Dr. Dai
@daigaole
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Director of 2nd Neurology Department at GDPH Guangzhou China. Guangzhou Neurothrombectomy Physicians Club. Views are my own
China
Joined February 2009
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Technical Video: Endovascular therapy for Carotid chronic total occlusion by TRA approach under local anesthesia.
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A 33-year-old man underwent a neck massage two days ago. When he got up in the morning, he appeared slurred. During a doctor's visit, his condition suddenly deteriorated with aphasia and right-sided hemiplegia.When the stroke team evaluated him, his symptoms were basically
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Venous sinus stenosis is an important cause of intracranial hypertension. How to distinguish whether the venous sinus is real stenosis or dysplasia?
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What is the diagnosis? Which blood vessel is wrong? What are the symptoms of the patient?
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A 85-year-old female patient suddenly experienced left limb weakness for 2 hours. CTA revealed an aneurysm in the left MCA and the right MCA occlusion. ASPECT score was 10. Should thrombolysis be performed? Should endovascular treatment be used? What is your decision?
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Technical Video: Endovascular treatment for intracranial atherosclerosis-related MCA occlusion.
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The old traditional craftsmanship of INR, Shaping the MPA catheter into SIM-like.
#RadialFirst
#RadialForNeuro
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At the thrilling moment, both the patient and the physician are facing a test of life and death.
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Can you tell what is the cause from the picture, embolism or ICAS?
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Management of bilateral carotid arteries lesions at same stage,
the patient can move freely after procedure,
Only TRA can do.
Comfortable, safe and efficient.
#Radialfirst
#radialforneuro
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Timing of anticoagulation after recent ischaemic stroke in patients with atrial fibrillation,1-3-6-12 days rule, or Practical “1-2-3-4-Day” Rule, What's your choice?
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Technical Video: Endovascular treatment for posterior circulation tandem occlusion on 4th day after onset.
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Difficult access is one of reasons for thrombectomy failure. Video shows how different attempts overcome the problems.
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Endovascular intervention for MoyaMoya-like chronical occlusion of MCA.
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The patient's CTA examination revealed severe stenosis of the carotid artery. However, a significant increase in creatinine levels was noticed later. The use of contrast agent can adversely affect renal function. To avoid this adverse effect, CAS without contrast agent was
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How to deal with carotid artery stenosis with such anatomical feature if CAS is chosen?
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A 28-year-old male patient experienced slurred speech 8 hours ago. NIHSS 3 points. What do you think is the problem on the CTA/CTP?
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Carotid CTO caused by dissection,
Endvascular therapy with TRA approach Part 1
#RadialFirst
#RadialforNeuro
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The first Case in 2024
Endovascular therapy for Carotid dissection by TRA approach under local anesthesia.
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Technical Video: No exchange technique with a novel designed balloon catheter deliver Enterprise stent for MCA stenosis by TRA approach under local anesthesia.
#Radialfirst
#Radialforneuro
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A case in October 2023 presented with progressive stroke and underwent recanalization of the occluded MCA two weeks after symptom onset. The patient was transferred to a rehabilitation facility, where symptoms gradually improved to mRS score of 3. However, one week ago the
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Tricks and tips of CAS. The application of Wallstent in tortuous blood vessels has a unique effect.
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After nearly half a year of medical treatment, there is no change in the dissection. What will you choose to do?
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Brudzinski test Inducing cardiac arrest in a patient with autoimmune GFAP astrocytopathy
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ICAS related vertebral artery occlusion, IV thromblysis followed by stenting.
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Technical video: Endovascular treatment of in-stent acute thrombosis and reocclusion of the basilar artery.
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Ten months ago, the 78-year-old man was found to have basilar artery occlusion demonstrated by DSA examination(as shown in the figure).His symptoms at that time were repeated dizziness and unstable walking. The symptoms gradually improved after drug treatment. The patient had a
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Case of carotid tandem occlusion by dissection. Dr. Hongyu Qiao brought an interesting solution. Highlights include: 1. Large borne catheter for aspiration & stent delivery, 2. Wallstent to cover dissection and straighten ICA torque segment, 3. Long stent cover wallstent outlet
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Technical Video: ADAPT for ICA occlusion with heavy clot burden in a 93-year-old female patient with marked vascular tortuosity.
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Bridging thrombectomy
ADAPT for MCA occlusion，one pass
then what’s your next steps?
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Stenting for Chronic Occlusion of MCA >3Months with a drug-eluting coronary stent.
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A man had right hemisphere cerebral infarction a month ago, his MRA showed severe stenosis or occlusion of MCA. What’s wrong with the MCA shown by the arrow?
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Technical video：Endovascular therapy for chronic occlusion of MCA with moyamoya-like changes.
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Carotid stent fracture, Although not common, it still needs attention.
How common？What causes? How to manage?
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64-year-old male, onset 18 days ago with right-sided weakness and slurred speech, currently NIHSS 3. MMSE 20.
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How to overcome the difficult anatomy during transradial approach?
#radialfirst
#radialforneuro
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ADAPT for MCA occlusion in a patient following IVT thrombolysis.
what’s your next step.
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The bilateral vertebral arteries V4 segment are occluded, and the symptoms are gradually worsening. It has been 96 hours since the symptoms appeared. What would you decide?
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Technical Video: Angioplasty & Stenting for R MCA near-occlusion by TRA approach under local anesthesia.
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Technical Video: Angioplasty for left MCA stenosis by TRA approach under local anesthesia
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#RadialFirst
#RadialForNeuro
#ldtra
Basilar artery stenting performed under local anesthesia through radial approach. Immediate snapshot after procedure.
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Within 12hr of the onset, what is your diagnosis and what to do next?
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On New Year's Eve, a 58-year-old male patient suddenly let out a cry while watching television and collapsed. Upon being rushed to the hospital, examination revealed aphasia and paralysis on the right side of his body. The patient had undergone heart mechanical valve replacement
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Caplan’s Stroke, 5th. p222.
The patient mentioned above progressed from similar to Figure L. to K.
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Large Subcortical Infarctions caused by MCA Atherosclerotic Stenosis.
20 hrs after onset
Does EVT play a role?
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The patient presented mild hemiplegia 6 days ago. and MRI showed left MCA occluded. His condition gradually worsened. He was completely hemiplegic and aphasia a day ago, and NIHSS scored 16 points. The latest CT scans are as follows. Will you choose to open the occluded MCA?
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65-year-old woman, who repeated episodes of slurred speech in the past month, is currently partial aphasia, NIHSS 4 points, will you consider opening the occluded MCA?
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Chronic MCA occlusion with Moyoya-like changes. NIHSS 12 point, 16h after onset. Can EVT play a role?
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A 92-year-old gentleman had a stroke after waking up. DSA showed the left MCA occlusion, and Solitaire did not resume blood flow after deployment. What do you think is the cause? What is the next step?
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What is your treatment strategy for common carotid artery stenosis with bovine aortic arch？
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86-year-old patient with severe carotid stenosis and subdural hematoma underwent MMAE and CAS via radial approach at the same time.
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The last elective procedure in 2023.
Stenting the basilar artery chronic total occlusion with TRA approach.
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