Interventional radiology is a new subspecialty in West Africa that uses minimally invasive image-guided techniques to treat diseases of the body's vascular and non-vascular systems. The presentation aims to provide an overview of interventional radiology, highlight common procedures relevant to the environment, and discuss procedures performed at the speaker's center. Interventional radiologists can treat conditions like stroke through procedures such as angioplasty, stent placement, thrombolysis, and aneurysm coiling to restore blood flow and remove blood clots. Stroke treatment is time-sensitive, so certified stroke centers are needed to ensure standardized care and improved patient outcomes.
Stroke a rare complication in Post PCI patientPRAVEEN GUPTA
In this ppt i am going to describe about one patient who develop acute stroke after PCI in our hospital. Also i am going to discuss how to diagnose, manage and treat such patient, risk factor associated with stroke after PCI.
Stroke a rare complication in Post PCI patientPRAVEEN GUPTA
In this ppt i am going to describe about one patient who develop acute stroke after PCI in our hospital. Also i am going to discuss how to diagnose, manage and treat such patient, risk factor associated with stroke after PCI.
Endovascular treatments are minimally invasive procedures that are done inside the blood vessels and can be used to treat peripheral arterial disease. Treatments like Anti Platelets, Anti-Diabetics, Statins, Promote Collaterals, etc.
Neurointerventional Therapy for Brain Aneurysms and Acute Stroke Allina Health
By Yasha Kadkhodayan, MD. Overview of interventional neuroradiology approaches to brain aneurysm and stroke care, discussion of processes in place at Abbott Northwestern to enhance the delivery of stroke care.
There are two basic IVUS catheter designs: mechanical/rotational and solid state. The mechanical catheters (OptiCross IVUS catheter, Boston Scientific, Santa Clara, California; Revolution IVUS catheter, Volcano, Rancho Cordova, California; ViewIT IVUS catheter, Terumo, Tokyo, Japan; and Kodama HD IVUS catheter, ACIST Medical Systems, Eden Prairie, Minnesota) consist of a single transducer element located at the tip of a flexible drive cable housed in a protective sheath and operated by an external motor drive unit. The drive cable rotates the transducer around the circumference (1800rpm) and the transducer sends and receives the ultrasound signals at 1° increment to form the cross-sectional image. The imaging catheters operate at a central frequency of 40 MHz or 60 MHz and are 5F or 6F compatible [Figure 1]A. In the solid-state catheter design (Eagle Eye Catheter, Volcano), no rotating components are present. There are 64 transducer elements mounted circumferentially around the tip of the catheter. The transducer elements are sequentially activated with different time delays to produce an ultrasound beam that sweeps around the vessel circumference. The catheter works at a central frequency of 20 MHz and is 5F compatible
Endovascular treatments are minimally invasive procedures that are done inside the blood vessels and can be used to treat peripheral arterial disease. Treatments like Anti Platelets, Anti-Diabetics, Statins, Promote Collaterals, etc.
Neurointerventional Therapy for Brain Aneurysms and Acute Stroke Allina Health
By Yasha Kadkhodayan, MD. Overview of interventional neuroradiology approaches to brain aneurysm and stroke care, discussion of processes in place at Abbott Northwestern to enhance the delivery of stroke care.
There are two basic IVUS catheter designs: mechanical/rotational and solid state. The mechanical catheters (OptiCross IVUS catheter, Boston Scientific, Santa Clara, California; Revolution IVUS catheter, Volcano, Rancho Cordova, California; ViewIT IVUS catheter, Terumo, Tokyo, Japan; and Kodama HD IVUS catheter, ACIST Medical Systems, Eden Prairie, Minnesota) consist of a single transducer element located at the tip of a flexible drive cable housed in a protective sheath and operated by an external motor drive unit. The drive cable rotates the transducer around the circumference (1800rpm) and the transducer sends and receives the ultrasound signals at 1° increment to form the cross-sectional image. The imaging catheters operate at a central frequency of 40 MHz or 60 MHz and are 5F or 6F compatible [Figure 1]A. In the solid-state catheter design (Eagle Eye Catheter, Volcano), no rotating components are present. There are 64 transducer elements mounted circumferentially around the tip of the catheter. The transducer elements are sequentially activated with different time delays to produce an ultrasound beam that sweeps around the vessel circumference. The catheter works at a central frequency of 20 MHz and is 5F compatible
What is a Brain CT Imaging Perfusion Study?Carestream
Computed tomography perfusion (aka CTP) imaging shows which areas of the brain are supplied or perfused adequately with blood and provides detailed information on delivery of blood or blood flow to the brain. Here are 10 things you need to know about the procedure.
Trans catheter intervention is emerging field in cardiac intervention. due to complex anatomy of mitral valve understanding of anatomy and three dimensional imaging is most important aspect of successful intervention and could be life saving in high risk surgical candidate
A study to assess the effectiveness of structured teaching program on knowledge regarding care of patients after cardiac surgery among staff nurses at Shree Narayana, Hospital, Raipur, chhattisgarh.
Terapi Endovaskuler, Standar Baru Manajemen Stroke Iskemik Akut? Ersifa Fatimah
Konon, plenary pertama International Stroke Conference (ISC) 2015 yang digelar di Nashville, Tennessee bulan Februari lalu merupakan sesi ISC terseru selama beberapa tahun terakhir. Sebagaimana diberitakan dalam Medscape (Hughes, 2015), para presenter terpaksa memberi jeda beberapa saat untuk menyambut applause dari audiens. Suatu kejadian langka dalam partemuan saintifik. Adalah MR CLEAN, ESCAPE, EXTEND-IA, dan SWIFT PRIME yang menjadi topik hangat lantaran keempat studi ini dirilis dengan hasil yang positif dramatis hingga diprediksi bakal menjadikan terapi endovascular sebagai standar baru dalam manajemen stroke iskemik akut. Sehebat apakah 4 studi yang “menyejarah” dalam tatalaksana stroke iskemik akut ini? Bagaimana bila studi-studi ini diadopsi dan diaplikasikan dalam praktik sehari-hari di sentra kita?
Note: Esai ini ditulis saat SWIFT PRIME fulltext belum published (akhir Maret-awal April 2015). Update & beberapa revisi dibuat menjelang presentasi tanggal 18 Mei 2015.
Usefulness of Non-Enhanced 3-Dementional CT with Partial Maximum Intensity Pr...science journals
Computed Tomography (CT) with contrast material is often used for preoperative assessment and planning of embolotherapy in the treatment of Pulmonary Arteriovenous Malformations (PAVMs).
"Revolutionizing Stroke Care: Endovascular Therapy and Neuro Intervention in Acute Ischemic Stroke with Dr. Ganesh"
🌟 Greetings, everyone! Dr. Ganesh here, and today, we're exploring a groundbreaking topic that's transforming the landscape of stroke care: Endovascular Therapy and Neuro Intervention in Acute Ischemic Stroke (AIS). Whether you're a healthcare professional, a patient, or simply intrigued by medical advancements, this discussion is tailored for you.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Sroke and interventional radiology july 2020 neurological society copy
1. Prof. Dr Ahmed Ahidjo
Professor of Radiology
Consultant Diagnostic and Interventional Radiologist
Department of Radiology
University of Maiduguri Teaching Hospital
PMB 1414, Borno State, Nigeria
Email: ahmedahidjo@hotmail.com
Interventional Radiology
2. INTRODUCTION
Interventional Radiology is a new
subspecialty in the West African sub
region, hence the need to educate the
our community on its benefits and
available services.
3. The aim of this presentation is to;
Highlight on the overview of interventional
radiology
Point out the most common interventional
radiology procedures relevant to our environment
Enlighten our board members on the
interventional radiology procedures that are
performed in our centre and the peculiarity of an
interventional radiologist working in this
environment.
4. Interventional radiology is a
vibrant and rapidly evolving
specialty due to in large part to the
ingenuity and creativity of its
practitioners.
Vascular and Interventional
Radiology has been referred to as
"The Surgery of the 21st Century."
5. The specialty of interventional
radiology has never been and never
will be static, boring or easily
characterized.
It comprises a unique combination of
imaging, technology, procedures and
clinical variety, for treatment of
patients, there is hardly a more
exciting specialty!
6. Along with the satisfaction of
performing interventions comes the
responsibility:
to see patients in clinics
render consultations
recommend a course of action
perform the procedure
follow up treatment outcomes
7. The procedures that once require the
services of surgeons or surgical incisions
have been replaced by interventional
radiologists to percuteneous image
guided techniques.
Interventional Radiology procedures
are performed across all body system
and can be broadly classified as vascular
or non-vascular.
8. The major categories of vascular
interventions are:
angioplasty and stenting
embolization
thrombolysis and thrombectomy
haemodialysis access
venous interventions
foreign body removal
9. Although angiography machine is the basic
equipment used by all interventionists,
other imaging modalities are also used
ultrasound
fluoroscopy
CT
MRI
10. NEURO-INTERVENTION
Interventional neuroradiology (IR)is medical subspecialty developed in
1980s neuroradiologists and neurosurgeons
Used to treat cerebrovascular, head and neck, and spinal disease by
using minimally invasive techniques.
Since then there has been dramatic advances in IR which have been
made possible by similarly rapid advances in neuroimaging particularly
digital subtraction cerebral angiography and development of
revolutionary medical devices.
Many medical conditions which could not be treated effectively 15-20
years ago can now be treated curatively using current endovascular
techniques.
New technology and devices introduced within the past 5 -10 years have
allowed IRs to increase the number of life-threatening CVDs which can
be treated effectively.
10
11. TREATMENT OPTIONS IN INTERVENTIONAL NEURORADIOLOGY
Diagnostic catheter angiography is firstly performed to:
define the vascular anatomy
determine if stenosis or occlusion is present
rule out cerebral aneurysms
arteriovenous malformation
11
13. Acute management of ruptured and unruptured cerebral
aneurysms
coil embolization
balloon-assisted coiling
stent-assisted coiling
13
14. Diagnosis and/or embolization of AV malformations – either
ruptured or not ruptured.
AV malformation: Before and after embolization
14
15. (A) Acute middle cerebral artery occlusion (arrow). (B) Placement
of the stent retriever with immediate flow restoration. Distal marker
of the device (thin black arrow), the thrombus is pressed to the
vessel wall (thick black arrow). (C) Successful recanalization of
the artery.
15
16. STROKE
Stroke occurs when blood supply to a
vascular territory of the brain is suddenly
interrupted (ischaemia) or when blood
vessel is ruptured (haemorrhagic).
The location is mostly supratentorial-90%
(70% cerebral mantle and 20% basal
ganglia and internal capsule) ,
17. Epidemiology
Stroke is a main cause of death worldwide and is one of the
most common causes of disability in developed countries.
Most patients are above 40 years
Only 3% of cases occurs in younger people, mostly due t:o
cardiac diseases
hematological disease
vascular dissection
19. Angiographic methods currently
used include:
1. Magnetic resonance angiography (MRA)
2. CT angiography
3. Sonographic vascular imaging
4. Intravenous digital subtraction angiography (IV DSA)
5. Direct intra-arterial angiography.
20. Conventional Angiography
Conventional angiography of cerebral vessels
was the gold standard examination
It is recommended primarily when Doppler
ultrasonography and MRA/CTA yield
discordant results or if they are not feasible
21. Angiography:
May show narrowed or occluded vessel
supplying the area, delay filling and
emptying of involved vessel and early
draining vein
22. TREATMENT
Some stroke symptoms can be reversed with prompt
diagnosis and treatment, healthcare providers should use
standardized protocols to improve outcomes.
The Brain Attack Coalition recommends the following key
interventional components be integrated into hospital-
based programs to improve patient outcomes:
treatment by healthcare personnel with expertise in
neurosurgical and endovascular techniques
advanced neuroimaging techniques, such as magnetic resonance
imaging, computed tomography, and angiography
surgical and endovascular techniques, including intracranial
aneurysm clipping and coiling, carotid endarterectomy, and intra-
arterial thrombolytic therapy
specific infrastructure and program elements, such as intensive
care and stroke registry
23. TIME IS BRAIN
The earlier the patient present to hospital
the better the outcome.
Indeed, animal experimental and clinical
evidence shows that the time to treatment
is the primary determinant of outcome.
24. TIME IS BRAIN-IV THROMBOLYSIS
In 1995, the National Institute of Neurological Disorders and
Stroke (NINDS) study group reported that patients with
acute ischemic stroke who received alteplase (0.9 mg per
kilogram of body weight) within 3 hours after the onset of
symptoms were at least 30% more likely to have minimal or
no disability at 3 months than those who received placebo.
Alteplase is a tissue plasminogen activator (tPA). It works
by helping to break down unwanted blood clots.
25. IV THROMBOLYSIS
The potential for clot recanalisation with intravenous
thrombolysis is markedly dependent on the site of the
occlusion.
It is more successful in distal middle cerebral artery
occlusions than in recanalisation of larger vessels such
as the internal carotid artery (ICA) or proximal (M1)
segment of the middle cerebral artery.
26. IV THROMBOLYSIS
Unfortunately, only 2% to 3% of ischemic stroke victims
meet I.V. tPA criteria. Patients can’t receive tPA if they:
have had recent surgery
received recent blood thinner therapy increasing
prothrombin time
have suffered a hemorrhagic stroke
have nonthrombotic emboli
are younger than age 18
have rapidly improving symptoms.
Because of the small number of patients presenting to
emergency departments within the treatment window
who meet I.V. tPA eligibility requirements, additional
treatment options have been developed.
These include endovascular stenting, balloon
angioplasty, intra-arterial thrombolytics, and clot or
plaque retrieval.
27. INTERVENTIONAL RADIOLOGY TREATMENT
OPTIONS
Cerebrovascular interventional radiology
treatments expand the treatment options for
acute ischemic stroke victims.
Recent innovations include:
MERCI Retriever®
Penumbra System®
intra-arterial tPA
Each offers a longer treatment window and can be
used in some patients ineligible for I.V. tPA.
28. RETRIEVAL DEVICE
Approved in 2004, the Mechanical Embolus Removal in
Cerebral Ischemia (MERCI) Retriever is the first mechanical
device for use in endovascular procedures in stroke
patients.
With a treatment window of up to 8 hours from symptom
onset, the MERCI Retriever is most successful when used in
larger cerebral vessels, such as:
vertebral arteries
basilar artery
internal carotid arteries
middle cerebral artery
The corkscrew-shaped device is threaded directly into the
clot.
The interventional radiologist or neurosurgical
interventionist threads the microcatheter into the femoral
artery, advances the device to the site of the clot, deploys
the retriever into the clot to capture it, inflates a balloon
to occlude blood flow, and pulls the clot through the
catheter.
29.
30. THROMBO-ASPIRATION DEVICE
Another innovation, approved in 2008, is a
thrombo-aspiration device called the
Penumbra System.
Offering an 8-hour window from onset of
acute ischemic stroke symptoms, it has been
82% successful in recanalization.
Introduced through percutaneous angiography,
the system is threaded into the cerebral
circulation to the area of the clot; the
interventional radiologist deploys a separator
to break up the clot and the Penumbra device
then sucks the clot out.
31.
32. INTRA-ARTERIAL/DIRECT THROMBOLYSIS
Another new treatment is intra-arterial tPA
administration, often used in conjunction
with the MERCI Retriever or the Penumbra
System.
Tissue plasminogen activator (abbreviated
tPA or PLAT) is a protein involved in the
breakdown of blood clots
When delivered intra-arterially directly to
the site of the clot, tPA has the same clot-
busting potential as when given I.V., but
with a longer treatment window—6 hours
from symptom onset.
33.
34. Interventional Radiology for
Hemorrhagic Stroke
In hemorrhagic stroke, interventional radiological
treatment such as coiling has established itself as a
standard procedure for treating aneurysms
Moreover, in some cases of arteriovenous malformations
(AVM), interventional embolization may be a treatment
option as well
Stenting, balloons
Excellent imaging during intervention is indispensable
for safe and efficient vascular therapy. Interventional
radiology suites should therefore reflect the therapeutic
requirements of the interventional imaging technique
and the skills of the interventional team
48. STROKE CENTERS
Certified primary stroke centers should meet the following
requirements:
use standardized methods of delivering care based on the
Brain Attack Coalition recommendations
support patients’ self-management activities
provide treatments and interventions tailored to meeting
patients’ individual needs
promote the flow of patient information across care settings
analyze standardized performance measure data to promote
continual process-improvement
demonstrate application of and compliance with clinical
practice guidelines
49. SUMMARY
Stroke is a major cause of morbidity and mortality in Nigeria
and worldwide.
Interventional Radiology plays important roles in modern
diagnosis and treatment of stroke patients.
CT, MRI and Angiography are essential imaging modalities for
diagnosis and treatment of stroke.
Establishment of designated stroke national center and other
accredited zonal centers in Nigeria will assist in improving
health care service to stroke patients.