March 4, 2021 - 14:00-15:10
After large-vessel ischemic strokes, it’s been seen that 90-day results of endovascular thrombectomies were worse after treating carotid-T occlusions than M1 occlusions. What makes carotid-T occlusions so challenging?
Join Professors Jacques Moret and Laurent Spelle along with their expert panel as they explore the key elements involved, including…
The challenge of collateral circulation in carotid-T occlusions:
- These occlusions might have little or no anterior circulation – if the collateral flow is compromised, what is the outcome?
- Speed and technique are critical in removing clots in these situations, but should we use a medical approach first? What evidence do we have to make our decision?
High clot volume – the clot burden of carotid-T occlusions:
- What is the importance of clot mass?
- Does clot size equally impact the efficacy of mechanical thrombectomy and thrombolytics?
- Which type of occlusions would lytics be most effective in? Is thrombolysis more effective if the occlusion is distal?
- Can clot size affect the number of passes necessary for MT?
Mechanical thrombectomy techniques used in managing carotid-T occlusions – from stentriever or aspiration alone, or both in the “full” or “BADDASS” technique.
- Learn why the treatment of carotid-T occlusions, with their greater clot load and larger vessel diameter, are perfectly suited for any of these MT strategies.
- Discover ongoing trials such as SWIFT DIRECT and what current studies and trials say about the preferred MT strategy to employ.
Specially chosen cases further illustrate:
- The dangers involved in embolization.
- Which type of anesthesia or conscious sedation should be preferred in treating carotid-T occlusions and whether patient age could play a role in which one to use.
- Issues involved in thrombolysis – could it useful before or after MT? Does bridging thrombolysis necessarily prevent using lytics after an intervention?
- What impact has the COVID pandemic had on the management of these patients?