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(Stroke OR stenosis OR occlusion OR atherosclerosis) AND collateral

He Huang, Yao-Jun Zhang, Yong-Zhen Fan, Xi Wu, Christos V Bourantas
RATIONALE: Chronic total occlusion continues to be a challenging lesion subset for percutaneous coronary intervention. PATIENT CONCERNS: A 65-year-old male patient was admitted with symptoms of angina pectoris for 9 months. DIAGNOSES: Coronary angiography showed a severe stenosis in the proximal left anterior descending artery and a chronic total occlusion (CTO) in the proximal right coronary artery. The complexity of the CTO was stratified using the J-CTO score and the PROGRESS CTO score...
July 2018: Medicine (Baltimore)
Chang-Woo Ryu, Byung Moon Kim, Hyug-Gi Kim, Ji Hoe Heo, Hyo Suk Nam, Dong Joon Kim, Young Dae Kim
BACKGROUND: Although several outcome prediction scores incorporated with pretreatment variables have been developed for acute ischemic stroke (AIS) patients, there is not currently a prediction score that includes pretreatment imaging that can show salvageable brain tissue. OBJECTIVE: To evaluate whether addition of the collateral grade on computed tomography angiography to previously published prediction scores could increase accuracy of clinical outcome prediction in endovascular thrombectomy (EVT) for AIS...
July 13, 2018: Neurosurgery
Mersedeh Bahr Hosseini, Graham Woolf, Latisha K Sharma, Jason D Hinman, Neal M Rao, Bryan Yoo, Reza Jahan, Sidney Starkman, May Nour, Radoslav Raychev, David S Liebeskind, Jeffrey L Saver
BACKGROUND AND PURPOSE: Endovascular therapy (ET) has become the standard of care for selected patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, many LVO or medium vessel occlusion (MVO) patients are ineligible for ET, including some who harbor salvageable tissues. To develop complementary therapies for these patients, it is important to delineate their prevalence, clinical features, and outcomes. METHODS: In a prospectively maintained database, we reviewed consecutive AIS patients between December 2015 and September 2016...
July 16, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Yi-Fan Zhou, Peng-Cheng Li, Jie-Hong Wu, James Andrew Haslam, Ling Mao, Yuan-Peng Xia, Quan-Wei He, Xu-Xia Wang, Hao Lei, Xiao-Li Lan, Qing Robert Miao, Zhen-Yu Yue, Ya-Nan Li, Bo Hu
Brain tissue survival and functional recovery after ischemic stroke greatly depend on cerebral vessel perfusion and functional collateral circulation in the ischemic area. Semaphorin 3E (Sema3E), one of the class 3 secreted semaphorins, has been demonstrated to be a critical regulator in embryonic and postnatal vascular formation via binding to its receptor PlexinD1. However, whether Sema3E/PlexinD1 signaling is involved in poststroke neovascularization remains unknown. To determine the contribution of Sema3E/PlexinD1 signaling to poststroke recovery, aged rats (18 months) were subjected to a transient middle cerebral artery occlusion...
June 11, 2018: Neurobiology of Aging
Ji Man Hong, Mun Hee Choi, Sung-Il Sohn, Yang-Ha Hwang, Seong Hwan Ahn, Yeong-Bae Lee, Dong-Ick Shin, Ángel Chamorro, Dennis W Choi
BACKGROUND: The potential of neuroprotective agents should be revisited in the era of endovascular thrombectomy (EVT) for acute large-artery occlusion because their preclinical effects have been optimized for ischemia and reperfusion injury. Neu2000, a derivative of sulfasalazine, is a multi-target neuroprotectant. It selectively blocks N-methyl-D-aspartate receptors and scavenges for free radicals. This trial aimed to determine whether neuroprotectant administration before EVT is safe and leads to a more favorable outcome...
July 13, 2018: Trials
Alessandro Arrigo, Adriano Carnevali, Riccardo Sacconi, Lea Querques, Giuseppe Querques, Francesco Bandello
Purpose: To report a case of a patient affected by branch retinal vein occlusion (BRVO) showing a possible spontaneous retinal-choroidal anastomosis (RCA) at the level of the fovea. Observations: A 72 years old male patient with diagnosis of BRVO of left eye (LE) one year before came to our observation for a follow-up visit.The patient underwent a complete ophthalmologic examination, including fluorescein angiography, structural optical coherence tomography (OCT), OCT-Angiography (OCT-A)...
September 2018: American Journal of Ophthalmology Case Reports
Benjamin Friedrich, Felix Kempf, Tobias Boeckh-Behrens, Johanna Fischer, Manuel Lehm, Maria Bernd, Silke Wunderlich, Sebastian Mönch, Claus Zimmer, Christian Maegerlein
PURPOSE: In patients with acute occlusions of the middle cerebral artery, the collaterals play an important role in infarct growth and potentially on clinical outcome. As the primary collateral pathway, the posterior cerebral artery with the posterior communicating artery (PComA) is important. We analyzed the influence of the presence of an ipsilateral PComA on infarct growth and clinical outcome. METHODS: We included 101 patients with M1 occlusions and subsequent endovascular treatment and differentiated patients without an ipsilateral PComA from those with an ipsilateral PComA...
July 10, 2018: Cardiovascular and Interventional Radiology
Siu-Lung Chan, Nicole Bishop, Zhaojin Li, Marilyn J Cipolla
BACKGROUND AND PURPOSE: Aging and hypertension, comorbidities prevalent in the stroke population, are associated with poor collateral status and worsened stroke outcome. However, underlying mechanisms by which these conditions affect stroke outcome are not clear. We studied the role of PAI (plasminogen activator inhibitor)-1 that is increased in aging and hypertension on brain and vascular expression of inflammatory factors and perfusion that may contribute to worse stroke outcomes. METHODS: Aged (≈50 weeks) and young (≈18 weeks) spontaneously hypertensive rats (SHR) were subjected to ischemia by middle cerebral artery occlusion (2 hours) and reperfusion (2 hours) with or without treatment with the PAI-1 inhibitor TM5441...
July 10, 2018: Stroke; a Journal of Cerebral Circulation
Jaechun Hwang, Mi Ji Lee, Jong-Won Chung, Oh Young Bang, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee
Background and purpose The status of collateral vessels has important clinical implications in acute ischemic stroke. To evaluate which components of ischemic symptoms were predictive of pretreatment collateral status, we tested the hypothesis that sub-item scores from the National Institutes of Health Stroke Scale (NIHSS) are associated with leptomeningeal collateral status in acute ischemic stroke with middle cerebral artery (MCA) occlusion. Methods This study included consecutive patients with acute M1 occlusion who underwent revascularization treatment for acute MCA infarction...
January 1, 2018: Interventional Neuroradiology
Zheng Zachory Wei, Dongdong Chen, Li-Ping Liu, Xiaohuan Gu, Weiwei Zhong, Yong-Bo Zhang, Yongjun Wang, Shan Ping Yu, Ling Wei
Ischemic stroke remains a serious threat to human life. There are limited effective therapies for the treatment of stroke. We have previously demonstrated that angiogenesis and neurogenesis in the brain play an important role in functional recovery following ischemic stroke. Recent studies indicate that increased arteriogenesis and collateral circulation are determining factors for restoring reperfusion and outcomes of stroke patients. Danshensu, the Salvia miltiorrhiza root extract, is used in treatments of various human ischemic events in traditional Chinese medicine...
April 2018: Cell Transplantation
Zakaria Hindi, Yousef Hindi, Rami Batarseh
Introduction: Complete heart block (CHB) is considered as one of the dangerous rhythms since it can progress to lethal arrhythmias such as ventricular tachycardia. It can be congenital or acquired. Patients may present with frequent palpitations, presyncope, dyspnea, or chest pain but also may remain asymptomatic. Extensive work-up should be conducted to exclude secondary causes such as infections, cardiac ischemia or myopathies, autoimmune diseases, or endocrinological diseases. In our paper, we would like to present a case of CHB in the setting of aortic abdominal thrombus that nearly occluded both renal arteries...
2018: Case Reports in Cardiology
Péter Vince Banga, Andrea Varga, Csaba Csobay-Novák, Márton Kolossváry, Emese Szántó, Gustavo S Oderich, László Entz, Péter Sótonyi
OBJECTIVE: A complete circle of Willis (CoW) is considered an important collateral network to maintain blood flow during cross-clamping in carotid endarterectomy (CEA). The aim of this study was to evaluate the impact of an incomplete CoW with isolated middle cerebral artery (iMCA) on immediate neurologic events (INEs) after CEA. METHODS: We prospectively collected the clinical data and outcomes of 902 patients who underwent CEA under general anesthesia between 2013 and 2015...
July 5, 2018: Journal of Vascular Surgery
Steven G Chrysant, George S Chrysant
Hyperhomocysteinemia has been considered as a risk factor for systemic atherosclerosis, cardiovascular disease (CVD) and stroke and many epidemiologic and case-controlled studies have demonstrated its association with these complications. In addition, treatment of hyperhomocysteinemia with folic acid ± B vitamins prevents the development of atherosclerosis, CVD and strokes. However, subsequent prospective, randomized, placebo- controlled trials have not shown an association of high homocysteine levels or their lowering with treatment with the incidence of atherosclerosis, CVD or strokes, due possibly, to the fortification of flower with folic acid...
July 6, 2018: Expert Review of Cardiovascular Therapy
Kai Du, Na Nu, Yan Shen, Shu Wang
WANG Leting , known as gold-needle master has its own unique academic system in the treatment of stroke. In view of principle, rule, recipe, acupoint and technique, WANG Leting 's academic thoughts were reviewed in the treatment of stroke. In terms of theoretic foundation, treating principles, formula application, rules of acupoint selection and manipulation techniques, the characteristics on the academic thoughts on the treatment of stroke were explained. Professor WANG believes that stroke is caused by deficiency, fire, wind, phlegm, qi and blood...
June 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Zhen-Ni Guo, Xin Sun, Jia Liu, Huijie Sun, Yingkai Zhao, Hongyin Ma, Baofeng Xu, Zhongxiu Wang, Chao Li, Xiuli Yan, Hongwei Zhou, Peng Zhang, Hang Jin, Yi Yang
The influence of the anterior and posterior communicating artery (ACoA and PCoA) on dynamic cerebral autoregulation (dCA) is largely unknown. In this study, we aimed to test whether substantial differences in collateral anatomy were associated with differences in dCA in two common types of stenosis according to digital subtraction angiography (DSA): either isolated basal artery and/or bilateral vertebral arteries severe stenosis/occlusion (group 1; group 1A: with bilateral PCoAs; and group 1B: without bilateral PCoAs), or isolated unilateral internal carotid artery severe stenosis/occlusion (group 2; group 2A: without ACoA and with PCoA; group 2B: with ACoA and without PCoAs; and group 2C: without both ACoA and PCoA)...
2018: Frontiers in Physiology
Alejandro Gutiérrez-Barrios, Dolores Cañadas-Pruaño, Teresa Bretones-Del Pino, Miguel Alba-Sánchez, Dolores Ruiz-Fernández, Germán Calle-Perez, Antonio Agarrado-Luna, Ricardo Zayas-Rueda, Ernesto Marante-Fuertes, Alberto Giráldez-Valpuesta, Jesús Oneto-Otero, Rafael Vázquez-García
BACKGROUND: Debate still remains on whether the presence of early recruited collateral circulation (ERCC) in the setting of an acute coronary occlusion (ACO) has a prognosis benefit. Some previous reports have shown lower mortality and morbidity rates in well-collateralized patients compared with those with poorly recruited collateral circulation (PCC), but others have not. In the primary angioplasty era, the role of collateral circulation in these studies may have been influenced by the effect of early reperfusion...
June 30, 2018: Coronary Artery Disease
Mark Nowell, Richard Nelson
PURPOSE: Traumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. 2015; Zhen et al. in Arch Orthop Trauma Surg 131:681-685, 2011; de Carvalho and Swash in Handb Clin Neurol 119:435-448, 2014). METHOD: We present a previously undescribed case of posterior AAD associated with a C1 Jefferson fracture but no odontoid fracture and bilateral vertebral artery occlusion without neurological deficit...
July 2, 2018: European Spine Journal
Masakazu Kobayashi, Kenji Yoshida, Daigo Kojima, Sotaro Oshida, Shunrou Fujiwara, Yoshitada Kubo, Kuniaki Ogasawara
OBJECTIVE: The external carotid artery (ECA) is inadvertently occluded during carotid endarterectomy (CEA). The importance of ECA occlusion has been emphasized as a loss of extracranial to intracranial collaterals, a source of chronic embolization, or a site for extended thrombosis during wound closure. This study aimed to determine whether ECA occlusion that inadvertently developed during endarterectomy and that was eventually detected using blood flow measurement of the ECA after declamping of all carotid arteries is a risk factor for development of new postoperative ischemic lesions at declamping of the ECA and common carotid artery (CCA) while clamping the internal carotid artery (ICA)...
June 27, 2018: Journal of Vascular Surgery
F Simon, A Oberhuber, N Floros, P Düppers, H Schelzig, M Duran
Chronic ischemia of the lower extremities is an everyday problem in vascular surgery clinics. In Germany, approximately 3% of all hospitalizations are due to peripheral artery disease (PAD), with critical limb ischemia (CLI) in particular showing a rapid increase. The consequences of chronic undersupply range from reduced walking distance to loss of limbs. At the beginning there are stress factors, such as hyperlipidemia (LDL), free radicals, arterial hypertension, infections or subclinical inflammation that interfere with endothelial homeostasis and cause endothelial dysfunction with increased permeability...
2018: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
Islam Abdelmoneim, Ayman Sadek, Mohamed Ahmed Mosaad, Ibrahim Yassin, Yasser Radwan, Khalid Shokry, Ahmed Magdy, Mohammed Yasser Elsherbeny, Abdelrahman Ibrahim Abushouk
We performed this study to compare the sensitivity and specificity of multi-slice computed tomography (MSCT) to coronary angiography (CA) in detecting coronary total occlusion (CTO) lesion characteristics. Moreover, we analyzed the association between these characteristics and the risk of revascularization failure. Fifty patients with confirmed CTO diagnosis were tried for revascularization using the antegrade (all 50) or retrograde (in failed nine antegrade interventions) approaches. Each patient underwent CA and MSCT before the intervention and data from both modalities were compared using the SPSS software...
June 8, 2018: International Journal of Cardiovascular Imaging
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