would like to thank the iCureStroke meeting organization and faculty, Professor Serdar Geyik, Dr Arsida Bajrami, and the Aydin University Hospital Stroke staff, as well as Professor Raul Nogueira presenting the case, and the iCureStroke faculty members for this valuable learning experience.