Permanent stent placement with the Solitaire FR compared with other self-expanding stents appears to be feasible and safe as a rescue tool for refractory intra-arterial therapy.

BACKGROUND AND PURPOSE:CT is currently the method of choice for guiding biopsy of lesions of the spine. However, in our hospital, fluoroscopy-guided percutaneous biopsy has been preferred for several years because of equipment availability and easy craniocaudal angulation. The aim of this study was to evaluate the efficacy of fluoroscopy-guided percutaneous biopsy in a clinical setting for diagnosing infectious spondylitis.

BACKGROUND AND PURPOSE: Data on adjunctive intra-arterial thrombolysis during mechanical thrombectomy for refractory thrombus are sparse. The aim of this study was to evaluate the efficacy and safety of local intra-arterial urokinase as an adjunct to mechanical thrombectomy for refractory large-vessel occlusion. MATERIALS AND METHODS:We retrospectively evaluated patients with acute ischemic stroke who underwent mechanical thrombectomy for anterior circulation large-vessel occlusion between January 2016 and December 2019. Patients were divided into 2 groups based on the use of intra-arterial urokinase as an adjunctive therapy during mechanical thrombectomy for refractory thrombus: the urokinase and nonurokinase groups. Herein, refractory thrombus was defined as the target occlusion with minimal reperfusion (TICI 0 or 1) despite .3 attempts with conventional mechanical thrombectomy. The baseline characteristics, procedural outcomes, and clinical outcome were compared between the 2 groups.RESULTS: One hundred fourteen cases of refractory thrombus were identified. A total of 45 and 69 patients were in the urokinase and the nonurokinase groups, respectively. The urokinase group compared with the nonurokinase group showed a higher rate of successful reperfusion (82.2% versus 63.8%, P ¼ .034), with lower procedural times (54 versus 69 minutes, P ¼ .137). The rates of good clinical outcome, distal embolism, and symptomatic intracranial hemorrhage were similar between the 2 groups. The use of intraarterial urokinase (OR ¼ 3.682; 95% CI, 1.156-11.730; P ¼ .027) was an independent predictor of successful reperfusion. CONCLUSIONS:The use of local intra-arterial urokinase as an adjunct to mechanical thrombectomy may be an effective and safe method that provides better recanalization than the conventional mechanical thrombectomy for refractory thrombus in patients with embolic large-vessel occlusion.

and 5. 87 ± 4.36 (p-value = 0.193)24 hours after admission, 3.06 ± 2.74and 4.93 ± 4.69 (p-value = 0.061)2 weeks later, 2.39 ± 2.41 and 3.66 ± 4.98 (p-value = 0.2 25) one month later, and, 1.07 ± 2.12 and 2.36 ± 2.28 (p-value = 0.511) 3 months later respectively, which were not statistically significant. Also, the relationship between MMP9 and NIHSS was evaluated using Pearson correlation coefficient. There was no significant correlation between MMP9 changes and neurological deficits in any of the time intervals. In both intervention and control groups, the amount of MMP9 24 hours after injection was decreased dramatically (p-value = 0.000) and showed that MMP9 reduction was not dependent on NAC injection. ConclusionsNAC injection did not show clinical and laboratory benefits in patients with AIS in addition to standard therapy.