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(Stroke OR stenosis OR occlusion OR atherosclerosis) AND collateral

Hajime Imura, Yuji Maruyama, Ryosuke Amitani, Motohiro Maeda, Makoto Shirakawa, Takashi Nitta
BACKGROUND: Cerebrovascular disease (CVD) with brain hypoperfusion is a strong risk factor for stroke. However, how this pathology influences long-term outcomes after coronary artery bypass graft (CABG) surgery is not known. METHODS: Magnetic resonance imaging/angiography (MRI/A) of the neck and brain was performed in 318 out of 575 consecutive CABG patients between May 2005 and April 2018. Critical CVD with chronic hypoperfusion was defined as multiple severe stenoses (⩾70%) and/or occlusion in the carotid and/or vertebral systems associated with reduced collateral flow due to severe contralateral and/or circle of Willis lesion...
November 16, 2018: Perfusion
Johannes Rigger, Colm G Hanratty, Simon J Walsh
Despite the ongoing development of technical skills, increasing operator experience and improvements in medical devices, percutaneous coronary interventions (PCI) for chronic total occlusions (CTO) are still the most challenging procedures in interventional cardiology for coronary artery disease. Due to the complexity of the procedures, there is an increased complication rate compared with PCIs for the treatment of non-occlusive disease. This may significantly increase procedural morbidity and potentially mortality...
September 2018: Interventional Cardiology
Chih-Ming Lin, Chi-Kuang Liu, Yu-Jun Chang, Wei-Liang Chen, Henry Horng-Shing Lu
Stroke is the leading cause of death worldwide and stenosis of the carotid artery accounts for more than half of all cases. Carotid duplex is an effective non-invasive ultrasound test which identifies stroke patients with moderate to severe carotid stenosis who are candidates for preventative intervention to reduce the risk of recurrence. In patients with moderate to severe carotid stenosis, reversed ophthalmic artery flow (ROAF) is often observed at the time of the carotid duplex scan. In this study, we investigated whether ROAF, denoting exhaustion of cerebral collateral flow in ischemic stroke patients affected mid-term functional outcomes following carotid artery stenting (CAS) procedures...
November 15, 2018: Neurological Research
Kyoung Hoon Lim, Jinyoung Park
RATIONALE: Blunt injury of major visceral arteries such as celiac artery (CA) and superior mesenteric artery (SMA) are very rare but fatal, therefore, these injuries are challenging to trauma surgeons. The patient with occlusion of CA or SMA is theoretically viable by visceral collateral circulation. However, there are very rare cases in clinics. To date, there have been few reports of both CA and SMA occlusions after blunt trauma. Herein we describe our successful conservative treatment of patients with both CA and SMA occlusions...
November 2018: Medicine (Baltimore)
Gianni Boris Bradac, Fabrizio Venturi, Giovanni Bosco, Domenica Garabello, Mario Coriasco, Guido Stura, Giancarlo Ventilii, Mauro Bergui, Paolo Cerrato
PURPOSE: The acute distal intracranial occlusion of the internal carotid artery (ICA) is a very complex heterogeneous pathology, characterized by various patterns. Aim of this work is to identify the different types and propose a classification. METHODS: Among the patients admitted for stroke in the anterior circulation from august 2014 to October 2017, 46 (25%) presented with intracranial distal carotid artery occlusion. The mean age of the patients was 71 (SD 13...
November 13, 2018: Clinical Neuroradiology
Edward Krajicek, Stuart Sherman, Marco Lacerda, Matthew S Johnson, Raj Vuppalanchi
Hepatic artery thrombosis is a concerning complication of orthotopic liver transplantation, and it most often occurs early in the posttransplant period. However, on rare occasions it can occur at a time remote from transplant. We present a case of ischemic cholangiopathy complicated by stricture and anastomotic bile leak from chronic hepatic artery thrombosis that occurred 11 years after the transplant. The initial biliary stenting helped with the resolution of the leak but she was found to have stones, sludge and copious pus at the time of stent exchange...
2018: ACG Case Reports Journal
Nomazulu Dlamini, Prakash Muthusami, Catherine Amlie-Lefond
Moyamoya is a chronic, progressive steno-occlusive arteriopathy that typically affects the anterior circulation arteries of the circle of Willis. A network of deep thalamoperforating and lenticulostriate collaterals develop to by-pass the occlusion giving rise to the characteristic angiographic "puff of smoke" appearance. Moyamoya confers a lifelong risk of stroke and neurological demise, with peak age of presentation in childhood ranging between five and 10 years. Moyamoya disease refers to patients who do not have a comorbid condition, whereas moyamoya syndrome refers to patients in whom moyamoya occurs in association with an acquired or inherited disorder such as sickle cell disease, neurofibromatosis type-1 or trisomy 21...
October 15, 2018: Pediatric Neurology
Katharina Millesi, Johannes Sebastian Mutzenbach, Monika Killer-Oberpfalzer, Constantin Hecker, Lukas Machegger, Nele Bubel, Christian Ramesmayer, Slaven Pikija
BACKGROUND: Clinical outcome after large vessel occlusion (LVO) stroke depends on collateral integrity. We aimed to evaluate whether the completeness of the circle of Willis (CoW) and anterior temporal artery (ATA) determines the status of leptomeningeal collaterals (LC) in patients with acute LVO (internal carotid artery (ICA) and middle cerebral artery M1 (MCA) occlusion) treated with endovascular thrombectomy. PATIENTS AND METHODS: LC, cross-flow through the anterior communicating artery (ACoA), presence of the ipsilateral posterior communicating artery (IpsiPCoA) and presence of the ATA were evaluated using CT angiography...
November 3, 2018: Journal of the Neurological Sciences
Jonathan C Horton, Daniel L Adams
The cerebral cortex is supplied by vascular microlobules, each comprised of a half dozen penetrating arterioles that surround a central draining venule. The surface arterioles that feed the penetrating arterioles are interconnected via an extensively anastomotic plexus. Embolic occlusion of a small surface arteriole rarely produces a local infarct, because collateral blood flow is available through the vascular reticulum. Collateral flow also protects against infarct after occlusion of a single penetrating arteriole...
December 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Loukman Omarjee, Antoine Larralde, Vincent Jaquinandi, Olivier Stivalet, Guillaume Mahe
RATIONALE: Buerger disease (BD) is a nonatherosclerotic, inflammatory, segmental vascular occlusive disease, which affects small and medium-sized arteries and veins and is triggered by substantial tobacco exposure. Angiographic findings consistent with BD are required for diagnosis. Laser Doppler flowmetry (LDF) and laser speckle contrast imaging (LSCI) could represent potential noninvasive alternative techniques to angiography. PATIENT CONCERNS: We report the case of a 49-year-old smoker who developed an ischemic ulcer in the distal segment of the second finger of the left hand...
October 2018: Medicine (Baltimore)
Diogo C Haussen, Mehdi Bouslama, Seena Dehkharghani, Jonathan A Grossberg, Nicolas Bianchi, Meredith Bowen, Michael R Frankel, Raul G Nogueira
Background and Purpose: We have observed that large vessel occlusion acute strokes (LVOS) due to intracranial atherosclerotic disease (ICAD) present with more benign CT perfusion (CTP) profiles, which we presume to potentially represent enhanced collateralization compared to embolic LVOS. We aim to determine if CTP profiles can predict ICAD in LVOS. Methods: Retrospective review of a prospectively collected interventional stroke database from September 2010 to March 2015...
October 2018: Interventional Neurology
Amy Cheney, Kathleen E Kearney, William Lombardi
ᅟ: Chronic total occlusions (CTOs) are an important and increasingly recognized subgroup of coronary lesions, documented in at least 30%, but up to 52% of patients with coronary artery disease (CAD) undergoing coronary angiography. Percutaneous coronary intervention (PCI) of these lesions is increasingly pursued, with excellent success rates. PURPOSE OF REVIEW: It is known that gender differences exist in the presentation of CAD, as well as in clinical outcomes after routine PCI; however, it is not well described how these differences pertain to management of CTOs...
November 7, 2018: Current Atherosclerosis Reports
S Miyagi, C Nakanishi, Y Hara, W Nakanishi, K Tokodai, K Shimizu, S Uematsu, H Kumata, Y Kakizaki, M Goto, T Kamei, M Unno, S Satomi
OBJECTIVES: In adults undergoing living donor liver transplantation (LDLT), the transplanted livers are partial grafts, and the portal venous pressure is higher than that observed with whole liver grafts. In patients undergoing LDLT concomitant with splenomegaly, portal venous flow is often diverted to collateral vessels, leading to a high risk of portal vein thrombosis. In such cases, occlusion of the collateral veins is important; however, complete occlusion of all collaterals without blocking the blood flow through the splenic artery causes portal hypertension and liver failure...
November 2018: Transplantation Proceedings
Satoshi Matsuo, Akira Nakamizo, Yutaka Fujioka, Toshiyuki Amano, Masahiro Yasaka, Yasushi Okada, Shinji Nagata
Arterial signal intensities on magnetic resonance angiography (MRA) correlate with the relevant hemisphere's hemodynamics in patients with cerebrovascular diseases. We evaluated whether superficial temporal artery (STA) signal intensities (SI) on MRA were useful to evaluate the postoperative cerebral hemodynamics of patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) steno-occlusive disease who underwent unilateral STA-MCA anastomosis. Twenty-one consecutive patients undergoing unilateral STA-MCA anastomosis for symptomatic ICA or MCA steno-occlusive disease were enrolled...
November 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Wen-Huo Chen, Ting-Yu Yi, Yan-Min Wu, Mei-Fang Zhang, Ding-Lai Lin, Xiao-Hui Lin
BACKGROUND AND PURPOSE: The prognosis of progressive ischemic stroke (PIS) caused by large proximal artery occlusion companied with hemodynamic was poor. Our study aimed to investigate the safety of ET for patients with PIS who were selected based on ischemic penumbra detected on brain imaging. METHODS: A cohort of consecutive patients with PIS who were treated with ET were identified. Patients were selected for ET based on the presence of ischemic penumbra using magnetic resonance imaging...
October 31, 2018: World Neurosurgery
Nolan S Hartkamp, Jeroen Hendrikse, Gert J de Borst, L Jaap Kappelle, Reinoud P H Bokkers
BACKGROUND AND PURPOSE: Intracerebral steal is a paradoxical vasodilatory response that reduces cerebral blood flow (CBF) in hemodynamically compromised brain tissue when blood is rerouted to more healthy areas. The aim of our study was to investigate the presence and extent of steal in patients with steno-occlusive internal carotid artery (ICA) disease, and to assess its relation with collateral blood flow through the circle of Willis (CoW). MATERIALS AND METHODS: Thirty-eight patients with symptomatic steno-occlusive ICA disease underwent MRI examination with arterial spin labeling (ASL) perfusion imaging before and after a vasodilatory challenge...
October 30, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
T R Miller, M J Kole, E J Le, G Cannarsa, S Jones, A P Wessell, G Jindal, E F Aldrich, J M Simard, D Gandhi
BACKGROUND AND PURPOSE: Although covered side branches typically remain patent acutely following Pipeline Embolization Device embolization of intracranial aneurysms, the long-term fate of these vessels remains uncertain. We therefore elected to investigate factors that may influence the long-term patency of these covered side branches. MATERIALS AND METHODS: We retrospectively evaluated the long-term patency of side branches covered by the Pipeline Embolization Device at our institution during treatment of intracranial aneurysms with at least 6 months of conventional angiography follow-up...
November 1, 2018: AJNR. American Journal of Neuroradiology
Haytham Rizk, Mahmoud Allam, Ahmed Hegazy, Haytham Khalil, Hanan Helmy, Hebatalla Hashem, Foad Abd-Allah
BACKGROUND: This study aims to investigate the relationship between cerebrovascular reserve (CVR) capacity, as measured by single-photon emission computed tomography (SPECT) and collateral blood flow, according to a transcranial colour-coded duplex(TCCD), in patients with symptomatic total carotid occlusion (TCO). Additionally, the study aims to determine whether vascular risk factors have an effect on collateral blood flow, as well as on the CVR. METHODS: Thirty-four patients with chronic TCO, diagnosed by carotid duplex scanning and confirmed by other vascular imaging modalities, who had ischaemic symptoms either as stroke or transient ischaemic attack (TIA), were subjected to clinical assessment, SPECT under dipyridamole stress, and grading of cerebral collateral blood flow using TCCD...
October 29, 2018: International Journal of Neuroscience
X Zhao, Q M Jing, Z F Wang, Y Han, X Z Wang, G Wang, Y L Han
Objective: To investigate the effect of excimer laser coronary atherectomy (ELCA) in the interventional treatment of acute coronary syndrome (ACS). Methods: This prospective study enrolled 31 patients with ACS who underwent ELCA treatment in our hospital from November 8, 2016 to December 13, 2017. The efficacy and complications of ELCA were observed, and patients were followed up for postoperative observation of major adverse cardiovascular and cerebrovascular events (including target vessel revascularization, stroke, stent thrombosis, coronary artery bypass grafting, and death)...
October 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Joon-Tae Kim, David S Liebeskind, Reza Jahan, Bijoy K Menon, Mayank Goyal, Raul G Nogueira, Vitor M Pereira, Jan Gralla, Jeffrey L Saver
Background and Purpose- Understanding the influence of hyperglycemia on outcomes in terms of the pretreatment collateral status might contribute to the achievement of case-specific glucose management in acute ischemic stroke. We sought to investigate whether the glucose level can influence the pretreatment collateral status and functional outcomes of endovascular thrombectomy in acute ischemic stroke and whether the impact of hyperglycemia on outcomes can be modified by the pretreatment collateral status. Methods- We analyzed the Triple-S database, which includes individual patient data pooled from 3 prospective Solitaire stent retriever studies (SWIFT [Solitaire With the Intention for Thrombectomy], SWIFT PRIME [SWIFT as Primary Endovascular Treatment], and STAR [Solitaire Flow Restoration Thrombectomy for Acute Revascularization])...
November 2018: Stroke; a Journal of Cerebral Circulation
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