Risultati per: Utilizzo degli stent-retriever nell’ictus ischemico acuto

Non solo cibi sani ma anche in quantità moderate e associati

Combinazione trombolisi endovena e rimozione del coagulo

La scoperta può aiutare a riconoscere le persone più a rischio

Per l’associazione italiana è necessaria più prevenzione

Studio su oltre 6 milioni di persone tra i 20 e i 39 anni

Several studies have compared primary EUS-guided biliary drainage to ERCP with insertion of metal stents in unresectable malignant distal biliary obstruction (MDBO) and the results were conflicting. The aim of the current study was to compare the outcomes of the procedures in a large-scale study.

Univ. Cattolica, orienta su come trattare i casi più a rischio

Comunicato del 07/04/2023 n°14

Soc. italiana ictus, ‘urge omogeneità cura su tutto territorio’

Con la campagna didattica Fast Heroes di Alice Italia

La campagna mondiale dal 13 al 19 marzo

Stroke, Volume 54, Issue Suppl_1, Page A133-A133, February 1, 2023. Introduction:Based largely on the inclusion criteria of clinical trials, the degree of cervical carotid artery stenosis is often used as an indication for stent placement in the setting of carotid atherosclerotic disease. However, the rigor and consistency with which such stenosis is measured outside of clinical trials is unclear. We compared the percent stenosis as measured by real world physician operators to that measured by independent expert reviewers.Hypothesis:We hypothesized that the documented degree of stenosis, termed operator-reported stenosis (ORS), from real world facilities performing carotid stent placement would be larger than the reviewer-measured stenosis (RMS) as assessed by clinicians experienced in treating carotid artery disease.Methods:Images were selected from patient cases used for carotid stenting facility accreditation. Data collected included demographics, National Institutes of Health Stroke Scale, modified Rankin Score, and the documented degree of stenosis (ORS). The ORS was compared to the RMS, derived from a panel of expert clinicians.Results:A total of 68 angiograms were reviewed from 39 symptomatic and 29 asymptomatic patients. The RMS values demonstrated excellent agreement with an intra-class correlation of 0.80. The median ORS was 90.0% (IQR 80.0, 90.0) versus a median RMS of 61.1% (IQR 49.8, 73.6), with a median difference of 21.8% (IQR 13.7, 34.4),p< 0.001. This discrepancy persisted within several subpopulations and was larger among asymptomatic patients and those treated at facilities granted delayed accreditation. Based on RMS values, 72% of symptomatic patients and only 10% of asymptomatic patients would meet the Centers for Medicare and Medicaid Services criteria for carotid stent placement.Conclusions:Real world operators tend to overestimate cervical carotid artery stenosis compared to external expert reviewers. Since decisions regarding carotid revascularization are often based at least partially on percent stenosis, such measuring discrepancies inevitably lead to a higher volume of procedures, which may in turn represent a degree of procedural over utilization.