These initial results suggest that stent-graft coverage of the primary entry tear may be a promising new treatment for selected patients with acute aortic dissection. This technique requires further evaluation, however, to assess its therapeutic potential fully.

IMPORTANCEWhether intravenous thrombolysis is needed in combination with mechanical thrombectomy in patients with acute large vessel occlusion stroke is unclear.OBJECTIVE To examine whether mechanical thrombectomy alone is noninferior to combined intravenous thrombolysis plus mechanical thrombectomy for favorable poststroke outcome. Investigator-initiated, multicenter, randomized, open-label, noninferiority clinical trial in 204 patients with acute ischemic stroke due to large vessel occlusion enrolled at 23 hospital networks in DESIGN, SETTING, AND PARTICIPANTS

The solid-state reaction using a high-speed vibration milling (HSVM) technique has been applied to the [4 + 2] cycloaddition of fullerene C(60) with condensed aromatics such as anthracenes, tetracene, pentacene, and naphtho[2,3-a]pyrene. From the reaction with anthracene, [4 + 2] cycloadduct 1 was obtained in better yield than the reaction in solution. Despite such heterogeneous solid-state reaction conditions, an equilibrium state appears to be attained between the reactants (C(60) and anthracene) and products (mono- and bisadducts) since essentially the same product mixture was obtained starting either from the reactants or from the monoadduct after 30 min of the HSVM reaction. The reaction with pentacene gave double C(60) adduct 4 with two C(60) cages attached to a pentacene molecule, which cannot be obtained in the reaction in toluene solution, in addition to symmetrical monoadduct 3. The HSVM treatment of C(60) with 9,10-dimethylanthracene, tetracene, or naphtho[2,3-a]pyrene also gave the corresponding [4 + 2] cycloadducts in fair yields. The redox properties of these adducts were investigated by the use of cyclic voltammetry.

Transluminal placement of endovascular stent-grafts is a technically feasible method for treatment of traumatic thoracic aortic aneurysm and may be an effective alternative to open-chest surgery.