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https://www.readbyqxmd.com/read/29163956/eversion-endarterectomy-under-full-prasugrel-treatment
#1
Thomas Kotsis, Panagitsa Christoforou, Nikolaos Asaloumidis, Erifyli Argyra
The third-generation thienopyridine prasugrel has much stronger antiplatelet effect compared to other current antiplatelet inhibitors and exhibits practically zero resistance in healthy people. Prasugrel is used as a pre- and post-treatment in percutaneous coronary or neurovascular interventions with parallel aspirin regime. However, as there is a higher reported bleeding with intraluminal interventions and meticulous technique is recommended, there is nearly non-existent international experience of open surgery under full prasugrel treatment...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/29163750/long-acting-liposomal-bupivacaine-for-percutaneous-sympathetic-stellate-ganglion-blockade-a-technical-note
#2
Adnan I Qureshi, Muhammad A Waqas, Vikram Jadhav, Muhammad A Saleem, Jeff Campbell, Shawn S Wallery
Introduction: We describe the use of long acting liposomal bupivacaine for percutaneous stellate ganglion blockade to treat severe headaches following internal carotid artery dissection. Methods: A 43-year old woman developed right-sided refractory headache after right internal carotid artery dissection. Patient underwent percutaneous stellate ganglion block using bupivacaine hydrochloride (0.25%-20 ml) in the past with short acting relief. Liposomal bupivacaine (EXPAREL) 13...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29163748/transradial-approach-for-deployment-of-a-flow-diverter-for-an-intracranial-aneurysm-in-a-patient-with-a-type-3-aortic-arch
#3
Geoffrey W Peitz, Bhavani Kura, Jeremiah N Johnson, Ramesh Grandhi
Background: Flow diversion with the Pipeline embolization device (PED) is an effective treatment for giant and wide-neck intracranial aneurysms, but the standard transfemoral approach may not be feasible in patients with Type-3 aortic arches. Case Report: An 84-year-old woman presented with a right internal carotid artery (ICA) giant aneurysm and a Type-3 aortic arch, necessitating a transradial approach for access to the right common carotid artery. A triaxial catheter system made for a stable platform for the deployment of two telescoping PEDs to treat the patient's right ICA giant aneurysm...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29163747/endovascular-stenting-of-tandem-carotid-artery-origin-and-bifurcation-stenotic-lesions-using-flow-reversal
#4
Andrew A Fanous, Parham Yashar, Ashish Sonig, Amanda Zakeri, Kenneth V Snyder, Elad I Levy, Jason M Davies, Adnan H Siddiqui
Background: The treatment of tandem lesions involving severe stenosis of the internal carotid artery with concomitant stenosis of the ipsilateral common carotid artery (CCA) origin represents an ongoing challenge. Current options for the treatment of tandem carotid artery origin and bifurcation stenotic lesions include open surgical endarterectomy, endovascular stenting, balloon angioplasty, and hybrid procedures combining both modalities. However, these options are either associated with high peri-operative risks or not always anatomically feasible...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29163742/endovascular-treatment-of-spontaneous-intracranial-internal-carotid-dissection-in-a-young-patient-affected-by-systemic-lupus-erythematosus-a-case-report
#5
Sergio Racchiusa, Marcello Longo, Gianmarco Bernava, Antonio Pitrone, Rosario Papa, Francesca Granata, Giuseppe Centorrino, Sergio Lucio Vinci
Systemic lupus erythematosus (SLE) increases the risk of cerebrovascular events due to vascular changes, resulting in the weakening of the vessel walls. Moreover, patients with SLE have more incidence of arterial lesions such as dissections. Internal carotid dissection (ICA) is an infrequent cause of ischemic stroke, representing 2% of all ischemic events. We present a case of ischemic stroke, caused by a spontaneous dissection of intracranial ICA, treated with endovascular stent implantation, in a 22-year-old woman affected by SLE, newly diagnosed...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29163339/predictors-of-infarct-growth-in-patients-with-large-vessel-occlusion-treated-with-endovascular-therapy
#6
Claus Z Simonsen, Irene K Mikkelsen, Sanja Karabegovic, Pia Kjaer Kristensen, Albert J Yoo, Grethe Andersen
Introduction: Endovascular therapy (EVT) is now evidence based in anterior circulation stroke caused by large vessel occlusion. Outcome is related to infarct size, but data on predictors of infarct growth is limited. We analyzed our cohort of EVT treated patients primarily selected by magnetic resonance imaging (MRI) to examine predictors of infarct growth and the association between infarct size and outcome. Methods: We identified 342 patients with anterior circulation stroke from 2004 to 2014 in our prospectively collected EVT database...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29163214/predictive-value-of-dynamic-cerebral-autoregulation-assessment-in-surgical-management-of-patients-with-high-grade-carotid-artery-stenosis
#7
Vladimir B Semenyutin, Gregory A Asaturyan, Anna A Nikiforova, Vugar A Aliev, Grigory K Panuntsev, Vadim B Iblyaminov, Alexander V Savello, Andreas Patzak
Dynamic cerebral autoregulation (DCA) capacity along with the degree of internal carotid artery (ICA) stenosis and characteristics of the plaque can also play an important role in selection of appropriate treatment strategy. This study aims to classify the patients with severe ICA stenosis according to preoperative state of DCA and to assess its dynamics after surgery. Thirty-five patients with severe ICA stenosis having different clinical type of disease underwent reconstructive surgery. DCA was assessed with transfer function analysis (TFA) by calculating phase shift (PS) between Mayer waves of blood flow velocity (BFV) and blood pressure (BP) before and after operation...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29163140/simultaneous-imaging-of-cerebrovascular-structure-and-function-in-hypertensive-rats-using-synchrotron-radiation-angiography
#8
Liping Wang, Zhihao Mu, Xiaojie Lin, Jieli Geng, Ti Qiao Xiao, Zhijun Zhang, Yongting Wang, Yongjing Guan, Guo-Yuan Yang
Hypertension has a profound influence on the structure and function of blood vessels. Cerebral vessels undergo both structural and functional changes in hypertensive animals. However, dynamic changes of cerebrovasculature and the factors involved in this process are largely unknown. In this study, we explored the dynamic changes of vascular structure in hypertensive rats using novel synchrotron radiation angiography. Twenty-four spontaneously hypertensive rats (SHR) and 24 Sprague-Dawley (SD) rats underwent synchrotron radiation (SR) angiography...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29159156/self-expandable-graft-stenting-in-an-iatrogenic-fistula-between-common-carotid-artery-and-internal-jugular-vein
#9
Sung Chul Jin, Dong Hyuk Lee, Chae Wook Huh
A 47-year-old woman with stage IV chronic kidney disease developed a fistula between common carotid artery (CCA) and internal jugular vein (IJV) during central catheterization of the right IJV. The patient was treated with a self-expandable graft stent, which achieved successful closure of the carotid-jugular fistula. As demonstrated in our case, self-expandable graft stents could be a feasible treatment option for CCA-IJV fistulas without additional interventional procedures such as balloon angioplasty.
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29159155/how-to-escape-stentriever-wedging-in-an-open-cell-carotid-stent-during-mechanical-thrombectomy-for-tandem-cervical-internal-carotid-artery-and-middle-cerebral-artery-occlusion
#10
Hae Won Rho, Won Ki Yoon, Jang Hun Kim, Jong Hyun Kim, Taek Hyun Kwon
We present 2 cases of complicated mechanical thrombectomy involving tandem cervical internal carotid artery and middle cerebral artery occlusion using the Solitaire FR stent and simultaneous carotid stent angioplasty. During the procedures, the Solitaire stents containing the thrombus were wedged into the open-cell carotid stents, which were already deployed for proximal flow restoration. We describe the methods used to avoid and overcome such complications.
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29159153/endovascular-treatment-of-a-fusiform-aneurysm-involving-a-premammillary-artery-originating-from-the-internal-carotid-artery-a-case-report
#11
Se Jin Choi, Se-Yang Oh, Yu Shik Shim, Dong Keun Hyun
The premammillary artery (PMA) is a branch of the posterior communicating artery (PCoA). While the PMA is known to originate from the PCoA as demonstrated by most anatomical studies, it originates directly from the internal carotid artery in approximately 1% of patients. Cerebral aneurysms associated with the PMA have rarely been reported. We report an extremely rare case of a ruptured PMA aneurysm that was managed using endovascular treatment.
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29155470/safety-and-effectiveness-of-endovascular-embolization-or-stent-graft-reconstruction-for-treatment-of-acute-carotid-blowout-syndrome-in-patients-with-head-and-neck-cancer-case-series-and-systematic-review-of-observational-studies
#12
Daniel J Y Wong, Christopher Donaldson, Leon T Lai, Andrew Coleman, Charles Giddings, Lee-Anne Slater, Ronil V Chandra
BACKGROUND: Indications for treatment and outcomes after endovascular management of carotid blowout syndrome for patients with head and neck cancer are not well defined. We investigated the safety and effectiveness of endovascular embolization and stent-graft reconstruction. METHODS: A literature review was performed for studies published between 2001 and 2015 with relevance to treatment outcomes. Our institutional database was examined to identify patients treated with endovascular techniques...
November 20, 2017: Head & Neck
https://www.readbyqxmd.com/read/29154893/an-interleaved-sequence-for-simultaneous-magnetic-resonance-angiography-mra-susceptibility-weighted-imaging-swi-and-quantitative-susceptibility-mapping-qsm
#13
Yongsheng Chen, Saifeng Liu, Sagar Buch, Jiani Hu, Yan Kang, E Mark Haacke
PURPOSE: To image the entire vasculature of the brain with complete suppression of signal from background tissue using a single 3D excitation interleaved rephased/dephased multi-echo gradient echo sequence. This ensures no loss of signal from fast flow and provides co-registered susceptibility weighted images (SWI) and quantitative susceptibility maps (QSM) from the same scan. MATERIALS AND METHODS: The suppression of background tissue was accomplished by subtracting the flow-dephased images from the flow-rephased images with the same echo time of 12...
November 14, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29154859/expression-of-cgrp-neurotransmitter-and-vascular-genesis-marker-mrna-is-age-dependent-in-superior-cervical-ganglia-of-senescence-accelerated-prone-mice
#14
Kazuyuki Mitsuoka, Takeshi Kikutani, Yoko Miwa, Iwao Sato
Calcitonin gene-related peptide (CGRP) is a neurotransmitter that is released from the superior cervical ganglion (SCG) and causes head and neck pain. The morphological properties of human SCG neurons, including neurotransmitter content, are altered during aging. However, morphological changes in CGRP in the SCG during aging are not known. Therefore, we investigated CGRP and other markers in the SCG during aging in an aging model of senescence-accelerated prone mouse (SAMP8) and senescence-accelerated resistant mice (SAMR1) using real-time RT-PCR mRNA analyses and in situ hybridization...
November 14, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29153302/accuracy-of-carotid-duplex-criteria-in-diagnosis-of-significant-carotid-stenosis-in-asian-patients
#15
Pornpatr A Dharmasaroja, Nattaphol Uransilp, Arvemas Watcharakorn, Pritsana Piyabhan
BACKGROUND: Extracranial carotid stenosis can be diagnosed by velocity criteria of carotid duplex. Whether they are accurately applied to define severity of internal carotid artery (ICA) stenosis in Asian patients needs to be proved. The purpose of this study was to evaluate the accuracy of 2 carotid duplex velocity criteria in defining significant carotid stenosis. METHODS: Carotid duplex studies and magnetic resonance angiography were reviewed. Criteria 1 was recommended by the Society of Radiologists in Ultrasound; moderate stenosis (50%-69%): peak systolic velocity (PSV) 125-230 cm/s, diastolic velocity (DV) 40-100 cm/s; severe stenosis (>70%): PSV greater than 230 cm/s, DV greater than 100 cm/s...
November 16, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29152471/internal-carotid-artery-dissection-in-brazilian-jiu-jitsu
#16
Zeferino Demartini, Maxweyd Rodrigues Freire, Roberto Oliver Lages, Alexandre Novicki Francisco, Felipe Nanni, Luana A Maranha Gatto, Gelson Luis Koppe
Carotid artery dissection is a significant cause of stroke in young patients. It may be asymptomatic and go undiagnosed, or minimal transient manifestations may follow, commanding a higher index of suspicion than ordinarily exists to avoid misdiagnosis. Reported herein is a 27-year-old man who suffered extracranial internal carotid artery dissection while practicing a Brazilian Jiu-Jitsu submission maneuver. The patient's condition suddenly deteriorated one week later due to distal embolization and stroke. Despite endovascular treatment, with stenting of the cervical carotid artery, neurologic deficits remained...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#17
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29147634/intracranial-ischemic-infarct-due-to-blunt-force-trauma-in-a-high-school-football-player
#18
Brandon I Esianor, Ali S Haider, Margaret I Engelhardt, Tijani Osumah, Steven Vayalumkal, Richa Thakur, Dean Leonard, Jeffrey Haithcock, Kennith F Layton
Ischemic stroke is an uncommon cause of death among teenagers and young adults; however, the etiologies differ when compared to ischemic strokes in older individuals. Large-vessel atherosclerosis and small-vessel disease causing ischemic stroke are rare for the teenage population, while cervicocerebral arterial dissections account for up to 20% of ischemic strokes. Here, we present the case of a 16-year-old male who developed internal carotid artery dissection (ICAD) after a head injury and subsequently developed ischemic stroke and seizures...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29147633/a-unique-case-of-carotid-splaying-by-a-cervical-vagal-neurofibroma-and-the-role-of-neuroradiology-in-surgical-management
#19
Sally A Itawi, Mark Buehler, Robert E Mrak, Tarek R Mansour, Yacine Medhkour, Azedine Medhkour
Carotid splaying, also known as the Lyre sign, is a widening of the carotid bifurcation due to the displacement of the internal carotid artery and the external carotid artery just distal to the point of divergence. This phenomenon is classically exhibited by highly vascularized carotid body tumors and, in rare cases, by cervical sympathetic chain schwannomas. Demonstration of the Lyre sign by a cervical vagal neurofibroma, however, is a unique occurrence that has not been previously documented in the literature...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29147475/an-extensive-chronic-aortic-dissection-presenting-with-acute-embolic-stroke
#20
Sijan Basnet, Naba Raj Mainali, Biswaraj Tharu, Rashmi Dhital, Dilli Ram Poudel
Herein, we present a rare case of extensive chronic aortic dissection with extension to bilateral subclavian arteries, bilateral common carotid arteries, right internal carotid artery, bilateral proximal external iliac arteries and simultaneous presentation of acute embolic stroke and seizure. The rarity of this case presentation and the presence of neurological features necessitated a high index of clinical suspicion to reach the definitive diagnosis. This study also demonstrates a unique situation requiring correlation between chronic aortic dissection and multi-organ system dysfunction from chronic ischemia...
2017: Journal of Community Hospital Internal Medicine Perspectives
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