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carotid/subclavian/innominate thrombectomy

Indications: - carotid artery thrombosis - subclavian artery thrombosis - brachiocephalic artery thrombosis Benefit/risk: - endovascular thrombectomy within 12 hours after symptom onset (stroke) significantly reduces 90-day disability, with a number-needed-to-treat of 2.6 patients to reduce disability on the modified Rankin Scale by at least 1 point in 1 patient [1] - for up to 24 hours after symptom onset in eligible patients with ischemic stroke* [3] - Trevo clot retrieval device FDA-approved [4]

General

subclavian/innominate thrombectomy

References

  1. Goyal M, Menon BK, van Zwam WH et al. Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet 2016 Feb 18 PMID: 26898852
  2. Dippel DWJ Thrombectomy Options for Acute Ischemic Stroke. Which Way to Go? JAMA Neurol. Published online Jan 2, 2018. PMID: 29297050 https://jamanetwork.com/journals/jamaneurology/article-abstract/2666951
  3. Powers WJ, Rabinstein AA, Ackerson T et al 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018; Jan 24 PMID: 29367334 http://stroke.ahajournals.org/content/early/2018/01/23/STR.0000000000000158 - Furie KL, Jayaraman MV 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke. PMID: 29367335 http://stroke.ahajournals.org/content/early/2018/01/24/STROKEAHA.118.020176
  4. FDA News Release. Feb 15, 2018 FDA expands treatment window for use of clot retrieval devices in certain stroke patients. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm596983.htm