Mechanical Thrombectomy in acute phase of stroke

8 12 2014

The mechanical thrombectomy in acute phase of stroke can improve the prognosis and recovery of some patients

 

In a selected group of patients, treatments of revascularization by mechanical thrombectomy in acute phase of stroke could improve the functional prognosis and clinical recovery of the patient. This is one of the conclusions of the study Outcomes of a contemporary cohort of 536 consecutive patients with acute ischemic stroke treated with endovascular therapy, by Neurology and Neuroradiology services of the Hospital Universitario de Bellvitge, Hospital Vall d ' Hebron, Hospital Germans Trias i Pujol and Hospital Clínic, and where the Bellvitge University Hospital has provided the largest number of patients. Pere Cardona, M. Angels of Miguel and Francisco Rubio of the University Hospital de Bellvitge and the Group of neurological diseases and the IDIBELL neurogenetics have participated in the study.

 

Shorten the time in which the patient is assessed and that the treatment of reperfusion is performed are variables associated with good results, and corroborate the idea of "time is brain". The fact of getting an effective and complete recanalization via a next-generation stent retriever type has increased the success rate of these procedures. Variables such as the upper age to the 80 years, vertebrobasilar stroke or high blood pressure are that have been associated to a worse functional prognosis and a worse mortality, while severe neurological clinical and atrial fibrillation clinical debut are variable they were associated with some better results.

 

The objectives of the study are to assess the effectiveness in neurological recovery and functional independence of patients who were treated with Endovascular reperfusion in acute phase of stroke. The procedure followed was a multi-center prospective observational study of patients in acute phase of stroke with or without intravenous Thrombolysis after Endovascular treatment.

 

Sonia's Master Plan of cerebral vascular disease is an analysis of treatments of repefusion registration, the Department of health. We assessed patients treated with repefusion treatments and different variable and subgroups were analyzed to assess the functional independence, the prognosis and mortality in the third month of receiving them. This database is audited by the Department of health and the Agency's evaluation and sanitary quality of Catalonia.

 

access to the Abstract

 

Idibell.cat [en línea] Barcelona (ESP): idibell.cat, 08 de diciembre de 2014 [REF. 02 in December of 2014] Available on Internet:http://modul/noticies/es/741/la-trombectomia-mecanica-en-la-fase-aguda-del-ictus-puede-mejorar-el-pronostico-y-la-recuperacion-de-algunos-pacientes www.idibell.cat/



Doctors and engineers design a new thrombectomy device

24 04 2014

The UPM researchers collaborate with British doctors in the design and optimization of a device aimed at the Elimination of clogged arteries more safely.

 

The Railway Technology Research Center (ICR) of the Polytechnic University of Madrid (UPM), one of whose lines of work is the use of different techniques of simulation in multi-domain systems, He is working on the improvement of a device for the extraction of clots by means of absorption that can function effectively without causing possible strokes by the break of the clot. The work is done in collaboration with a medical team of United Kingdom, where are the laboratory tests for the modeling and characterization of the device carried out.

A stroke occurs when the blood flow to a part of the brain is stopped; in the event of an arrest for more than a few seconds, the brain cannot receive blood and oxygen, causing permanent damage. According to the World Health Organization (WHO), more than 15 millions of people die in the world because of brain vascular diseases. In particular, cerebrovascular accidents represent one of the leading causes of death and the leading cause of disability in adults, being one of the neurological pathologies of greater social impact, with more than 120.000 new cases each year in Spain.

Treatments for this type of accident can be divided in chemical agents and mechanical thrombectomy devices. Any mechanical device for extraction purposes can be summarized to make removal of the clot formed on the inside of the arteries and restore blood flow in the artery. Numerous devices have been developed for years, many of them operate on the periphery of the vascular system; However, There are relatively few who have been employed in the cerebral vasculature. One of the main problems of these devices is that it can cause embolism downstream or rupture of artery walls due to its moving parts.

 

 

The development of new devices that allow to effectively remove the presence of these clots is supported by the high percentage of population affected and the different existing risks, Noting the possibility of designing a device based on absorption, no moving parts and a simple design, that it can function as an effective exhaust of clots without causing possible strokes due to breakage of the clot.

The new extraction device being developed is based on the trombectomico device by absorption called GP, invented in United Kingdom, that it has no moving parts. Taking as starting point the initial and according to British medical equipment design, researchers from the ICR are proceeding to the introduction of improvements and optimization through the use of different simulation techniques, for which he is working on modelling and characterization of the medical device from laboratory tests carried out in United Kingdom. In this way, He is working on the optimization of the geometry of the device, in the estimation of the optimal range of pressures to different situations and characteristics of the clot, en la distribución del flujo en el entorno del mismo y en el proceso de eliminación del coágulo de la pared arterial.

 

ROMERO, G; HIGUERA, I; MARTÍNEZ, ML; PEARCE, G; PERKINSON, N; ROOM, (C); WONG, J. "Computational Modeling of a New Thrombectomy Device for the Extraction of Blood Clots". Advances in Experimental Medicine and Biology, Vol. 680. 2010. DOI: 10.1007/978-1-4419-5913-3_69

PEARCE, G; BROOKER, L; MIRZA, N; JONES, T; ROOM, (C); WONG, J; PERKINSON,NN; ROMERO,GG; MARTINEZ, ML; HIGUERA, I. "Bond graph modeling of the in vitro performance of the GP thrombectomy Device in combination with local delivery of alteplase". International Journal of Stroke, Vol. 5(see). 2010. DOI: 10.1111/j. 1747-4949.2010.00492. x

ROMERO, G; MARTÍNEZ, ML; MAROTO, J; FÉLEZ, J. "Blood Clot Simulation Model by Using the Bond-Graph Technique". The Scientific World Journal , Volume 2013. DOI: 10.1155/2013/519047

ROMERO, G; MARTÍNEZ, ML; PEARCE, G; WONG, J. "Analysis of the GPATD: Geometrical Influence on Blood Clot Extraction Using CFD Simulation ". UkSim-AMS 16th International Conference on Modeling and Simulation. 26-28 March 2014. Cambridge (UK).

 

Enlaces de interés:

"The ‘ GP’ Mechanical Thrombectomy Device ". Journal of Stroke and Cerebrovascular Diseases 18(4), 2009, pp. 288-293.

 

 

 

Upm.es [en línea] Madrid (ESP): upm.es, 24 de abril de 2014 [REF. 07 April of 2014] Available on Internet: http://www.upm.es/institucional/UPM/CanalUPM/Noticias/2d168776be125410VgnVCM10000009c7648aRCRD