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Case Reports
. 2010 Apr 1:2010:950524.
doi: 10.4061/2010/950524.

Lower body positive pressure application with an antigravity suit in acute carotid occlusion

Affiliations
Case Reports

Lower body positive pressure application with an antigravity suit in acute carotid occlusion

Karine Berthet et al. Stroke Res Treat. .

Abstract

The challenge in acute stroke is still to reperfuse as early as possible the ischemic territory. Since fibrinolytic therapies have a limited window with potential risk of bleeding, having a nonpharmacologic mean to recruit vessels in area surrounding necrosis might be useful. We propose here to use antigravity suit inflated at "venous" pressure levels to shift blood towards thoracic and brain territories. We report two cases of spectacular clinical recovery after acute carotid occlusion.

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Figures

Figure 1
Figure 1
(a) Patterns of intracranial MCA blood flow velocities with time in both the right and left sides, before, during, and after (10 minutes and 48 hours) LBPP application. Note the left side improvement in systolic and diastolic blood flow velocity induced by LBPP, which was sustained for at least 2 days. (b) Vascular resistance index (RI) evolution (method for computation: systolic V/diastolic V). A clear difference between right and left RI occurred only after 48 hours of LBPP application. Corresponding mean arterial pressure (mean AP) and heart rate (HR) at each time.
Figure 2
Figure 2
MRI diffusion-weighted images showing left superficial MCA infarct. (a) 24 hours after stroke onset, (b) 5 days after stroke onset.
Figure 3
Figure 3
MRI T2 flair-weighted images showing left superficial MCA infarct. (a) 24 hours after stroke onset, (b) 5 days after stroke onset.
Figure 4
Figure 4
(a) Intracranial MRA of Willis circle: right siphon, right and left MCAs were not visible. Posterior communicating arteries were also not visible, with visible posterior cerebral arteries. (b) Cervical MRA showing proximal left internal carotid artery occlusion and distal right internal carotid artery tight stenosis (arrows).
Figure 5
Figure 5
MRI T1-FAT-SAT-weighted images showing the dissecting process visible as a hypersignal in the wall of both ICAs as well as an enhancement of ICA diameter (arrows).
Figure 6
Figure 6
Intracranial MRA showing recanalisation of the right ICA; the right and left MCAs are visible as well as both posterior communicating arteries (arrows).

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