CATHETER-DIRECTED THERAPY COMBATS CONVOLUTED CLOT

Intracranial thrombolysis via a catheter embedded in the clot.

We treated a patient with acute stroke by clot lysis with urokinase. The drug was administered via an arterial catheter that had been positioned in the middle cerebral artery with the catheter tip embedded in the thrombus. The use of a microcatheter that is not flow-directed was essential to performing this procedure. Thrombolysis was successful, but an underlying high-grade vascular stenosis c...

How Melatonin Combats Aging

Clot Length Assessment in Stroke Therapy Decisions.

See related article, p 756. Identifying suitable patients for reperfusion therapies using imaging parameters is an exciting but controversial field of research. Numerous prognostic markers have been proposed, yet few modify the risk–benefit of reperfusion sufficiently to alter a decision to treat. The study by Yan et al uses gadolinium-enhanced T1 magnetic resonance imaging to measure clot leng...

MicroRNA-Mediated Repression Combats Depression

Precisely how SSRIs induce long-term modifications in serotonin transmission to elicit their antidepressant actions is unclear. In this issue of Neuron, Issler et al. (2014) identify a key role for microRNA-135a [corrected] in the raphe nuclei in the molecular mechanisms underlying the therapeutic actions of SSRIs.

Catheter - Directed Sclerotherapy for Saphenous Vein Incompetence

S clerotherapy refers to the introduction of a drug into the lumen of a vein with the intended consequence of endoluminal venous fibrosis and subsequent vein closure. Clinically, vein closure is desired to mitigate the effects of venous hypertension caused by retrograde venous flow. The mechanism of action of sclerosing solutions is directed toward the complete destruction of endothelial cells ...