Jordi Blasco Andaluz

Jordi Blasco Andaluz
Hospital Clínic de Barcelona · Interventional Neuroradiology - C.D.I.

PhD

About

91
Publications
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5,149
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Publications

Publications (91)
Article
Objective: To evaluate functional and safety outcomes for endovascular thrombectomy (EVT) versus medical management (MM) in patients with large vessel occlusion (LVO) and mild neurological deficits, stratified by perfusion imaging mismatch. Methods: Pooled cohort of patients with NIHSS<6 and ICA, M1, M2 occlusions from EXTEND-IA, EXTEND-IA-TNK I...
Article
Full-text available
Background The Advanced Neurovascular Access (ANA) thrombectomy system is a novel stroke thrombectomy device comprising a self-expanding funnel designed to reduce clot fragmentation by locally restricting flow while becoming as wide as the lodging artery. Once deployed, the ANA device allows distal aspiration combined with a stent retriever to mobi...
Article
Full-text available
Importance: It is estimated that only 27% of patients with acute ischemic stroke and large vessel occlusion who undergo successful reperfusion after mechanical thrombectomy are disability free at 90 days. An incomplete microcirculatory reperfusion might contribute to these suboptimal clinical benefits. Objective: To investigate whether treatment...
Article
Full-text available
Background and purpose Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hos...
Article
Introduction : The ANA™ (Anaconda Biomed) thrombectomy system is a novel stroke thrombectomy device comprising a self‐expanding funnel designed to reduce clot fragmentation by locally restricting flow while becoming as wide as the lodging artery. Once deployed, ANA allows distal aspiration in combination with a stentretriever (SR) to mobilize the c...
Article
Background and Purpose Mechanical thrombectomy (MT) in ischemic stroke patients with poor prestroke conditions remains controversial. We aimed to analyze the frequency of previously disabled patients treated with MT in clinical practice, the safety and clinical response to MT of patients with preexisting disability, and the disabled patient charact...
Article
Full-text available
Background: Flow-Diverter (FD) porosity has been pointed as a critical factor in the occlusion of cerebral aneurysms after treatment. Objective: Verification and Validation of computational models in terms of predictive capacity, relating FD porosity and occlusion after cerebral aneurysms treatment. Methods: Sixty-four aneurysms, with pre-treatment...
Article
Background Balloon guide catheter (BGC) in stent retriever based thrombectomy (BGC+SR) for patients with large vessel occlusion strokes (LVOS) improves outcomes. It is conceivable that the addition of a large bore distal access catheter (DAC) to BGC+SR leads to higher efficacy. We aimed to investigate whether the combined BGC+DAC+SR approach improv...
Article
Full-text available
Background Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed...
Article
Background COVID-19 infection has been known to predispose patients to both arterial and venous thromboembolic events such as deep venous thrombosis, pulmonary embolism, myocardial infarction, and stroke. A few reports from the literature suggest that Cerebral Venous Sinus Thrombosis (CVSTs) may be a direct complication of COVID-19. Objective To...
Article
Background: Efficacy and safety of endovascular thrombectomy (EVT) in large vessel occlusion (LVO) patients with mild deficits is unclear. Methods: Pooled cohort of pts with mild deficits (NIHSS<6) due to (ICA, M1, M2) LVO from EXTEND IA TNK I & II RCTs and prospective data from 12 centers (US, AUS, NZ, Canada, Spain) from 1/2013 to 2/2020 was divi...
Article
Background First-pass effect (FPE) has been established as a key metric for technical success and strongly correlates with better clinical outcomes. Most data supporting improved outcomes with the use of a balloon guide catheter (BGC) predate the advent of last-generation large-bore intracranial aspiration catheters. We aim to evaluate the impact o...
Article
Objectives Recent small subcortical infarcts (RSSI) are considered an acute manifestation of cerebral small vessel disease. Paramagnetic signals in perforating arteries supplying RSSI may be detected on T2*-relaxation derived sequences on MRI and is defined as susceptibility vessel sign (SVS). We aimed to study the prevalence of SVS in patients wit...
Article
Background: According to current guidelines, aneurysmal subarachnoid haemorrhage (aSAH) patients are mostly managed in intensive care units (ICU) regardless of baseline severity. We assessed the prognostic and economic implications of initial admission of low-grade aSAH patients into a Stroke Unit (SU) compared to initial ICU admission. Methods:...
Article
Full-text available
BACKGROUND AND AIMS: Emergent stent placement may be required during neurothrombectomy. Our aim was to investigate the incidence, predictors and clinical relevance of early extracranial carotid stent occlusion following neurothrombectomy. METHODS: We retrospectively analyzed a cohort of 761 consecutive neurothrombectomies performed at our center...
Article
Full-text available
Delayed cerebral ischemia (DCI) is a dreadful complication present in 30% of subarachnoid hemorrhage (SAH) patients. DCI prediction and prevention are burdensome in poor grade SAH patients (WFNS 4–5). Therefore, defining an optimal neuromonitoring strategy might be cumbersome. Cerebral microdialysis (CMD) offers near-real-time regional metabolic da...
Article
Context: Spinal cord infarction is a rare condition that develops as a result of insufficient vascular perfusion, sometimes related to procedures involving the aorta and vertebral arteries. Findings: We present the case of a 66-year-old woman who developed weakness on all four extremities and thermalgesic sensory deficit following an elective endov...
Article
RATIONALE The potential value of rescue intraarterial thrombolysis in patients with large vessel occlusion stroke treated with mechanical thrombectomy has not been assessed in randomized trials. AIM The CHemical OptImization of Cerebral Embolectomy trial aims to establish whether rescue intraarterial thrombolysis is more effective than placebo in...
Article
Full-text available
Objective The rate of progression of the ischemic lesion is variable in patients with stroke. We tested the hypothesis that the tissue saving effect of mechanical thrombectomy (MT) is greater in fast progressors. Methods A single-center cohort of consecutive patients (n=242) with occlusions of the terminal internal carotid or M1 segment of the mid...
Article
Introduction: The NeVa (Vesalio) thrombectomy device is a CE approved novel hybrid-cell stent retriever with offset enlarged openings coupled with enhanced expansive radial force and a closed distal end. The device was designed to incorporate and trap resistant emboli inside the device. Materials and Methods: Prospective data was collected on the f...
Article
Importance The positive treatment effect of endovascular therapy (EVT) is assumed to be caused by the preservation of brain tissue. It remains unclear to what extent the treatment-related reduction in follow-up infarct volume (FIV) explains the improved functional outcome after EVT in patients with acute ischemic stroke. Objective To study whether...
Poster
Full-text available
BACKGROUND: Recent trials on mechanical thrombectomy (MT) in late time windows have excluded from treatment patients with large baseline infarct cores (IC). We aimed to compare the quantitative effectiveness of MT in terms of infarct growth (IG) on clinical outcomes in patients with small, medium or large pre-treatment IC. METHODS: We studied a p...
Article
Background Follow-up infarct volume (FIV) has been recommended as an early indicator of treatment efficacy in patients with acute ischemic stroke. Questions remain about the optimal imaging approach for FIV measurement. Objective To examine the association of FIV with 90-day modified Rankin Scale (mRS) score and investigate its dependency on acqui...
Article
BACKGROUND Sizing of flow diverters (FDs) stent in the treatment of intracranial aneurysms is a challenging task due to the change of stent length after implantation. OBJECTIVE To quantify the size change and assess the error in length prediction in 82 simulated FD deployments. METHODS Eighty-two consecutive patients treated with FDs were retrosp...
Article
Full-text available
A mTICI 2b or a mTICI 3 score are currently considered success following mechanical thrombectomy (MT) in acute stroke but is undetermined whether the two scores translate equivalent outcomes. We present a single-center, retrospective cohort of patients with anterior circulation stroke treated with MT and achieving a final mTICI score 2b or 3. A mul...
Article
Purpose: To describe radiologic findings, embolization technique, and clinical outcomes in patients with renal subcapsular hematoma and diffuse cortical hemorrhage. Materials and methods: Ten patients with renal subcapsular hematoma and diffuse cortical hemorrhage were reviewed. Nine of the 10 had undergone procedures (nephrostomy, n = 4; biopsy...
Article
Background: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. Methods: Patients with acute ischaemic st...
Article
Background Numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischemic stroke, making the search for new treatments imperative. Uric acid is an endogenous antioxidant making it a drug candidate to improve stroke outcomes. Aim To report the effects of uric acid therapy in stroke patients receiving intravenous throm...
Poster
Full-text available
Background: CT-Perfusion (CTP) provides information of the hemodynamic status of brain parenchyma during the acute phase of stroke. Several perfusion profiles have been described, including the target mismatch, the non target mismatch and the malignant profile (MP). CTP defined MP has been identified as a marker of poor clinical outcome, increased...
Article
Objective: Shows the experience in four different neurointerventional centres in Barcelona with the PED (Covidien) between February 2010 and October 2013. Methods: We reviewed retrospectively patients treated with PED in four neurointerventional centres in Barcelona between February 2010 and October 2013. Results: Forty-two patients (89.4%) wi...
Article
Background and purpose: Recent positive randomized trials of endovascular therapy for ischemic stroke used predominantly stent retrievers. We pooled data to investigate the efficacy and safety of stent thrombectomy using the Solitaire device in anterior circulation ischemic stroke. Methods: Patient-level data were pooled from trials in which the...
Article
Full-text available
An important issue in the deployment of braided stents, such as flow diverters, is the change in length, also known as foreshortening, underwent by the device when is released from the catheter into a blood vessel. The position of the distal end is controlled by the interventionist, but knowing a priori the position of the proximal end of the devic...
Article
Full-text available
Background: We aimed to assess the safety and efficacy of thrombectomy for the treatment of stroke in a trial embedded within a population-based stroke reperfusion registry. Methods: During a 2-year period at four centers in Catalonia, Spain, we randomly assigned 206 patients who could be treated within 8 hours after the onset of symptoms of acu...
Article
In a recent randomized controlled trial comparing vertebroplasty (VP) versus conservative treatment (CT) in patients with symptomatic vertebral fractures (VF), we observed the development of chronic back pain (CBP) in nearly one-quarter of patients. The aim of this study was to identify the risk factors related to the development of severe CBP in t...
Article
Full-text available
Background: Among the acute ischemic stroke patients with large vessel occlusions and contraindications for the use of IV thrombolysis, mainly on oral anticoagulation or presenting too late, primary endovascular therapy is often performed as an alternative to the standard therapy even though evidence supporting the use of endovascular reperfusion...
Article
Validation studies are prerequisites for computational fluid dynamics (CFD) simulations to be accepted as part of clinical decision-making. This paper reports on the 2011 edition of the Virtual Intracranial Stenting Challenge. The challenge aimed to assess the reproducibility with which research groups can simulate the velocity field in an intracra...
Article
BACKGROUND AND PURPOSE: We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome. METHODS: We used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusion therapies for consecutive...
Conference Paper
PURPOSE To assess the accuracy of DECT and NECT in the characterization of hyperattenuation areas on CT follow-up after endovascular treatment for acute ischemic stroke, in order to determine the start of early heparin treatment. METHOD AND MATERIALS A retrospective study in 35 patients with hyperattenuation areas on CT follow-up after endovascula...
Article
We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. We evaluated risk...
Article
We recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) vs conservative treatment (CT) in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. Methods and results: W...
Article
Background and objective: Percutaneous vertebroplasty (PVP) has been successfully used in the treatment of pain related to osteoporotic vertebral fractures refractory to medical therapy, especially in the treatment of acute factures. However, the effectiveness of this therapeutic approach in the treatment of painful chronic vertebral fractures is...
Article
Full-text available
Computational algorithms modeling the insertion of endovascular devices, such as coil or stents, have gained an increasing interest in recent years. This scientific enthusiasm is due to the potential impact that these techniques have to support clinicians by understanding the intravascular hemodynamics and predicting treatment outcomes. In this wor...
Article
Uncertainty regarding the benefits of vertebroplasty (VP) for the treatment of acute osteoporotic vertebral fractures has recently arisen. A prospective, controlled, randomized single-center trial (ClinicalTrials.gov registration number NCT00994032) was designed to compare the effects of VP versus conservative treatment on the quality of life and p...
Article
Full-text available
We sought to explore the safety and efficacy of the new TREVO stent-like retriever in consecutive patients with acute stroke. We conducted a prospective, single-center study of 60 patients (mean age, 71.3 years; male 47%) with stroke lasting <8 hours in the anterior circulation (n=54) or <12 hours in the vertebrobasilar circulation (n=6) treated if...
Conference Paper
PURPOSE Flow diverting (FD) devices are self-expanding tight-mesh stents which represents a new tool treatment of wide-neck saccular aneurysms(SA) and fusiform aneurysms (FA) METHOD AND MATERIALS We report our treatment experiences with FD during 2010. The patient selection includes unruptured SA with wide-necked (> 4mm), fusiform aneurysms (FA)...
Article
Full-text available
Morphological descriptors are practical and essential biomarkers for diagnosis and treatment selection for intracranial aneurysm management according to the current guidelines in use. Nevertheless, relatively little work has been dedicated to improve the three-dimensional quantification of aneurysmal morphology, to automate the analysis, and hence...
Article
The endovascular technique is the gold standard treatment in dural arteriovenous fistulas. Due to the limited number of series published it is difficult to create rigid guidelines in terms of the best endovascular treatment approach. Treatment must be tailored to each particular case, but it is important to keep in mind that the possibility of trea...
Article
Full-text available
The value of multimodal CT to assist thrombolysis has received little attention in stroke. We assessed prospectively the impact derived from the routine application of CT perfusion and CTA in patients with acute stroke treated consecutively with alteplase. The safety and efficacy of thrombolytic therapy were compared in 106 patients assisted with C...
Conference Paper
Computational models arise as an attractive source of information for clinicians to decide the most suitable treatment for a particular patient. The purpose of this work is to evaluate how intra-aneurysmal hemodynamics is affected by the insertion of endovascular devices (coils and stents), by computational fluid dynamics (CFD) models. One aneurysm...
Article
Full-text available
To evaluate the suitability of an improved version of an automatic segmentation method based on geodesic active regions (GAR) for segmenting cerebral vasculature with aneurysms from 3D x-ray reconstruction angiography (3DRA) and time of flight magnetic resonance angiography (TOF-MRA) images available in the clinical routine. Three aspects of the GA...
Article
Full-text available
The quantification of wall motion in cerebral aneurysms is becoming important owing to its potential connection to rupture, and as a way to incorporate the effects of vascular compliance in computational fluid dynamics simulations. Most of papers report values obtained with experimental phantoms, simulated images or animal models, but the informati...
Conference Paper
Full-text available
The goal of this work is to study the wind-induced and density-driven coupling circulation in the Bay of Biscay using a stabilized 3-dimensional finite element model, HELIKE (Maidana, 2007) and (Blasco et al., 2009). This model is based upon the incompressible Navier-Stokes equations for geophysical fluids. The model utilizes the two components of...
Article
Full-text available
Saccular intracranial aneurysms are balloon-like dilations of the intracranial arterial wall; their hemorrhage commonly results in severe neurologic impairment and death. We report a second genome-wide association study with discovery and replication cohorts from Europe and Japan comprising 5,891 cases and 14,181 controls with approximately 832,000...
Conference Paper
PURPOSE Although vertebroplasty is a well-known treatment for the osteoporotic vertebral fracture, allowing pain relief in a high percentage of patients, the long-term effect of this treatment regarding quality of life has not been studied on a randomized study. The main purpose of our study was to evaluate the effect of vertebroplasty not only on...