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intracranial atherosclerosis

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https://www.readbyqxmd.com/read/28637237/long-term-evolutionary-change-in-the-lumen-of-intracranial-atherosclerotic-stenosis-following-angioplasty-and-stenting
#1
Simon C H Yu, Tiffany W W Lau, Simon S M Wong, Kwok T Lee, Lawrence K S Wong, Thomas W H Leung
BACKGROUND: Angioplasty and stenting is a recognized treatment option for patients with intracranial atherosclerosis. OBJECTIVE: To evaluate the long-term evolutionary luminal changes of intracranial atherosclerosis after angioplasty and stenting. METHODS: This was a retrospective study with patient consent. Eighty-two patients presenting with acute and minor cerebral ischemia due to stenosis ≥70%, who had received medical therapy with or without stenting (Wingspan), were invited...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28611827/repeated-mechanical-thrombectomy-in-recurrent-large-vessel-occlusion-acute-ischemic-stroke
#2
Mehdi Bouslama, Diogo C Haussen, Leticia C Rebello, Jonathan A Grossberg, Michael R Frankel, Raul G Nogueira
BACKGROUND: Endovascular therapy has been proven effective for the treatment of large vessel occlusion strokes (LVOS). However, the feasibility and potential benefits of repeat thrombectomy for recurrent stroke is unclear. We aim to report our experience with repeat thrombectomy for recurrent LVOS. METHODS: We reviewed our prospectively collected endovascular database for patients who underwent repeated mechanical thrombectomy. Baseline characteristics, procedural data and outcomes were evaluated...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28606562/the-efficacy-and-safety-of-3-types-of-interventions-for-stroke-prevention-in-patients-with-cardiovascular-and-cerebrovascular-diseases-a-network-meta-analysis
#3
Qian Sun, Shumei Chang, Songtao Lu, Yajing Zhang, Yajun Chang
PURPOSE: The goal of this study was to compare the relative efficacy and safety of different types of interventions for stroke prevention in patients with cardiovascular and cerebrovascular diseases. METHODS: This network meta-analysis (NMA) was conducted with a random effects model of Bayesian framework using Stata version 12.0. Odds ratios (ORs) and their credible intervals (CrIs) were applied for the efficacy and safety evaluation of various medical interventions, including aspirin, dipyridamole, ticlopidine, warfarin, and apixaban...
June 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28599801/relation-of-ideal-cardiovascular-health-metrics-to-asymptomatic-polyvascular-disease-in-a-chinese-population
#4
Qian Zhang, Ruixuan Jiang, Yizheng Wang, Shufeng Zhang, Shengyun Chen, Yaqing Zhang, Xiuhua Guo, Shouling Wu, Xingquan Zhao
Atherosclerosis is a systemic disease with manifestations in multiple vascular beds. Ideal cardiovascular health (CVH) metrics relate to cardiovascular and cerebrovascular disease. However, the relation between ideal CVH metrics and asymptomatic polyvascular disease (polyVD) is unknown. We collected information on the 7 CVH metrics among 5,224 participants aged ≥40 years from 2010 to 2011. Intracranial artery stenosis, extracranial artery stenosis, and lower extremity artery disease were detected by transcranial Doppler, duplex sonography, and by calculating ankle-brachial index...
May 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28592778/diagnostic-and-therapeutic-strategies-for-acute-intracranial-atherosclerosis-related-occlusions
#5
REVIEW
Jin Soo Lee, Ji Man Hong, Jong S Kim
Intracranial atherosclerosis-related occlusion (ICAS-O) is frequently encountered at the time of endovascular revascularization treatment (ERT), especially in Asian countries. However, because baseline angiographic findings are similar between ICAS-O and embolism-related occlusion (EMB-O), it is difficult to differentiate the etiologies before the ERT procedure. Moreover, despite successful randomized trials on ERT, results from studies examining the optimal treatment protocol in ICAS-O patients remain unclear...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28583043/intracranial-stenting-for-nilotinib-treatment-associated-cerebrovascular-stenosis-in-chronic-myeloid-leukemia
#6
Tomohiko Ozaki, Hajime Nakamura, Nobuyuki Izutsu, Hiroaki Masaie, Jun Ishikawa, Manabu Kinoshita
One of the second-generation tyrosine kinase inhibitors (TKIs), nilotinib, is increasingly used for imatinib-resistant or intolerant chronic myeloid leukemia (CML). Nilotinib is considered well tolerated with few side effects including hyperglycemia, hyperbilirubinemia and elevated levels of pancreatic enzymes. However, there is growing evidence that nilotinib accelerates atherosclerosis and causes peripheral arterial occlusive disease such as stroke, transient ischemic attack (TIA) and cardiovascular diseases...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28557988/synergy-of-circulating-mir-212-with-markers-for-cardiovascular-risks-to-enhance-estimation-of-atherosclerosis-presence
#7
Hye Seon Jeong, Jee-Yeon Kim, Seo Hyun Lee, Junha Hwang, Jong Wook Shin, Kyu Sang Song, Sukhoon Lee, Jei Kim
Synergy of specific microRNAs (miRNAs) with cardiovascular risk factors to estimate atherosclerosis presence in ischemic stroke patients has not been investigated. The present study aimed to identify atherosclerosis-related circulating miRNAs and to evaluate interaction with other cardiovascular markers to improve the estimation of atherosclerosis presence. We performed a miRNA profiling study using serum of 15 patients with acute ischemic stroke who were classified by the presence of no (n = 8) or severe (n = 7) stenosis on intracranial and extracranial vessels, which identified miR-212, -372, -454, and -744 as miRNAs related with atherosclerosis presence...
2017: PloS One
https://www.readbyqxmd.com/read/28553032/stroke-in-patients-with-chronic-kidney-disease%C3%A2-how-do-we-approach-and-manage-it
#8
REVIEW
S Nayak-Rao, M P Shenoy
Renal failure is a potent risk factor for stroke, which is a leading cause of morbidity and mortality worldwide. The risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially on dialysis. Case fatality rates are also higher reaching almost 90%. It is therefore important to understand the factors that predispose to stroke in this vulnerable population to better apply preventive strategies. The heightened risk of stroke in CKD represents the interplay of the vascular co-morbidities that occur with renal impairment and factors specific to renal failure such as malnutrition-inflammation-atherosclerosis complex, the effect of uremic toxins, dialysis techniques, vascular access, and the use of anticoagulants to maintain flow in the extracorporeal circuit...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28526767/migraine-and-cerebrovascular-atherosclerosis-in-patients-with-ischemic-stroke
#9
Hendrikus J A van Os, Inge A Mulder, Alexander Broersen, Ale Algra, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis, Gisela M Terwindt, Wouter J Schonewille, Marieke C Visser, Michel D Ferrari, Marianne A A van Walderveen, Marieke J H Wermer
BACKGROUND AND PURPOSE: Migraine is a well-established risk factor for ischemic stroke, but migraine is also related to other vascular diseases. This study aims to investigate the association between migraine and cerebrovascular atherosclerosis in patients with acute ischemic stroke. METHODS: We retrieved data on patients with ischemic stroke from the DUST (Dutch Acute Stroke Study). Migraine history was assessed with a migraine screener and confirmed by telephone interview based on the ICHD criteria (International Classification of Headache Disorders)...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28504557/carotid-angioplasty-assisted-mechanical-thrombectomy-without-urgent-stenting-may-be-a-better-option-in-acute-tandem-occlusions
#10
Cetin K Akpinar, Erdem Gürkaş, Emrah Aytac
Background The aim of the study was to assess the efficacy of balloon angioplasty-assisted mechanical thrombectomy without urgent stenting in the carotid artery as another approach for endovascular treatment of tandem occlusions. Methods Fifteen consecutive cases of tandem occlusions treated with the endovascular approach between January 2014 and May 2016 were reviewed. The study cohort included patients with an etiology of large vessel atherosclerosis. Extracranial carotid stenting was performed in another session if post-thrombectomy mRS modified Rankin Score (mRS) was 0-2...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28503487/discrepancy-between-angiography-and-operative-findings-of-small-side-wall-aneurysms-in-atherosclerotic-parent-arteries
#11
Sook Young Sim
Preoperative evaluation of precise aneurysmal geometry is important for the treatment of intracranial aneurysms. We present two cases of unclippable side wall aneurysms due to their extremely low dome height, which appeared as saccular in the preoperative image because of a comparatively narrow atherosclerotic parent arterial lumen. In both cases, a calcified vessel wall was noted preoperatively. Lack of a definitive neck and abrupt discrepancy between the fragile aneurysmal wall and the atherosclerotic parent arterial wall was confirmed intraoperatively in both cases...
March 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28500366/comparison-of-3d-magnetic-resonance-imaging-and-digital-subtraction-angiography-for-intracranial-artery-stenosis
#12
Ji Eun Park, Seung Chai Jung, Sang Hun Lee, Ji Young Jeon, Ji Ye Lee, Ho Sung Kim, Choong-Gon Choi, Sang Joon Kim, Deok Hee Lee, Seon-Ok Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
OBJECTIVES: To compare three-dimensional high-resolution magnetic resonance imaging (3D HR-MRI) and digital subtraction angiography (DSA) for diagnosing and evaluating stenosis in the entire circle of Willis. METHODS: The study included 516 intracranial arteries from 43 patients with intracranial artery stenosis (ICAS) who underwent both 3D HR-MRI and DSA within 1 month. Two readers independently diagnosed atherosclerosis, dissection, moyamoya disease and vasculitis, rated their diagnostic confidence for each vessel and measured the luminal diameters...
May 12, 2017: European Radiology
https://www.readbyqxmd.com/read/28480112/nontraumatic-posterior-circulation-pseudoaneurysm-of-the-basilar-artery-summit-with-complete-spontaneous-resolution-case-report-and-literature-review
#13
Nefize Turan, Shannon Butler, Theodore C Larson, Alexander Mason
BACKGROUND: Intracranial pseudoaneurysms are rare vascular defects of arterial walls that are classically the result of traumatic injury, iatrogenic causes, or infection. Idiopathic pseudoaneurysms are seen even less frequently and are often related to atherosclerosis. Pseudoaneurysms are most commonly found along the distal wall of the internal carotid artery, however, can occur at any location in the cerebrovascular circulation. Treatment of these arterial defects is often challenging due to their frail nature...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28463782/asymptomatic-polyvascular-disease-and-the-risks-of-cardiovascular-events-and-all-cause-death
#14
Qian Zhang, Anxin Wang, Shufeng Zhang, Na Li, Shengyun Chen, Yaqing Zhang, Yong Zhou, Shouling Wu, Xingquan Zhao
BACKGROUND AND AIMS: Atherosclerosis is a diffuse and systemic disease. We aimed to assess prevalence and outcome of extracoronary polyvascular disease (polyVD) in the asymptomatic Chinese community population. METHODS: A random sample of 5440 participants aged 40 years or older were enrolled in the Asymptomatic Polyvascular Abnormalities Community Study from 2010 to 2011. Intracranial artery stenosis, extracranial artery stenosis, and lower extremity artery disease were detected by transcranial Doppler and duplex sonography, and by calculating the ankle brachial index...
April 21, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28448235/intracranial-artery-steno-occlusion-diagnosis-by-using-three-dimensional-parallel-multichannel-transmission-mr-imaging
#15
Mi Sun Chung, Seung Chai Jung, Seon-Ok Kim, Ho Sung Kim, Choong Gon Choi, Sang Joon Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
Purpose To determine whether magnetic resonance (MR) imaging by using two-dimensional spatially selective radiofrequency (RF) excitation pulses (zoomed MR imaging) is a reliable method for the diagnosis of intracranial artery steno-occlusion compared with full-field-of-view (FOV) MR imaging. Materials and Methods The institutional review board approved this retrospective study and informed consent was waived. From December 2014 to August 2015, 88 patients who underwent both full-FOV MR imaging and zoomed MR imaging for further evaluation of intracranial artery steno-occlusion at prior luminal evaluation were included...
April 27, 2017: Radiology
https://www.readbyqxmd.com/read/28417216/pathogenic-mechanisms-following-ischemic-stroke
#16
REVIEW
Seyed Esmaeil Khoshnam, William Winlow, Maryam Farzaneh, Yaghoob Farbood, Hadi Fathi Moghaddam
Stroke is the second most common cause of death and the leading cause of disability worldwide. Brain injury following stroke results from a complex series of pathophysiological events including excitotoxicity, oxidative and nitrative stress, inflammation, and apoptosis. Moreover, there is a mechanistic link between brain ischemia, innate and adaptive immune cells, intracranial atherosclerosis, and also the gut microbiota in modifying the cerebral responses to ischemic insult. There are very few treatments for stroke injuries, partly owing to an incomplete understanding of the diverse cellular and molecular changes that occur following ischemic stroke and that are responsible for neuronal death...
April 17, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28416412/successful-treatment-of-symptomatic-intracranial-carotid-artery-stenosis-using-a%C3%A2-24-mm-long-bare-metal-coronary-stent
#17
Azeem A Rehman, Ryan C Turner, Brandon P Lucke-Wold, SoHyun Boo
BACKGROUND: Intracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis. CASE DESCRIPTION: We present a case of a 42-year-old man with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#18
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28366059/stent-technology-in-ischemic-stroke
#19
REVIEW
Nam K Yoon, Al-Wala Awad, M Yashar S Kalani, Philipp Taussky, Min S Park
Atherosclerotic disease of the cerebral vasculature is a major cause of stroke worldwide. Atherosclerosis that is refractory to best medical management may require revascularization. In these instances, endovascular treatment provides a popular and safe alternative to open surgical techniques. The authors provide an overview of stent technology in the treatment of ischemic stroke, discussing the major studies evaluating stenting for extracranial carotid artery, vertebral artery, and intracranial atherosclerotic disease...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28334718/sex-differences-do-not-exist-in-outcomes-among-stroke-patients-with-intracranial-atherosclerosis-in-china-subgroup-analysis-from-the-chinese-intracranial-atherosclerosis-study
#20
Yuehua Pu, Na Wei, Dandan Yu, Yilong Wang, Xinying Zou, Yannie O Y Soo, Yuesong Pan, Thomas W H Leung, Lawrence K S Wong, Yongjun Wang, Liping Liu
BACKGROUND: To date, sex difference in outcomes among patients with intracranial atherosclerosis (ICAS) has rarely been discussed in China as well as in the world. This study aimed to estimate the sex difference in outcomes among patients with ICAS in Chinese cerebral ischemia patients. METHODS: We analyzed 1,335 men and women with ICAS who were enrolled in the Chinese Intracranial Atherosclerosis study. They were followed-up for ischemic stroke recurrence, any cause of death, cerebral vascular events (including transient ischemic attack, ischemic and hemorrhagic stroke), combined end points (including cerebral vascular events, angina or myocardial infarction, pulmonary embolism, peripheral vascular events), and unfavorable outcome (modified Rankin scale score of 3-6) at 1 year...
2017: Neuroepidemiology
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