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(Stroke OR stenosis OR occlusion OR atherosclerosis) AND collateral

Dong Chan Lee, Dong Hwa Heo, Kyoung Seok Cho
BACKGROUND AND STUDY AIMS:  Vascular narrowing or obstruction reduces blood flow to the lower limbs during exercise or at rest. Symptoms may range from intermittent claudication to pain at rest. Narrowing of these arteries may produce pain in the buttocks, thighs, or legs. These symptoms may resemble those of lumbar radicular pain. Spine surgeons may overlook obstructive vascular lesions of the lower limbs in patients with lumbar degenerative diseases such as spinal stenosis and spondylolisthesis...
September 17, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Boehme J, Wenz H, Al-Zghloul M, Alonso A, Groden C, Förster A
PURPOSE: Aim of this study was to evaluate the collateral blood flow between more distal branches of the middle cerebral artery (MCA) in the case of peripheral MCA branch occlusion on dynamic 4D angiograms. We sought to individually predict the finally resulting infarction volume with regard to the extent of collateral blood flow. METHODS: Overall, 35 acute ischemic stroke patients with peripheral MCA branch occlusion were included. Volumes of the ischemic infarctions and perfusion deficits were measured on diffusion weighted images DWI and time-to-peak TTP (>4S)...
September 13, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Abhilash Koratala, Deepti Bhattacharya, Gajapathiraju Chamarthi
Hemodialysis catheters are associated with upper extremity deep vein thrombosis, and chronic venous occlusion leads to the formation of collateral pathways. Knowledge of these pathways aids in accurate interpretation of upper extremity venograms. Arteriovenous fistula is the preferred access for chronic hemodialysis, and long-term use of catheters should be avoided.
September 2018: Clinical Case Reports
Mary C Shields, Borna Mehrad, Ellen C Keeley
Circulating fibrocytes are a population of bone marrow-derived progenitor cells that have been implicated in neovascularization. The recruitment of coronary artery collaterals, a form of neovascularization, is associated with improved outcomes in coronary artery disease. In this study, we tested the hypothesis that, in subjects with stable chronic coronary artery disease, the blood concentration of fibrocytes is associated with the presence of angiographic coronary collaterals. A total of 58 subjects with at least one epicardial coronary artery with ≥ 90% luminal stenosis were enrolled, among whom 26 (45%) had angiographic evidence of coronary collaterals...
2018: American Journal of Translational Research
Suguru Ito, Masaaki Higashiyama, Kazuki Horiuchi, Akinori Mizoguchi, Shigeyoshi Soga, Rina Tanemoto, Shin Nishii, Hisato Terada, Akinori Wada, Nao Sugihara, Yoshinori Hanawa, Hirotaka Furuhashi, Takeshi Takajo, Kazuhiko Shirakabe, Chikako Watanabe, Shunsuke Komoto, Kengo Tomita, Shigeaki Nagao, Masami Shinozaki, Akihiko Nakagawa, Michio Kubota, Daisuke Miyagishima, Nobuaki Gotoh, Soichiro Miura, Hideki Ueno, Ryota Hokari
We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn's disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNFα agent improved his hypoalbuminemia after surgery...
September 12, 2018: Internal Medicine
Elodie Ong, Omer Eker, Leila Chamard, Tae Hee Cho, Laurent Derex, Marielle Buisson, Laura Mechtouff, Yves Berthezene, Norbert Nighoghossian
BACKGROUND AND PURPOSE: Transient ischemic attack may rarely reveal an intracranial artery occlusion. We analyzed acute magnetic resonance imaging (MRI) patterns and early outcome after reperfusion therapy in these cases. METHOD: Clinical and imaging data were taken retrospectively from our comprehensive stroke center registry. Two MRI patterns were determined. Pattern A: full mismatch with negative diffusion-weighted imaging (DWI) and perfusion defect. Pattern B: large mismatch with positive DWI and perfusion defect...
September 12, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Nicola Morelli, Eugenia Rota, Paolo Immovilli, Giuseppe Marchesi, Donata Guidetti, Emanuele Michieletti, John Morelli
Multiphase CT angiography (CTA) in collateral assessment provides time-resolved cerebral angiograms of the intracranial vasculature, requiring a high-speed multidetector CT (MDCT) scanner with ≥ 64 slices. Unfortunately, many hospitals are equipped with lower speed MDCT scanners. Herein, we present our experience performing dual-phase CTA (d-CTA) on a 16 slice MDCT with a biphasic rate injection to grade intracranial collaterals as predictor of clinical outcome. 42 patients were evaluated with both dual-phase CTA (d-CTA) and single-phase CTA (s-CTA) for occluded anterior intracranial circulation and collaterals...
September 8, 2018: Acta Neurologica Belgica
Biqiu Tang, Jiaxin Zeng, Lu Liu, Yuan Xiao, Zhenlin Li, Kai Zhang, Shah Chandan, Youjin Zhao, Zheng Ye, Wenhao Wang, Li He, Su Lui
PURPOSE: The aim of this study was to evaluate the potential value of low-dose multimodal computed tomography (CT) in predicting prognosis of acute ischemic stroke (AIS) within 6 hours. METHODS: The admission "one-stop-shop" multimodal CT examination, including noncontrast CT (NCCT), low-dose CT perfusion, and CT angiography (CTA), was performed in patients with symptoms of stroke within 6 hours. Noncontrast CT, CTA source image (CTA-SI), cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and mean transit time (MTT) maps were studied using Alberta Stroke Program Early CT Score (ASPECTS)...
September 4, 2018: Journal of Computer Assisted Tomography
Alejandro A Rabinstein, Gregory W Albers, Waleed Brinjikji, Sebastian Koch
Endovascular therapy with mechanical thrombectomy is a formidable treatment for severe acute ischemic stroke caused by occlusion of a proximal intracranial artery. Its strong beneficial effect is explained by the high rates of very good and excellent reperfusion achieved with current endovascular techniques. However, there is a sizable proportion of patients who do not experience clinical improvement despite successful recanalization of the occluded artery and reperfusion of the ischemic territory. Factors such as baseline reserve, collateral flow, anesthesia and systemic factors have been identified as potential culprits for lack of improvement in the setting of timely and successful revascularization...
September 6, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Hui Chen, Guangming Zhu, Nan Liu, Ying Li, Yonghong Xia
Brain permeability imaging techniques are specific for the assessment of blood-brain barrier integrity. The present review article primarily focuses on the application of permeability imaging in cases of ischemic stroke. The permeability maps may be used to predict future hemorrhagic transformation in patients following acute ischemic stroke, that have been treated with tissue plasminogen activator (tPA) or recanalization therapy. The permeability imaging would help make the clinical decision to administer tPA following acute ischemic stroke or not, which is not only due to the current 3-4...
September 2018: Experimental and Therapeutic Medicine
Takeshi Ikuta, Noriaki Kishimoto, Hirofumi Fujii, Eiji Kimura, Yoshihiro Shimizu
Ventricular septal rupture(VSR) after acute myocardial infarction(AMI) is a rare and serious complication that is associated with extremely high mortality. Delayed VSR is particularly uncommon and is difficult to diagnose and treat. A 68-year-old man presented with dyspnea on effort. Coronary angiography revealed subtotal occlusion of the right coronary artery(RCA) with collateral circulation to the chronically and totally occluded left anterior descending artery (LAD). Elective stenting of the RCA was successfully performed for a recent MI of the RCA, while percutaneous coronary intervention(PCI) in the LAD ended in failure...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jakob Almer, Robert B Jennings, Michael Ringborn, Henrik Engblom
OBJECTIVES: An acute coronary occlusion and its possible subsequent complications is one of the most common causes of death. One such complication is ventricular fibrillation (VF) due to myocardial ischemia. The severity of ischemia is related to the amount of coronary arterial collateral flow. In dog studies collateral flow has also been shown to be associated with QRS prolongation. The aim of this study was to investigate whether ischemic QRS prolongation (IQP) is associated with impending VF in an experimental acute ischemia dog model...
September 5, 2018: Scandinavian Cardiovascular Journal: SCJ
Shinichi Miura, Tsuyoshi Katsube, Satoshi Nakamizo, Yoshio Sakagami
A 69-year-old man presented with sudden loss of consciousness and was admitted to our hospital. Computed tomography revealed diffuse subarachnoid hemorrhage. Digital subtraction angiography revealed occlusion of the left M1 segment, collateral arteries from the left A1 to the left M2 via twig-like networks, and a 6-mm aneurysm in the collateral arteries. Clipping surgery was performed on the 3rd hospital day. Vascular abnormalities of the middle cerebral artery with twig-like networks have been reported with an incidence of 0...
September 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Jildaz Caroff, Robert M King, Rose Arslanian, Miklos Marosfoi, Erin T Langan, Matthew J Gounis, Ju-Yu Chueh
BACKGROUND: Despite high recanalization rates achieved with endovascular treatment of acute ischemic strokes, around 50% of eligible patients will not achieve a good outcome. Parameters that may determine patient outcomes include: time from puncture to recanalization, the collateral status, the anesthesia regimen, blood pressure management, and distal emboli. Characterization of distal emboli generated during mechanical thrombectomy has been performed in previous studies. OBJECTIVE: To further investigate the risk of distal embolization associated with microcatheter navigation across the clot...
September 3, 2018: Journal of Neurointerventional Surgery
Pablo Marques de Marino, Balazs Botos, George Kouvelos, Eric L G Verhoeven, Athanasios Katsargyris
OBJECTIVES: Iliac branch devices (IBD) have become a widespread option to preserve antegrade internal iliac artery (IIA) flow during endovascular aneurysm repair (EVAR). Reported experience with bilateral implantation of IBDs is limited. This study aimed to describe the indications, technical options, and outcomes with the use of bilateral IBDs. METHODS: All patients undergoing elective implantation of bilateral Cook Zenith IBD between January 2010 and September 2017 in a single centre were included...
August 31, 2018: European Journal of Vascular and Endovascular Surgery
Lina Feng, Jing Gao, Yuexiang Wang, Yuen-Ki Cheong, Guogang Ren, Zhuo Yang
As one of the bisphosphonate derivatives, etidronate has proved to be beneficial to spatial learning and memory deficits caused by two-vessel occlusion (2-VO). In this study, the novel drug etidronate-zinc complex (Eti-Zn) was used to detect its role in synaptic plasticity and learning and memory functions in a rat model of 2-VO. Chronic cerebral hypoperfusion was induced by permanent occlusion of the common carotid artery bilaterally in adult Sprague-Dawley rats. Eti-Zn (20 mg/kg/day, tail vein injection) was administered for 7 days after a two-week operation...
August 31, 2018: Neuroscience
Dragoş Cătălin Jianu, Claudia Bârsan, Traian Flavius Dan, Silviana Nina Jianu, Andrei Gheorghe Marius Motoc, Octavian Marius Creţu
Agenesis, aplasia and hypoplasia of the internal carotid artery are rare congenital malformations. They are usually asymptomatic and incidentally discovered through ultrasound or imagistic tests. The aim of this study is to improve their management in our Departments. We report here the case of a 39-year-old woman addressed to our ambulatory in 2013 for benign symptoms like dizziness and headache. Imagistic findings (magnetic resonance imaging of the brain, and cervical spine, and magnetic resonance angiography of the head and neck) indicated a very rare condition: left internal carotid artery agenesis accompanied by the absence of the pre-communicant part of the left anterior cerebral artery and of the right posterior communicating artery...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Timme M A J van Vuuren, Ralph L M Kurstjens, Cees H A Wittens, Jorinde H H van Laanen, Rick de Graaf
OBJECTIVE: Iliac vein compression syndrome can cause severe leg symptoms. In clinical practice, it remains a challenge to differentiate which compression is clinically relevant. The aim of the current study was to assess the general treatment indications and the prevalence of angiographic signs of iliac vein compression in a group of healthy participants. METHODS: This was a prospective cohort study. A total of 20 healthy volunteers (median age 21, range 20-22 years) were recruited through advertisement and underwent angiography of the iliac veins...
August 29, 2018: European Journal of Vascular and Endovascular Surgery
Dirk J van der Heijden, Maarten A H van Leeuwen, Marco J P F Ritt, Peter M van de Ven, Niels van Royen
OBJECTIVES: The aim of the study was to evaluate the occurrence of hand ischemia in patients with radial artery occlusion (RAO), using the contralateral hand as control. BACKGROUND: Radial artery occlusion is a common complication (6%) after transradial access (TRA) but rarely leads to major ischemic events due to the collateral perfusion of the hand. However, it has been reported that RAO can become symptomatic, possibly as a consequence of hand ischemia. To evaluate the existence of exercise induced hand ischemia in patients with RAO, we initiated the present study...
August 30, 2018: Journal of Interventional Cardiology
Adrien Guenego, Michael Mlynash, Soren Christensen, Stephanie Kemp, Jeremy J Heit, Maarten G Lansberg, Gregory W Albers
We hypothesized that automated assessment of collaterals on computed-tomography (CT) perfusion can predict the rate of infarct growth during transfer from a primary to a comprehensive stroke center for endovascular stroke treatment. We identified consecutive patients (N=28) and assessed their collaterals based on the hypoperfusion intensity ratio (HIR) prior to transfer. Infarct growth rate was strongly correlated with HIR (r= 0.78, p<0.001). ROC analysis identified an HIR of ≥0.5 as optimal for predicting infarct growth...
August 31, 2018: Annals of Neurology
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