Background It has been amply demonstrated that endovascular procedures can be successful treatment for stroke, both in terms of revascularization and clinical outcome. There is not, however, a published comparison of any histological or ultrastructural damage to the vessels that may be caused by a direct aspiration first pass technique (ADAPT) or stent retrievers (SR) used in these procedures. This study analyses and compares acute damage to the arterial wall caused by ADAPT or SR. Material and methods Damage to the walls of swine extracranial arteries was evaluated after ADAPT with the Penumbra system or thrombectomy with an SR (Solitaire 6×30). The procedures were performed after injecting thrombi into the selected arteries (arteries with diameters similar to those of the human internal carotid artery and first segment of the middle cerebral artery). After the procedures, the animal was euthanized and 12 arterial samples were obtained for analysis by optical and electronic microscopy. Results Tissue samples from the vessels treated with SR showed almost complete loss of endothelium, thickening of the internal elastic lamina, and degeneration of the elastic fibers of the bordering lamina media and adventitia. In contrast, tissue samples of the vessels treated with ADAPT had a clear integral internal elastic lamina and uninterrupted endothelial lining, although cell alignment was altered and there were surface lacerations due to manipulation of the samples. Conclusions Both techniques caused acute damage to the vessel walls, however, thrombectomy with SR appeared to be more harmful to all layers of the arterial wall, particularly the endothelium.

https://jnis.bmj.com/content/neurintsurg/9/8/743.full.pdf

A comparison of acute vascular damage caused by ADAPT versus a stent retriever device after thrombectomy in acute ischemic stroke: a histological and ultrastructural study in an animal model

The stroke is a cerebrovascular disorder and is the cause of a second mortality and long-lasting harm worldwide. It is classified into two types: hemorrhagic and ischemic stroke. Globally, 13% of cases of stroke are hemorrhagic, while the remaining 87% are ischemic. In this paper, we discuss the consideration of factors which possibly affect the effectiveness of antioxidant protection under oxygen deprivation, as well as oxidative stress. Such aspects as compartmentalization of reactive oxygen species (ROS)/reactive nitrogen species (RNS) formation and antioxidant localization, synthesis and transport of antioxidants, and ability to induce the antioxidant defense and cooperation (and/or compensation) between different antioxidant systems are the determinants of the competence of the antioxidant system. Overall, we describe the antioxidants, which interact with ROS and RNS, and terminated the chain reaction before vital molecules have been injured.

Oxidative stress and stroke: a review of upstream and downstream antioxidant therapeutic options

Alzheimer's Disease: Pathological and Clinical Findings

Abstract Stroke is the second result for death and ischemic stroke constitutes most of all stroke cases. Ischemic stroke takes place when blood clot or embolus blocks cerebral vessel and interrupts blood flow, which often leads to brain damage, permanent disability, or death. There is a 4.5‐hour (golden hour) treatment window to restore blood flow prior to permanent neurological impairment results. Current treatments of stroke consist mechanical system or thrombolytic drug therapy to disrupt or dissolve thrombus. Thrombolytics given more than 4.5 h after initial onset of symptoms are not effective on all thrombi. Also, the drugs may cause intracranial hemorrhage, which may be severe or fatal. New treatment modality should improve mortality rates and decrease morbidity. An effective treatment method should be easy, fast to deploy and resolve thrombus faster than current therapies. Promising method for treatment of stroke is mechanical retrieving of thrombi employing device deployed endovascularly. Advent of smart materials has led to research fabrication of several minimally invasive endovascular devices that take advantage of new materials capabilities. One of these capabilities is shape memory, is capability of material to store temporary form, then activate to primary shape as subjected to stimuli. Shape memory polymers (SMPs) have been employed as good materials for thrombectomy device fabrication. Therefore, current review presents thrombectomy device development with SMPs and fabrication of SMP‐based devices for improving stroke treatment is also described. Design, performance, limitations, and in vitro or in vivo clinical results of SMP‐based thrombectomy devices are identified. Furthermore, future directions of SMP‐based thrombectomy devices are highlighted. Review also sheds light on SMP's future outlook and recommendations for thrombectomy device application, opening a new era for advanced materials in materials science. This will demonstrate how new approaches can be achieved employing the latest trends in research world in the development of advanced SMP materials. This article is protected by copyright. All rights reserved 

Fabrication of Shape Memory Polymer Endovascular Thrombectomy Device for Treating Ischemic Stroke

Brain Ischemic Stroke - From Diagnosis to Treatment

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Brain Ischemic Stroke - From Diagnosis to Treatment