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Intraarterial therapy

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https://www.readbyqxmd.com/read/28407278/prevention-and-treatment-of-complications-of-selective-internal-radiation-therapy-expert-guidance-and-systematic-review
#1
REVIEW
Bruno Sangro, Diego Martínez-Urbistondo, Lourens Bester, Jose I Bilbao, Douglas M Coldwell, Patrick Flamen, Andrew Kennedy, Jens Ricke, Ricky A Sharma
Selective internal radiation therapy (SIRT or radioembolisation) by intraarterial injection of radioactive yttrium-90 ((90) Y)-loaded microspheres is increasingly used for the treatment of patients with liver metastases or primary liver cancer. The high-dose beta-radiation penetrates an average of only 2.5 mm from the source so that its effects are limited to the site of delivery. However the off-target diversion of (90) Y microspheres to tissues other than the tumor may lead to complications. The most prominent ones include: radiation gastritis and gastrointestinal (GI) ulcers, cholecystitis, radiation pneumonitis, and radioembolisation-induced liver disease (REILD)...
April 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28330501/intraarterial-transplantation-of-human-umbilical-cord-blood-mononuclear-cells-in-hyperacute-stroke-improves-vascular-function
#2
Lei Huang, Yichu Liu, Jianfei Lu, Bianca Cerqueira, Vivek Misra, Timothy Q Duong
BACKGROUND: Human umbilical cord blood (hUCB) cell therapy is a promising treatment for ischemic stroke. The effects of hyperacute stem cell transplantation on cerebrovascular function in ischemic stroke are, however, not well understood. This study evaluated the effects of hyperacute intraarterial transplantation of hUCB mononuclear cells (MNCs) on cerebrovascular function in stroke rats using serial magnetic resonance imaging (MRI). METHODS: HUCB MNCs or vehicle were administered to stroke rats via the internal carotid artery immediately after reperfusion at 60 min following ischemia onset...
March 22, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28320175/mechanical-embolectomy-for-acute-ischemic-stroke-beyond-six-hours-from-symptom-onset-using-mri-based-perfusion-imaging
#3
Ryan A McTaggart, Shadi Yaghi, Daniel C Sacchetti, Richard A Haas, Morgan Hemendinger, Daniel Arcuri, Jeffrey M Rogg, Karen L Furie, Mahesh V Jayaraman
INTRODUCTION: There is very limited data on the use of MRI based perfusion imaging to select patients with acute ischemic stroke and large vessel occlusion (LVO) for intraarterial therapy beyond 6h from onset. Our aim is to report the outcome of patients with acute ischemic stroke and large artery occlusion who presented beyond 6h from onset, had favorable MRI imaging profile, and underwent mechanical embolectomy. METHODS: This is a single institution (Rhode Island Hospital) retrospective study between December 1st, 2015, and July 30th, 2016 that included patients with acute ischemic stroke and proximal LVO with CT ASPECTS of 6 or more and 6-24h from symptom onset who were assessed for mechanical embolectomy using MRI based perfusion imaging...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28170316/medical-university-of-south-carolina-telestroke-a-telemedicine-facilitated-network-for-stroke-treatment-in-south-carolina-a-progress-report
#4
Sami Al Kasab, Robert J Adams, Ellen Debenham, David J Jones, Christine Ann Holmstedt
BACKGROUND: Patients in rural communities lack access to acute stroke therapies. Rapid administration of lytic therapy increases the likelihood of favorable functional outcome in acute ischemic stroke (AIS). At the Medical University of South Carolina (MUSC), we implemented a Web-based telestroke program that allows patients presenting with AIS at a rural hospital to receive expert stroke consultation within minutes. This increases their chances of receiving lytic therapy, and therefore increases the likelihood of good functional outcome...
February 7, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28098709/multimodal-imaging-during-the-evolution-of-blood-brain-barrier-disruption-maculopathy
#5
Bikramjit P Pal, Tapani Palosaari, Tero Kivelä
PURPOSE: To highlight the course of blood-brain barrier disruption maculopathy in a patient with successfully managed relapsed central nervous system lymphoma. METHODS: Case report with fundus autofluorescence and optical coherence tomography imaging, and literature review. RESULTS: A 57-year-old patient diagnosed with central nervous system large B-cell lymphoma had a normal ophthalmic evaluation on his first visit. Subsequently, when his malignancy recurred locally, he was started on blood-brain barrier disruption therapy and intraarterial methotrexate...
January 16, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28091591/intraarterial-route-increases-the-risk-of-cerebral-lesions-after-mesenchymal-cell-administration-in-animal-model-of-ischemia
#6
Bárbara Argibay, Jesse Trekker, Uwe Himmelreich, Andrés Beiras, Antonio Topete, Pablo Taboada, María Pérez-Mato, Alba Vieites-Prado, Ramón Iglesias-Rey, José Rivas, Anna M Planas, Tomás Sobrino, José Castillo, Francisco Campos
Mesenchymal stem cells (MSCs) are a promising clinical therapy for ischemic stroke. However, critical parameters, such as the most effective administration route, remain unclear. Intravenous (i.v.) and intraarterial (i.a.) delivery routes have yielded varied outcomes across studies, potentially due to the unknown MSCs distribution. We investigated whether MSCs reached the brain following i.a. or i.v. administration after transient cerebral ischemia in rats, and evaluated the therapeutic effects of both routes...
January 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28041782/intraarterial-therapy-using-micellar-nanoparticles-incorporating-sn-38-in-a-rabbit-liver-tumor-model
#7
Hideyuki Nishiofuku, Toshihiro Tanaka, Yasushi Fukuoka, Takeshi Sato, Tetsuya Masada, Shota Tatsumoto, Masayuki Sho, Ichiro Yamato, Satoshi Yasuda, Shigeru Matsushima, Masato Takano, Chiho Ohbayashi, Kimihiko Kichikawa
PURPOSE: To evaluate the pharmacokinetics of intraarterial (IA) administration of micellar nanoparticles incorporating SN-38 injection compared with intravenous (IV) administration in a rabbit liver tumor model. MATERIALS AND METHODS: In this animal care committee-approved study, 18 rabbits (mean weight, 3.89 kg; range, 3.20-4.70 kg) with VX2 liver tumors were divided into two groups (IA and IV). Micellar nanoparticles incorporating SN-38 (30 mg/kg) were injected through the left hepatic artery in the IA group and the right femoral vein in the IV group...
March 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28017233/bridging-therapy-with-intravenous-recombinant-tissue-plasminogen-activator-improves-functional-outcome-in-patients-with-endovascular-treatment-in-acute-stroke
#8
Ilko L Maier, Daniel Behme, Marlena Schnieder, Ioannis Tsogkas, Katharina Schregel, Alexander Kleinknecht, Katrin Wasser, Mathias Bähr, Michael Knauth, Marios Psychogios, Jan Liman
BACKGROUND: Although endovascular treatment for proximal cerebral vessel occlusion is very effective, it remains controversial if intravenous thrombolysis (IVT) prior to endovascular treatment is superior compared to endovascular treatment alone. In this study we compared functional outcomes and recanalization rates of endovascularly treated stroke patients with and without bridging IVT. METHODS: Patients with acute large artery occlusion within the anterior and posterior cerebral circulation eligible for intraarterial revascularization with and without prior IVT were included in this monocentric, prospective observational study...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27767350/transradial-approach-for-hepatic-radioembolization-initial-results-and-technique
#9
Vivian L Bishay, Derek M Biederman, Thomas J Ward, Imramsjah Martijn J van der Bom, Rahul S Patel, Edward Kim, Francis S Nowakowski, Robert A Lookstein, Aaron M Fischman
OBJECTIVE: The transradial approach (TRA) has been shown to reduce the morbidity and mortality associated with arterial coronary interventions. Selective internal radiation therapy (SIRT) performed via the TRA can enhance patient comfort, compared with the traditional transfemoral approach (TFA), by allowing immediate ambulation and precluding potential complications associated with the TFA, such as closure device injury or retroperitoneal hematoma. We report our initial experience with and technique for using the TRA for SIRT...
November 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27664152/endovascular-treatment-of-thrombosis-and-embolism
#10
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27641641/renal-cell-carcinoma-metastatic-to-the-liver-early-response-assessment-after-intraarterial-therapy-using-3d-quantitative-tumor-enhancement-analysis
#11
Florian Nima Fleckenstein, Rüdiger Egbert Schernthaner, Rafael Duran, Jae Ho Sohn, Sonia Sahu, Karen Marshall, MingDe Lin, Bernhard Gebauer, Julius Chapiro, Riad Salem, Jean-François Geschwind
PURPOSE: Liver metastases from renal cell carcinoma (RCC) are not uncommon in the course of disease. However, data about tumor response to intraarterial therapy (IAT) are scarce. This study assessed whether changes of enhancing tumor volume using quantitative European Association for the Study of the Liver (qEASL) on magnetic resonance imaging (MRI) and computed tomography (CT) can evaluate tumor response and predict overall survival (OS) early after therapy. METHODS AND MATERIALS: Fourteen patients with liver metastatic RCC treated with IAT (transarterial chemoembolization: n= 9 and yttrium-90: n= 5) were retrospectively included...
October 2016: Translational Oncology
https://www.readbyqxmd.com/read/27570387/factors-influencing-nonadministration-of-thrombolytic-therapy-in-early-arrival-strokes-in-a-university-hospital-in-hyderabad-india
#12
Lalitha Pidaparthi, Anitha Kotha, Venkat Reddy Aleti, Abhijeet Kumar Kohat, Mridula R Kandadai, Suryaprabha Turaga, Jabeen A Shaik, Suvarna Alladi, Meena A Kanikannan, Borgohain Rupam, Subhash Kaul
BACKGROUND: It is a well-known fact that very few patients of stroke arrive at the hospital within the window period of thrombolysis. Even among those who do, not all receive thrombolytic therapy. OBJECTIVE: The objectives of this study were to determine the proportion of early arrival ischemic strokes (within 6 h of stroke onset) in our hospital and to evaluate the causes of nonadministration of intravenous and/or intraarterial thrombolysis in them. MATERIALS AND METHODS: Data of all early arrival acute stroke patients between January 2010 and January 2015 were included...
July 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27440271/preclinical-benefit-of-hypoxia-activated-intra-arterial-therapy-with-evofosfamide-in-liver-cancer
#13
Rafael Duran, Sahar Mirpour, Vasily Pekurovsky, Shanmugasundaram Ganapathy-Kanniappan, Cory F Brayton, Toby C Cornish, Boris Gorodetski, Juvenal Reyes, Julius Chapiro, Rüdiger E Schernthaner, Constantine Frangakis, MingDe Lin, Jessica D Sun, Charles P Hart, Jean-François Geschwind
PURPOSE: To evaluate safety and characterize anticancer efficacy of hepatic hypoxia-activated intra-arterial therapy (HAIAT) with evofosfamide in a rabbit model. EXPERIMENTAL DESIGN: VX2-tumor-bearing rabbits were assigned to 4 intra-arterial therapy (IAT) groups (n = 7/group): (i) saline (control); (ii) evofosfamide (Evo); (iii) doxorubicin-lipiodol emulsion followed by embolization with 100-300 μm beads (conventional, cTACE); or (iv) cTACE and evofosfamide (cTACE + Evo)...
January 15, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/27366977/landmark-papers-in-cerebrovascular-neurosurgery-2015
#14
REVIEW
Justin M Moore, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Apar S Patel, Christopher S Ogilvy, Ajith J Thomas
The management of cerebrovascular disease has advanced considerably in 2015. Five randomized control trials have firmly established the role of endovascular thrombectomy for ischemic strokes due to large vessel occlusion. The randomized trial of intraarterial treatment for acute ischemic stroke (MR CLEAN) (Berkhemer et al. NEJM 2015;372:11-20) was the first of a series on the topic. There was a total of 5 randomized controlled trials published showing benefit in terms of functional outcomes at 90days for mechanical thrombectomy including the Endovascular Therapy for Ischemic stroke with perfusion-imaging selection (EXTEND IA) (Campbell et al...
September 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27363299/catheter-directed-intraarterial-thrombolysis-as-part-of-a-multidisciplinary-management-protocol-of-frostbite-injury
#15
Sidhartha Tavri, Suvranu Ganguli, Roy G Bryan, Jeremy Goverman, Raymond Liu, Zubin Irani, T Gregory Walker
PURPOSE: To evaluate intraarterial catheter-directed thrombolysis for prediction and prevention of delayed surgical amputation as part of multidisciplinary management of frostbite injury. MATERIALS AND METHODS: A retrospective review was performed of 13 patients (11 men, 2 women; median age, 33.4 y; range, 8-62 y) at risk of tissue loss secondary to frostbite injury and treated with catheter-directed tissue plasminogen activator (t-PA) thrombolysis. Amputation data were assessed on follow-up (mean, 23 mo; range, 9-83 mo)...
August 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27338497/neoadjuvant-intraarterial-chemotherapy-for-treatment-of-malignant-vaginal-tumors-in-children-a-single-center-experience
#16
De-Hua Wu, Min-Ju Li, Da-Xing Tang, Shan Xu, Yong Huang, Jin-Hu Wang, Qiang Shu
Six patients (aged 3-36 mo) with vaginal tumors (rhabdomyosarcoma and endodermal sinus tumor [EST]; n = 3 each) received intraarterial chemotherapy (IAC) and intravenous chemotherapy. Patients underwent internal iliac artery infusion with cisplatin, pirarubicin, and vindesine. Intravenous chemotherapy with vindesine, ifosfamide, and etoposide was administered after 3 weeks. Vaginal tumors disappeared in all patients after 2 or 3 cycles of alternating therapy. Two patients underwent resection of pelvic metastases...
July 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27255400/prediction-of-infarction-development-after-endovascular-stroke-therapy-with-dual-energy-computed-tomography
#17
Tanja Djurdjevic, Rafael Rehwald, Michael Knoflach, Benjamin Matosevic, Stefan Kiechl, Elke Ruth Gizewski, Bernhard Glodny, Astrid Ellen Grams
OBJECTIVES: After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT. METHODS: DECT scans of 20 patients showing 45 BBB disrupted areas after IAR were assessed and compared with follow-up examinations. Receiver operator characteristic (ROC) analyses using densities from the iodine map (IM) and virtual non-contrast (VNC) were performed...
March 2017: European Radiology
https://www.readbyqxmd.com/read/27184404/sulfamethazine-based-ph-sensitive-hydrogels-with-potential-application-for-transcatheter-arterial-chemoembolization-therapy
#18
Jae Seung Lym, Quang Vinh Nguyen, Da Woon Ahn, Cong Truc Huynh, Hwan Jun Jae, Young Il Kim, Doo Sung Lee
UNLABELLED: Transcatheter arterial chemoembolization (TACE) is the most common palliative therapy for unresectable hepatocellular carcinoma (HCC). The conventional TACE technique, which employs the Lipiodol® emulsion, has been widely used for human cancer treatments. However, this delivery system seems to be inconsistent and unstable in maintaining a high concentration of drugs at tumor sites. An alternative approach for TACE is loading drugs into a liquid embolic solution that exists as an injectable solution and can exhibit a sol-to-gel phase transition to form a solidified state once delivered to the tumor site...
September 1, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27173069/vasopressin-as-therapy-during-nonocclusive-mesenteric-ischemia
#19
Hagen Bomberg, Heinrich V Groesdonk, Miriam Raffel, Peter Minko, Wolfram Schmied, Matthias Klingele, Hans-Joachim Schäfers
BACKGROUND: Vasopressin is used as an adjunct to norepinephrine to support blood pressure in vasodilatory shock after cardiopulmonary bypass (CPB). In this study, we report our observation of vasopressin treatment in 11 patients with nonocclusive mesenteric ischemia (NOMI). METHODS: In an observational cohort study, 78 patients were studied after having been treated for NOMI with intraarterial iloprost infusion after elective cardiac operation. All patients received norepinephrine as vasopressor for marked vasodilation...
September 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27160892/ticagrelor-versus-aspirin-in-acute-stroke-or-transient-ischemic-attack
#20
RANDOMIZED CONTROLLED TRIAL
S Claiborne Johnston, Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Jenny Jonasson, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong
BACKGROUND: Ticagrelor may be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients with acute cerebral ischemia. METHODS: We conducted an international double-blind, controlled trial in 674 centers in 33 countries, in which 13,199 patients with a nonsevere ischemic stroke or high-risk transient ischemic attack who had not received intravenous or intraarterial thrombolysis and were not considered to have had a cardioembolic stroke were randomly assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive either ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2 through 90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2 through 90)...
July 7, 2016: New England Journal of Medicine
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