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Re-establishing Blood Flow After Intravascular Thrombosis

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Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology

Abstract

Thrombus formation occurs as the end result of a series of events and reactions. The coagulation cascade is initiated by damage to the endothelium, aggregation of activated platelet activation and the generation of thrombin. Thrombin causes fibrinogen cleavage and the formation of fibrin which is required for stabilisation of the thrombus. Thrombin-mediated fibrin formation occurs in direct relation to platelet activation.

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References

  1. Del Zoppo GJ, Zeumer H, Harker LA. Thrombolytic therapy in stroke: possibilities and hazards. Stroke. 1986;17(4):595–607.

    Article  PubMed  Google Scholar 

  2. Fletcher AP, Alkjaersig N, Lewis M, Tulevski V, Davies A, Brooks JE, et al. A pilot study of urokinase therapy in cerebral infarction. Stroke. 1976;7(2):135–42.

    Article  PubMed  CAS  Google Scholar 

  3. Hacke W, Zeumer H, Ferbert A, Brückmann H, del Zoppo GJ. Intra-arterial thrombolytic therapy impro­ves outcome in patients with acute vertebrobasilar occlusive disease. Stroke. 1988;19(10):1216–22.

    Article  PubMed  CAS  Google Scholar 

  4. Solis OJ, Roberson GR, Taveras JM, Mohr J, Pessin M. Cerebral angiography in acute cerebral infarction. Rev Interam Radiol. 1977;2(1):19–25.

    PubMed  CAS  Google Scholar 

  5. Nogueira RG, et al. Endovascular approaches to acute stroke, part 1: drugs devices, and data. AJNR Am J Neuroradiol. 2009;30:649–61.

    Article  PubMed  CAS  Google Scholar 

  6. Pendlebury ST, Rothwell PM. Acute non-­haemorrhagic stroke. In: Interventional Neuroradiology. Ed: Byrne JV. Oxford University Press, Oxford, New York 2002. pp. 266–76.

    Google Scholar 

  7. Hacke W, Kaste M, Fieschi C. Intravenous throm­bolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS) JAMA. 1995;274:1017–25.

    Google Scholar 

  8. Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet. 1998;352(9136):1245–51.

    Article  PubMed  CAS  Google Scholar 

  9. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581–7.

    Google Scholar 

  10. Wardlaw JM, Warlow CP, Counsell C. Systematic review of evidence on thrombolytic therapy for acute ischaemic stroke. Lancet. 1997;350(9078):607–14.

    Article  PubMed  CAS  Google Scholar 

  11. Weimar C, Kraywinkel K, Maschke M, Diener H-C. Intravenous thrombolysis in German stroke units before and after regulatory approval of recombinant tissue plasminogen activator. Cerebrovasc Dis. 2006;22(5–6):429–31.

    Article  PubMed  CAS  Google Scholar 

  12. Donnan GA, Baron J-C, Ma H, Davis SM. Penumbral selection of patients for trials of acute stroke therapy. Lancet Neurol. 2009;8(3):261–9.

    Article  PubMed  CAS  Google Scholar 

  13. Abciximab Emergent Stroke Treatment Trial (AbESTT) Investigators. Emergency administration of abciximab for treatment of patients with acute ­ischemic stroke: results of a randomized phase 2 trial. Stroke. 2005;36(4):880–90.

    Article  Google Scholar 

  14. Adams Jr HP, Effron MB, Torner J, Dávalos A, Frayne J, Teal P, et al. Emergency administration of abciximab for treatment of patients with acute ischemic stroke: results of an international phase III trial: Abciximab in Emergency Treatment of Stroke Trial (AbESTT-II). Stroke. 2008;39(1):87–99.

    Article  PubMed  CAS  Google Scholar 

  15. del Zoppo GJ, Higashida RT, Furlan AJ, Pessin MS, Rowley HA, Gent M. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism. Stroke. 1998;29(1):4–11.

    Article  PubMed  Google Scholar 

  16. Furlan A, Higashida R, Wechsler L, Gent M, Rowley H, Kase C, et al. Intra-arterial prourokinase for acute ­ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Throm­boembolism. JAMA. 1999;282(21):2003–11.

    Article  PubMed  CAS  Google Scholar 

  17. Mattle HP, Arnold M, Georgiadis D, Baumann C, Nedeltchev K, Benninger D, et al. Comparison of intraarterial and intravenous thrombolysis for ischemic stroke with hyperdense middle cerebral artery sign. Stroke. 2008;39(2):379–83.

    Article  PubMed  Google Scholar 

  18. Mazighi M, Labreuche J. Bridging therapy in acute ischemic stroke: are we ready for a new standard of care? Stroke. 2011;42(4):880–1.

    Article  PubMed  Google Scholar 

  19. Lewandowski CA, Frankel M, Tomsick TA, Broderick J, Frey J, Clark W, et al. Combined intravenous and ­intra-arterial r-TPA versus intra-arterial therapy of acute ischemic stroke: Emergency Management of Stroke (EMS) Bridging Trial. Stroke. 1999;30(12):2598–605.

    Article  PubMed  CAS  Google Scholar 

  20. Mazighi M, Serfaty J-M, Labreuche J, Laissy J-P, Meseguer E, Lavallée PC, et al. Comparison of intravenous alteplase with a combined intravenous-­endovascular approach in patients with stroke and confirmed arterial occlusion (RECANALISE study): a prospective cohort study. Lancet Neurol. 2009;8(9):802–9.

    Article  PubMed  CAS  Google Scholar 

  21. The IMS II Trial Investigators. The Interventional Management of Stroke (IMS) II Study. Stroke. 2007;38(7):2127–35.

    Article  Google Scholar 

  22. Rubiera M, Ribo M, Pagola J, Coscojuela P, Rodriguez-Luna D, Maisterra O, et al. Bridging ­intravenous-intra-arterial rescue strategy increases recanalization and the likelihood of a good outcome in nonresponder intravenous tissue plasminogen activator-treated patients: a case-control study. Stroke. 2011;42(4):993–7.

    Article  PubMed  CAS  Google Scholar 

  23. Hacke W, Kaste M, Bluhmki E, Brozman M, Dávalos A, Guidetti D, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359(13):1317–29.

    Article  PubMed  CAS  Google Scholar 

  24. Wahlgren N, Ahmed N, Dávalos A, Hacke W, Millán M, Muir K, et al. Thrombolysis with alteplase 3–4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet. 2008;372(9646):1303–9.

    Article  PubMed  CAS  Google Scholar 

  25. Brekenfeld C, Schroth G, El-Koussy M, Nedeltchev K, Reinert M, Slotboom J, et al. Mechanical thromboembolectomy for acute ischemic stroke: comparison of the catch thrombectomy device and the Merci Retriever in vivo. Stroke. 2008;39(4):1213–9.

    Article  PubMed  Google Scholar 

  26. Smith WS, Sung G, Starkman S, Saver JL, Kidwell CS, Gobin YP, et al. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke. 2005;36(7):1432–8.

    Article  PubMed  Google Scholar 

  27. Smith WS, Sung G, Saver J, Budjik R, Duckwiler G, Liebeskind DS, et al. Mechanical thrombectomy for acute ischemic stroke. Final results of the multi MERCI trial. Stroke. 2008;309:1205–12.

    PubMed  CAS  Google Scholar 

  28. Nakano S, Iseda T, Yoneyama T, Kawano H, Wakisaka S. Direct percutaneous transluminal angioplasty for acute middle cerebral artery trunk occlusion: an alternative option to intra-arterial thrombolysis. Stroke. 2002;33(12):2872–6.

    Article  PubMed  Google Scholar 

  29. Yoneyama T, Nakano S, Kawano H, Iseda T, Ikeda T, Goya T, et al. Combined direct percutaneous ­transluminal angioplasty and low-dose native tissue plasminogen activator therapy for acute embolic ­middle cerebral artery trunk occlusion. AJNR Am J Neuroradiol. 2002;23(2):277–81.

    PubMed  Google Scholar 

  30. Lin DDM, Gailloud P, Beauchamp NJ, Aldrich EM, Wityk RJ, Murphy KJ. Combined stent placement and thrombolysis in acute vertebrobasilar ischemic stroke. AJNR Am J Neuroradiol. 2003;24(9):1827–33.

    PubMed  Google Scholar 

  31. Levy EI, Siddiqui AH, Crumlish A, Snyder KV, Hauck EF, Fiorella DJ, et al. First Food and Drug Administration-approved prospective trial of primary intracranial stenting for acute stroke: SARIS (stent-assisted recanalization in acute ischemic stroke). Stroke. 2009;40(11):3552–6.

    Article  PubMed  Google Scholar 

  32. Brekenfeld C, Schroth G, Mattle HP, Do D-D, Remonda L, Mordasini P, et al. Stent placement in acute cerebral artery occlusion: use of a self-­expandable intracranial stent for acute stroke treatment. Stroke. 2009;40(3):847–52.

    Article  PubMed  Google Scholar 

  33. Chesebro JH, Knatterud G, Roberts R, Borer J, Cohen LS, Dalen J, et al. Thrombolysis in Myocardial Infarction (TIMI) Trial. Phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation. 1987;76(1):142–54.

    Article  PubMed  CAS  Google Scholar 

  34. Brekenfeld C, Tinguely P, Schroth G, Arnold M, El-Koussy M, Nedeltchev K, et al. Percutaneous transluminal angioplasty and stent placement in acute vessel occlusion: evaluation of new methods for interventional stroke treatment. AJNR Am J Neuroradiol. 2009;30(6):1165–72.

    Article  PubMed  CAS  Google Scholar 

  35. Papanagiotou P, Roth C, Walter S, Behnke S, Politi M, Fassbender K, et al. Treatment of acute cerebral artery occlusion with a fully recoverable intracranial stent: a new technique. Circulation. 2010;121(23):2605–6.

    Article  PubMed  Google Scholar 

  36. Wakhloo AK, Gounis MJ. Retrievable closed cell intracranial stent for foreign body and clot removal. Neurosurgery. 2008;62(5 Suppl 2):ONS390–3; discussion ONS393–4.

    Article  PubMed  Google Scholar 

  37. Adams Jr HP, Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR, et al. Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology. 1999;53(1):126–31.

    Article  PubMed  CAS  Google Scholar 

  38. Pexman JH, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22(8):1534–42.

    PubMed  CAS  Google Scholar 

  39. Barber PA, Hill MD, Eliasziw M, Demchuk AM, Pexman JHW, Hudon ME, et al. Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging. J Neurol Neurosurg Psychiatr. 2005;76(11):1528–33.

    Article  PubMed  CAS  Google Scholar 

  40. Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, et al. CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke. 2002;33(9):2206–10.

    Article  PubMed  CAS  Google Scholar 

  41. Davis SM, Donnan GA, Parsons MW, Levi C, Butcher KS, Peeters A, et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 2008;7(4):299–309.

    Article  PubMed  Google Scholar 

  42. Mishra NK, Albers GW, Davis SM, Donnan GA, Furlan AJ, Hacke W, et al. Mismatch-based delayed thrombolysis: a meta-analysis. Stroke. 2010;41(1):e25–33.

    Article  PubMed  Google Scholar 

  43. Latchaw RE, Alberts MJ, Lev MH, Connors JJ, Harbaugh RE, Higashida RT, et al. Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. Stroke. 2009;40(11):3646–78.

    Article  PubMed  Google Scholar 

  44. Lisboa RC, Jovanovic BD, Alberts MJ. Analysis of the safety and efficacy of intra-arterial thrombolytic therapy in ischemic stroke. Stroke. 2002;33(12):2866–71.

    Article  PubMed  CAS  Google Scholar 

  45. Schumacher M, Schmidt D. Thrombolysis and angioplasty in special situations. In: Byrne JV, editor. Interventional neuroradiology. Oxford: Oxford University Press; 2002.

    Google Scholar 

  46. Karjalainen K. Occlusion of the central retinal artery and retinal branch arterioles. A clinical, tonographic and fluorescein angiographic study of 175 patients. Acta Ophthalmol Suppl. 1971;109:1–95.

    PubMed  CAS  Google Scholar 

  47. Weber J, Remonda L, Mattle HP, Koerner U, Baumgartner RW, Sturzenegger M, et al. Selective intra-arterial fibrinolysis of acute central retinal artery occlusion. Stroke. 1998;29(10):2076–9.

    Article  PubMed  CAS  Google Scholar 

  48. Schmidt DP, Schulte-Mönting J, Schumacher M. Prognosis of central retinal artery occlusion: local intraarterial fibrinolysis versus conservative treatment. AJNR Am J Neuroradiol. 2002;23(8):1301–7.

    PubMed  Google Scholar 

  49. Beatty S, Au Eong KG. Local intra-arterial fibrinolysis for acute occlusion of the central retinal artery: a meta-analysis of the published data. Br J Ophthalmol. 2000;84(8):914–6.

    Article  PubMed  CAS  Google Scholar 

  50. Noble J, Weizblit N, Baerlocher MO, Eng KT. Intra-arterial thrombolysis for central retinal artery occlusion: a systematic review. Br J Ophthalmol. 2008;92(5):588–93.

    Article  PubMed  CAS  Google Scholar 

  51. Schumacher M, Schmidt D, Jurklies B, Gall C, Wanke I, Schmoor C, et al. Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial. Ophthal­mology. 2010;117(7):1367–75.e1.

    Article  PubMed  Google Scholar 

  52. Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352(17):1791–8.

    Article  PubMed  CAS  Google Scholar 

  53. Ferro JM, Canhão P, Stam J, Bousser M-G, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35(3):664–70.

    Article  PubMed  Google Scholar 

  54. Smith R, Hourihan MD. Investigating suspected ­cerebral venous thrombosis. BMJ. 2007;334(7597):794–5.

    Article  PubMed  CAS  Google Scholar 

  55. Connor SEJ. Magnetic resonance imaging of cerebral venous sinus thrombosis. Clin Radiol. 2002;57:449–61.

    Article  PubMed  CAS  Google Scholar 

  56. Kosinski CM, Mull M, Schwarz M, Koch B, Biniek R, Schläfer J, et al. Do normal D-dimer levels reliably exclude cerebral sinus thrombosis? Stroke. 2004;35(12):2820–5.

    Article  PubMed  Google Scholar 

  57. Einhäupl K, Bousser M-G, de Bruijn SFTM, Ferro JM, Martinelli I, Masuhr F, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis. Eur J Neurol. 2006;13(6):553–9.

    Article  PubMed  Google Scholar 

  58. Wasay M, Bakshi R, Kojan S, Bobustuc G, Dubey N, Unwin DH. Nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis. Stroke. 2001;32(10):2310–7.

    Article  PubMed  CAS  Google Scholar 

  59. Smith AG, Cornblath WT, Deveikis JP. Local thrombolytic therapy in deep cerebral venous thrombosis. Neurology. 1997;48(6):1613–9.

    Article  PubMed  CAS  Google Scholar 

  60. Barnwell SL, Higashida RT, Halbach VV, Dowd CF, Hieshima GB. Direct endovascular thrombolytic therapy for dural sinus thrombosis. Neurosurgery. 1991;28(1):135–42.

    Article  PubMed  CAS  Google Scholar 

  61. Chow K, Gobin YP, Saver J, Kidwell C, Dong P, Viñuela F. Endovascular treatment of dural sinus thrombosis with rheolytic thrombectomy and intra-arterial thrombolysis. Stroke. 2000;31(6):1420–5.

    Article  PubMed  CAS  Google Scholar 

  62. Dowd CF, Malek AM, Phatouros CC, Hemphill 3rd JC. Application of a rheolytic thrombectomy device in the treatment of dural sinus thrombosis: a new ­technique. AJNR Am J Neuroradiol. 1999;20(4):568–70.

    PubMed  CAS  Google Scholar 

  63. Marks MP, Dake MD, Steinberg GK, Norbash AM, Lane B. Stent placement for arterial and venous ­cerebrovascular disease: preliminary experience. Radiology. 1994;191(2):441–6.

    PubMed  CAS  Google Scholar 

  64. Canhão P, Ferro JM, Lindgren AG, Bousser M-G, Stam J, Barinagarrementeria F. Causes and predictors of death in cerebral venous thrombosis. Stroke. 2005;36(8):1720–5.

    Article  PubMed  Google Scholar 

  65. Maqueda VM, Thijs V. Risk of thromboembolism after cerebral venous thrombosis. Eur J Neurol. 2006;13(3):302–5.

    Article  PubMed  CAS  Google Scholar 

  66. Miranda B, Ferro JM, Canhão P, Stam J, Bousser M-G, Barinagarrementeria F, et al. Venous thromboembolic events after cerebral vein thrombosis. Stroke. 2010;41(9):1901–6.

    Article  PubMed  Google Scholar 

  67. Molina CA, Saver JL. Extending reperfusion therapy for acute ischemic stroke: emerging pharmacological, mechanical, and imaging strategies. Stroke. 2005;36(10):2311–20.

    Article  PubMed  Google Scholar 

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  1. Department of Neuroradiology The John Radcliffe Hospital, University of Oxford, Headley Way, OX3 9DU, Oxford, UK

    Dr. James Vincent Byrne

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Byrne, J.V. (2012). Re-establishing Blood Flow After Intravascular Thrombosis. In: Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19154-1_17

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  • DOI: https://doi.org/10.1007/978-3-642-19154-1_17

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