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Journal of Vascular and Interventional Neurology

Senka Runjaic, Jerah D Nordeen, Matthew W Soto-Arenall, Gretchen S Johns, David Miller, Benjamin Brown, William D Freeman
INTRODUCTION: The purpose of this study was to evaluate safety and efficacy of intensified antiplatelet therapy guided by VerifyNow assay P2Y12 reaction unit (PRU) reported values in patients undergoing neuroendovascular procedures. METHODS: An observational, retrospective review was conducted at a single academic tertiary referral center and comprehensive stroke center from December 1, 2012, to August 31, 2014. The primary objective was to determine the prevalence of thromboembolic complications stratified by preprocedural PRU values...
January 2017: Journal of Vascular and Interventional Neurology
Adnan I Qureshi, Muhammad A Saleem, Emrah Aytaç, Ahmed A Malik
BACKGROUND: The risk of catheter-based angiograms alone (non-therapeutic angiogram that does not lead to therapeutic intervention) in acute ischemic stroke patients who are considered for endovascular treatment is not well studied. METHODS: We compared the rates of neurological deterioration within 24 h; symptomatic intracranial hemorrhage (ICH) within 30 h; acute kidney injury (AKI) and major non-ICH within five days; and functional independence (defined by modified Rankin scale of 0-2) at three months among subjects who underwent a non-therapeutic catheter-based angiogram with subjects who did not undergo catheter-based angiogram in a multicenter clinical trial...
January 2017: Journal of Vascular and Interventional Neurology
Adnan I Qureshi, Muhammad A Saleem, Emrah Aytac, Shawn S Wallery
BACKGROUND: Intravenous contrast-enhanced ultrasonography is a recently developed technique for assessment of tissue perfusion, but has not been used for assessment of skeletal muscle perfusion. METHODS: We studied a 42-year-old woman in whom myonecrosis was suspected due to systemic vasculitis and ischemia. The biceps brachii (right) and quadriceps femoris (vastus medialis) on right-hand side and subsequently left-hand side were imaged. Intravenous bolus of activated perflutren lipid microspheres was injected and B-Flow color mode (brown color) was used within a selected region of interest to image the passage of contrast through muscle parenchyma throughout three cardiac cycles...
January 2017: Journal of Vascular and Interventional Neurology
Omar Saeed, Asif A Khan, Nabeel A Herial, Emrah Aytac, Adnan I Qureshi
BACKGROUND: Medical treatment of cranio-cervical pain can be suboptimal in patients with internal carotid artery (ICA) dissection. We report the use of cervical sympathetic block for treatment of pain in two patients with ICA dissection. CASE REPORTS: A 58-year-old man and a 43-year-old woman presented with severe cranio-cervical pain associated with left and right ICA dissection confirmed by magnetic resonance imaging and cerebral angiography. Due to suboptimal control of pain with medical treatment, cervical sympathetic block was performed under fluoroscopic guidance using 20 ml of bupivacaine injected lateral to the posterior aspect of sixth vertebral body in both patients...
January 2017: Journal of Vascular and Interventional Neurology
Daraspreet Kainth, Pascal Salazar, Cyrus Safinia, Ricky Chow, Ornina Bachour, Sasan Andalib, Alexander M McKinney, Afshin A Divani
BACKGROUND AND PURPOSE: Rabbit models of intracranial aneurysms are frequently used in pre-clinical settings. This study aimed to demonstrate an alternative, extravascular method for creating elastase-induced aneurysms, and how ligation of the right common carotid arteries (RCCA) can impact flow redistribution into left CCA (LCCA). METHODS: Elastase-induced aneurysms in 18 New Zealand rabbits (4.14 ± 0.314 kg) were created by applying 3-5 U of concentrated elastase solution to the exterior of the right and left CCA roots (RCCA and LCCA)...
January 2017: Journal of Vascular and Interventional Neurology
Juan M Remirez, Yasmin Sabet, Marshall Baca, Alberto Maud, Salvador Cruz-Flores, Gustavo J Rodriguez, Debabrata Mukherjee, Aamer Abbas
BACKGROUND: Mycotic aneurysms are a complication of infective endocarditis. Infection of left ventricular assist devices (LVADs) may lead to bacteremia and fever causing complications similar to those seen in patients with prosthetic valve endocarditis. Intracranial mycotic aneurysms are rare, and their presence is signaled by the development of subarachnoid hemorrhage in the setting of bacteremia and aneurysms located distal to the circle of Willis. CASE PRESENTATION: We present the case of a patient with a LVAD presenting with headache who is found to have an intracranial mycotic aneurysm through computed tomography angiography of the head...
January 2017: Journal of Vascular and Interventional Neurology
Seyedmehdi Pavabvash, Shayandokht Taleb, Shahram Majidi, Adnan I Qureshi
PURPOSE: The location of the arterial occlusion can help with prognostication and treatment triage of acute stroke patients. We aimed to determine the effects of M1 distance-to-thrombus on angiographic recanalization success rate and clinical outcome following endovascular treatment of acute M1 occlusion. METHODS: All acute ischemic stroke patients with M1 segment middle cerebral artery (MCA) occlusion on admission CT angiography (CTA) who underwent endovascular treatment were analyzed...
January 2017: Journal of Vascular and Interventional Neurology
Ali Al Balushi, Jacob Kitchener, Randall C Edgell
We present a rare case of bilateral expanding traumatic pseudoaneurysms of the ophthalmic arteries, due to a gunshot. The aneurysms presented with epistaxis. After a failure of conservative management, coil embolization of the aneurysms resulted in complete occlusion, with preservation of flow in the parent vessels.
January 2017: Journal of Vascular and Interventional Neurology
Manoj Jagani, Waleed Brinjikji, Mohammad H Murad, Alejandro A Rabinstein, Harry J Cloft, David F Kallmes
BACKGROUND AND PURPOSE: The capillary index score (CIS) has been recently introduced as a metric for rating the collateral circulation of ischemic stroke patients. Multiple studies in the last five years have evaluated the correlation of good CIS with clinical outcomes and suggested the use of CIS in selecting patients for endovascular treatment. We performed a meta-analysis of these studies comparing CIS with clinical outcomes. METHODS: We conducted a computerized search of three databases from January 2011 to November 2015 for studies related to CIS and outcomes...
January 2017: Journal of Vascular and Interventional Neurology
Enrique Villalobos, Scott R Barnes, Ihtesham A Qureshi, Salvador Cruz-Flores, Alberto Maud, Gustavo J Rodriguez
OBJECTIVE: To investigate the awareness and the use of Spanish version of National Institutes of Health Stroke Scale (NIHSS) throughout the United States (US) by regions using a web-based survey. METHODS: A survey targeting physicians from two specialties that regularly manage acute stroke patients was conducted from February to August of 2015. Academic centers from the Accreditation Council for Graduate Medical Education online directory belonging to emergency medicine (EM) and neurology residency programs were identified...
January 2017: Journal of Vascular and Interventional Neurology
Adnan I Qureshi, Thomas Kohl
No abstract text is available yet for this article.
October 2016: Journal of Vascular and Interventional Neurology
Adnan I Qureshi, Asif A Khan, Rachel Capistrant, Mushtaq H Qureshi, Kevin Xie, M Fareed K Suri
OBJECTIVE: To report upon technique of concurrent placement of angioplasty balloon at the internal jugular vein and sigmoid venous sinus junction to facilitate stent delivery in two patients in whom stent delivery past the jugular bulb was not possible. CLINICAL PRESENTATION: A 21-year-old woman and a 41-year-old woman with worsening headaches, visual obscuration or diplopia were treated for pseudotumor cerebri associated with transverse venous stenosis. Both patients had undergone primary angioplasty, which resulted in improvement in clinical symptoms followed by the recurrence of symptoms with restenosis at the site of angioplasty...
October 2016: Journal of Vascular and Interventional Neurology
Lakshmi Sudha Prasanna Karanam, Sridhar Reddy Baddam, Vijaya Pamidimukkala, Ramatharaknath Vemuri, Sravanthi Byrapaneni, Raghavasarma Polavarapu
BACKGROUND: Cerebral venous strokes due to cerebral venous sinus thrombosis (CVST) have varied presentation and clinical outcome. Despite aggressive medical treatment with optimal anticoagulation, some patients develop progressive neurologic deterioration causing significant morbidity and mortality. The aim of the present series is to analyze the safety and efficacy of in situ thrombolysis in patients with cerebral venous sinus thrombosis in severe clinical grade and refractory to conventional medical management...
October 2016: Journal of Vascular and Interventional Neurology
Cyrus Safinia, Eric M Bershad, H Brent Clark, Karen SantaCruz, Naila Alakbarova, Jose I Suarez, Afshin A Divani
BACKGROUND AND PURPOSE: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease occurring most commonly in athletes and is caused by repeated concussive or subconcussive blows to the head. The main purpose of this review is to evaluate the published literature on chronic traumatic encephalopathy (CTE) in athletes participating in high-impact sports. In particular, we highlight the significance of concussive and subconcussive impacts in multiple sports, elucidate the differences between clinical/pathological features of CTE and related neurodegenerative diseases, and provide an explanation for the variation in clinical presentation between athletes of different sports...
October 2016: Journal of Vascular and Interventional Neurology
Ameer E Hassan, Stephanie E Ossowski, Ahmed A Malik, Christina Sanchez, Erlinda Abantao, Olive Sanchez, Wondwossen G Tekle, Adnan I Qureshi
BACKGROUND AND PURPOSE: Hospitalist directed care is associated with improved outcomes in several medical conditions. The hospitalist effect has not been studied in acute ischemic stroke (AIS) patients. We compare length of stay (LOS), outcome, and adherence to "Get with the Guidelines" (GWTG) stroke quality measures among AIS patients admitted under a hospitalist with three other specialties (internist, family practice, or specialist). METHODS: We collected demographics, risk factors and discharge outcomes (modified Rankin Scale (mRS)) for consecutive AIS patients over 4-year period (2010-2014)...
October 2016: Journal of Vascular and Interventional Neurology
Luciana Maria Malosá Sampaio, Savitha Subramaniam, Ross Arena, Tanvi Bhatt
BACKGROUND: Physical inactivity and low resting heart rate variability (HRV) are associated with an increased cardiovascular deconditioning, risk of secondary stroke and mortality. Aerobic dance is a multidimensional physical activity and recent research supports its application as a valid alternative cardiovascular training. Furthermore, technological advances have facilitated the emergence of new approaches for exercise training holding promise, especially those methods that integrate rehabilitation with virtual gaming...
October 2016: Journal of Vascular and Interventional Neurology
Christoph Kabbasch, Anastasios Mpotsaris, Daniel Behme, Franziska Dorn, Pantelis Stavrinou, Thomas Liebig
OBJECTIVES: The pipeline embolization device (PED) is a treatment option for wide-neck intracranial aneurysms. The individual number of implants needed to securely exclude an aneurysm is unknown. Our primary objective was to compare midterm occlusion and complication rates in aneurysms treated with a single versus multiple PEDs without adjunctive coiling in a single procedure. PATIENTS AND METHODS: Fifty-five patients harboring 58 intracranial aneurysms were treated with 121 PEDs between March 2011 and December 2013...
October 2016: Journal of Vascular and Interventional Neurology
Sulaiman Iftikhar, Nicholas Rossi, Nitin Goyal, Nickalus Khan, Adam Arthur, Ramin Zand
BACKGROUND: Magnetic resonance imaging (MRI) of the brain is highly sensitive for detecting intracerebral hemorrhage (ICH). Understanding of the imaging characteristics of hyperacute ICH is limited secondary to availability and increased time to scan relative to other imaging modalities. OBJECTIVE: In this report, we present the MRI characteristics of two patients who developed ICH while on the MRI table. METHODS: A 44-year-old women presented with week-long headache associated with blurry vision and photophobia...
October 2016: Journal of Vascular and Interventional Neurology
Miguel A Barboza, José Chang, Alvaro Hernández, Emmanuel Martínez, Huberth Fernández, Gerardo Quirós, Johanna Salazar, Allan Ramos-Esquivel, Alberto Maud
INTRODUCTION: The incidence of recurrent carotid stenosis after carotid endarterectomy varies from 1% to 37% with only 0-8% symptomatic restenosis. Safety of short-term (30 days) dual-antiplatelet therapy has not been established in this type of procedure. AIMS: To investigate the safety of dual antiplatelet therapy after carotid endarterectomy to prevent restenosis. METHODS: We retrospectively identified all the patients who underwent carotid endarterectomy (symptomatic or asymptomatic) treated at our center between July 2010 and July 2013 according to local protocols...
October 2016: Journal of Vascular and Interventional Neurology
Ameer E Hassan, David H Kassel, Malik M Adil, Wondwossen G Tekle, Adnan I Qureshi
BACKGROUND: Recent studies have found an underutilization of hospital in-patient care for coronary artery disease in Hispanics living in border states. OBJECTIVE: To identify acute treatment disparities in acute ischemic stroke Hispanic patients and determine the effect of such disparity on patient outcomes. METHODS: We identified Hispanic and non-Hispanic acute ischemic stroke patients from the Nationwide Inpatient Sample-2011 data files...
October 2016: Journal of Vascular and Interventional Neurology
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