Please use this identifier to cite or link to this item: http://theses.ncl.ac.uk/jspui/handle/10443/4882
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dc.contributor.authorCora, Elena Adela-
dc.date.accessioned2021-03-25T09:32:11Z-
dc.date.available2021-03-25T09:32:11Z-
dc.date.issued2020-
dc.identifier.urihttp://theses.ncl.ac.uk/jspui/handle/10443/4882-
dc.descriptionPh. D.en_US
dc.description.abstractIn the past several years there have been major developments in the interventional treatment of acute ischaemic stroke. This thesis consists of four projects that I developed throughout my graduate studies. I started by working on setting up a phase 2 multicentre, randomised, controlled trial to assess the technical safety and efficacy of two new devices to be used in endovascular treatment: the ERIC retriever and the SOFIA distal access catheter. The trial has not yet finished, but partial results are presented. I went on to investigate the role of imaging in hyperacute stroke management. I developed a validated case archive of computed tomography angiography scans which was used for a radiological course. Assessing trainees reports pre- and post-training showed that there was a significant improvement in rates of major errors and this study concluded that an intensive hands-on radiological course was effective. While the trial was running, I developed a new technical index of thrombectomy difficulty. This score uses computed tomography angiographic images to evaluate key factors for predicting the expected procedural difficulty. The results demonstrated an excellent inter-rater reliability making this potentially a powerful tool to help with decision making and procedural planning. Due to limited evidence for mechanical thrombectomy in the older population, I worked on a study to assess the safety and efficacy of this treatment. Patients had more comorbidities, more tandem occlusions, but still good reperfusion rates with a similar safety profile to the younger population. Clinical results at 3 months were poorer than in the younger population, but milder presenting clinical deficits and good reperfusion rates were predictors of good outcomes. This thesis will first discuss stroke with a review of the evidence for performing mechanical thrombectomy. The projects undertaken during my studies will be discussed and I will finish with a succinct conclusion.en_US
dc.language.isoenen_US
dc.publisherNewcastle Universityen_US
dc.titleStroke thrombectomy : new devices, imaging, scoring system and outcomes in the older populationen_US
dc.typeThesisen_US
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