Journal article
Contemporary Methods for Detection and Intervention of Distal Medium and Small Vessel Occlusions
Journal of clinical medicine, Vol.12(18), 6071
09/20/2023
DOI: 10.3390/jcm12186071
PMCID: PMC10531921
PMID: 37763011
Abstract
The efficacy of using mechanical thrombectomy for proximal large vessel occlusions has been demonstrated in multiple large-scale trials and has further raised the question of its potential utility for distal medium and small vessel occlusions (DMSVOs). Their longer, more tortuous course and smaller corresponding vascular territories render a significant challenge for detection and intervention. The aim of this study is to provide a comprehensive overview of the current imaging and endovascular intervention options for DMSVOs and review the current works in the literature. Compared with traditional computed tomography angiography (CTA) and CT perfusion, recent advances such as multiphase CTA and maps derived from the time-to-maximum parameter coupled with artificial intelligence have demonstrated increased sensitivity for the detection of DMSVOs. Furthermore, newer generations of mini stent retrievers and thromboaspiration devices have allowed for the access and navigation of smaller and more fragile distal arteries. Preliminary studies have suggested that mechanical thrombectomy using this newer generation of devices is both safe and feasible in distal medium-sized vessels, such as M2. However, endovascular intervention utilizing such contemporary methods and devices must be balanced at the discretion of operator experience and favorable vascular anatomy. Further large-scale multicenter clinical trials are warranted to elucidate the indications for as well as to strengthen the safety and efficacy of this approach.
Details
- Title: Subtitle
- Contemporary Methods for Detection and Intervention of Distal Medium and Small Vessel Occlusions
- Creators
- Anthony Piscopo - University of IowaMario Zanaty - University of IowaKathleen Dlouhy - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of clinical medicine, Vol.12(18), 6071
- DOI
- 10.3390/jcm12186071
- PMID
- 37763011
- PMCID
- PMC10531921
- NLM abbreviation
- J Clin Med
- ISSN
- 2077-0383
- eISSN
- 2077-0383
- Language
- English
- Date published
- 09/20/2023
- Academic Unit
- Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984472660302771
Metrics
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