Semi-solid (polyvinyl alcohol [PVA], Gelfoam slurry, Embozenes) and liquid (glue) embolic
agents were injected through the coaxial needle after withdrawing the stylet.
Patients suffering from embolic
events had much higher mortality rate., Since antiplatelet therapy was widely used to prevent the recurrence of cerebral and myocardial infarction,, their use in patients with IE had been assessed in many studies.,,, However, most studies did not observe the beneficial effect of antiplatelet therapy; instead, the increasing risk of bleeding was the major concern.,,, Nowadays, antiplatelet therapy is not recommended as adjunctive therapy for prevention of embolism in IE patients.
Material and Methods: Patients suffering from old ([greater than or equal to]3 months) non-cardio embolic
stroke, taking anti-platelet agents for secondary prevention and visiting CMH Lahore neurology clinic.
If the nidus was in the range of the cannula, liquid embolic
agent (Onyx™18/34, eV3 Inc., Minneapolis, Minnesota, USA) was directly injected through it; otherwise, microcatheters were catheterized through the cannula into the nidus for safe embolization.
In our patient, with only 2 months elapsing between bilateral MCA embolic
occlusions, we were able to provide mechanical thrombectomy with an excellent outcome.
Several types of agents are available, including non-calibrated PVA particles (Contour; Boston Scientific, Marlborough, Massachusetts), acrylic polymer microspheres impregnated with gelatin (Embosphere Microspheres, Biosphere Medical, Rockland, MA) and calibrated PVA microspheres (Beadblock, Terumo, Leuven, Belgium), liquid embolic
agents including NBCA (Histoacryl, B.
Results: Sixteen out of fifty patients were diagnosed as cardiogenic embolic
cerebral infarction by TEE (32%), including two cases of aortic plaques, six cases of atrial septal defect, two cases of atrial septal aneurysm, two cases of patent foramen ovale, one case of left atrial spontaneous echo contrast, one case of mitral prolapse and two case of mitral stenosis.
84 cases of ischemic stroke patients (57.9%) were thrombotic and the other 61 (42.1%) were of embolic
It is a nonadhesive liquid embolic
agent made with EVOH (ethylene vinyl alcohol) copolymer dissolved in DMSO (dimethylsulfoxide), and suspended in a micronized tantalum powder.
Complications can be classified into two categories, those related to local impact of the thrombus with pulmonary oedema, infarction, right ventricular failure, or even lung gangrene [7, 13], and those resulting from peripheral embolic
phenomena to the brain (embolic
stroke, transient ischemic attack) [2, 4, 5, 18, 19], spleen , kidney [2,14], or limb circulation [2,16].
acute ischemic stroke patients, especially African Americans and Hispanics, generally have more intracerebral atherostenotic disease than do patients from European countries, while French patients tend to have more embolic
Anticoagulation was given in the setting of CHADS2Vasc score of 2, keeping in mind that the patient did not have any systemic embolic
manifestations from the right atrial mass.