Endovascular Thrombectomy in Acute Ischemic Stroke

Despite several effective strategies of stroke prevention, the stroke epidemic still constitutes the leading cause of permanent disability. The recent series of well-designed, convincingly-positive randomized controlled trials of endovascular thrombectomy in stroke patients with large vessel occlusion launched a paradigm shift and a new era in acute stroke management. The present review provides an overview of the technical aspects of the procedure, discusses patient selection criteria, summarizes the current evidence from randomized trials about its efficacy and safety, and explores its implications in the organization of acute stroke care. © 2018 American Heart Association, Inc

Thrombectomy for Treatment of Acute Stroke in the COVID-19 Pandemic

This commentary will focus on the role of thrombectomy for the treatment of embolic stroke during the 2019 novel coronavirus disease (COVID-19). We will begin with review of recently promulgated guidelines for use of thrombectomy in COVID-19-associated stroke. We will then survey the reported experience of thrombectomy applied to treatment of large-vessel occlusion (LVO) stroke in COVID-19. We will conclude by discussing unusual challenges confronted by neuro-interventionalists seeking to perform thrombectomy in COVID-19 patients with acute LVO stroke. © 2020 S. Karger AG, Basel. Copyright: All rights reserved

Outcome of Endovascular Thrombectomy in Pre-stroke Dependent Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Introduction: Endovascular thrombectomy (EVT) is a well-established and effective therapeutic option for patients that meet certain criteria. However, this modality is not well studied in patients with pre-existing disability. The aim of the present study was to investigate the impact of mechanical thrombectomy in patients with acute onset ischemic stroke and pre-stroke dependency (PSD) in regard to their clinical outcome and mortality. Materials and Methods: The MEDLINE, Scopus, and Cochrane Library databases were comprehensively searched with a cut-off date of December 11th, 2021. We performed meta-analysis to investigate the 90-day clinical outcome, the 90-day mortality, and the rate of symptomatic intracerebral hemorrhage (sICH) between the PSD (modified Rankin Scale score ≥ 3) and non-PSD (modified Rankin Scale score = 0–2) groups who underwent EVT for acute onset ischemic stroke. Results: Six studies were included in the meta-analysis involving 4,543 cases with no PSD and 591 cases with PSD. The non-PSD group showed a statistically significant better clinical outcome at 90 days compared to the PSD group [RR (95% CI) = 1.44 (1.06, 1.85); pz = 0.02]. The non-PSD group demonstrated a statistically significant lower risk of death at 90 days in comparison to the PSD group [RR (95% CI) = 0.45 (0.41, 0.50); pz < 0.01]. Lastly, the rate of sICH was comparable between the two groups [RR (95% CI) = 0.89 (0.64, 1.24); pz = 0.48]. Discussion: We report a higher rate of unfavorable clinical outcome and a higher mortality rate in patients with PSD undergoing EVT compared to those with no previous disability. However, there was a significant proportion of PSD cases who fared well post-procedurally, indicating that PSD patients should not be routinely excluded from mechanical thrombectomy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021284181, identifier: CRD42021284181. Copyright © 2022 Adamou, Gkana, Mavrovounis, Beltsios, Kastrup and Papanagiotou

Cross-sectional epidemiological study on the lead burden of children and workers in greece

Exposure of the general population to lead in the environment is mainly caused by motor traffic exhaust and by industrial pollution. The aim of the study in Greece was to assess lead exposure in children living in point source impacted areas (Lavrion and Aspropyrgos-Eleusis) using the biological monitoring parameter “blood lead concentration”. In addition, workers of a lead smelter, a battery plant and an oil refinery were investigated in these areas at the same time. Five hundred and thirty-four children and 105 workers took part in this investigation. The highest blood lead levels (mean; 24.16μg/100 ml; range: 10.40-60.49 μg/100 ml) were found in children living in a 500m-area around the lead smelter at Lavrion. Blood lead decreases corresponded to the increasing distance from the emitter. Nevertheless the values of children living in a 1500 m distance to the smelter are significantly higher than those of children living next to other kinds of industrial lead sources. The mean values of the children living in the two industrial towns were manifold higher than those of the control group. The blood lead levels of the investigated workers did not exceed the German BAT-value (Biologischer Arbeitsstoff-Toleranzwert) of 70/μg/100 ml. © 1991, Taylor & Francis Group, LLC. All rights reserved