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Intraarterial therapy

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https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#1
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29693791/feasibility-and-results-of-an-intraarterial-chemotherapy-program-for-the-conservative-treatment-of-retinoblastoma-in-argentina
#2
Santiago Funes, Claudia Sampor, Francisco Villasante, Adriana Fandiño, Julio Manzitti, Mariana Sgroi, Pablo Neira, Laura Peralta, Eduardo Lagomarsino, Paula Schaiquevich, Alejandro Ceciliano, Guillermo L Chantada
BACKGROUND: The feasibility and results of intraarterial chemotherapy, also termed ophthalmic artery chemosurgery (OAC), for retinoblastoma in less developed countries have seldom been reported. PROCEDURE: A retrospective evaluation of a program of OAC in Argentina from 2010 to 2015. RESULTS: Ninety-seven eyes from 81 patients (61 bilateral) were analyzed. In 35 eyes, OAC was given as primary therapy and in 62 it was used for the treatment of tumors with partial response or those relapsing after systemic chemoreduction with focal therapy or external-beam radiotherapy...
April 25, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29679441/feasibility-safety-and-outcome-of-recanalisation-treatment-in-childhood-stroke
#3
Sandra Bigi, Andrea Dulcey, Jan Gralla, Corrado Bernasconi, Amber Melliger, Alexandre N Datta, Marcel Arnold, Johannes Kaesmacher, Joel Fluss, Annette Hackenberg, Oliver Maier, Johannes Weber, Claudia Poloni, Urs Fischer, Maja Steinlin
Objective Intravenous thrombolysis and endovascular therapy (IVT/EVT) are evidence-based treatments for adults with arterial ischemic stroke (AIS). However, randomized controlled trials in pediatric patients are lacking. This study aimed to describe feasibility, safety, and outcome of IVT/EVT in children with AIS. Methods Retrospective study (01/2000-12/2015) of a multicenter, population-based consecutive cohort of patients aged 1 month - 16 years diagnosed with AIS presenting with a pedNIHSS ≥4. Clinical and radiological data of patients receiving IVT/EVT were compared to those receiving standard care (SC) using linear regression to adjust for potential confounders...
April 20, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29538016/noninvasive-blood-pressure-monitor-designed-for-patients-with-heart-failure-supported-with-continuous-flow-left-ventricular-assist-devices
#4
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29466201/-antiaggregants-in-primary-prevention-of-cardiovascular-diseases-and-prevention-of-atherothrombosis-in-patients-with-stable-ischemic-heart-disease-aspects-of-efficacy-and-safety
#5
N B Perepech, I E Mikhaylova
This review is devoted to the use of antiaggregants. We consider here pathogenesis of intraarterial thrombosis, mechanism of action of antiaggregants, and recommendations on the use of drugs of this class for primary prevention of cardiovascular diseases and prevention of atherothrombotic complications of stable ischemic heart disease. Information on mechanisms of development and causes of resistance to antiaggregants is also presented. Finally we discuss the problem of safety of therapy with antiaggregants, methods of lowering the risk of bleeding, and prevention of aspirin induced gastropathy...
February 2018: Kardiologiia
https://www.readbyqxmd.com/read/29443806/hand-held-optical-coherence-tomography-monitoring-of-chemoresistant-retinoblastoma
#6
Kunal Malik, R Joel Welch, Carol L Shields
PURPOSE: Retinoblastoma (Rb) is a potentially fatal intraocular malignancy in children, and hand-held optical coherence tomography (HH-OCT) can assist in submillimeter detection and monitoring after treatment of Rb. Retinoblastoma located in the macula, or those with chemoresistance, can be among the most difficult to manage. We describe HH-OCT features in a case of chemoresistant macular Rb that eventually responded to plaque radiotherapy after failing intravenous chemotherapy and intraarterial chemotherapy...
February 13, 2018: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29417839/mechanical-thrombectomy-is-time-still-brain-the-dawn-of-a-new-era
#7
Naveed Kamal, Neil Majmundar, Nitesh Damadora, Mohammad El-Ghanem, Rolla Nuoman, Irwin A Keller, Steven Schonfeld, Igor Rybinnik, Gaurav Gupta, Sudipta Roychowdry, Fawaz Al-Mufti
PURPOSE: The purpose of this study is to review the history of treatments for acute ischemic stroke, examine developments in endovascular therapy, and discuss the future of the management of acute ischemic stroke. METHODS: A selective review of recent clinical trials for the treatment of acute ischemic stroke was conducted. RESULTS: We reviewed completed trials of the management of acute ischemic stroke including intravenous thrombolytics, intraarterial thrombolytics, and thrombectomy...
February 8, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29230127/intraarterial-liver-directed-therapies-the-role-of-interventional-oncology
#8
REVIEW
Jenson Ma, Juan Martin Gimenez, Tyler Sandow, Daniel Devun, David Kirsch, Paul Gulotta, Patrick Gilbert, Dennis Kay
Background: Since the early 1990s, the minimally invasive image-guided therapies used in interventional oncology to treat hepatocellular carcinoma have continued to evolve. Additionally, the range of applications has been expanded to the treatment of hepatic metastases from colorectal cancer, neuroendocrine tumors, cholangiocarcinoma, breast cancer, melanoma, and sarcoma. Methods: We searched the literature to identify publications from 1990 to the present on various image-guided intraarterial therapies and their efficacy, as well as their role in the management of primary and secondary liver malignancies...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29075576/cost-benefits-of-rapid-recanalization-using-intraarterial-thrombectomy
#9
Hye Seon Jeong, Jong Wook Shin, Hyon-Jo Kwon, Hyeon-Song Koh, Hae-Sung Nam, Hee Seon Yu, Na Young Yoon, Jei Kim
OBJECTIVES: Thrombolytic therapy is associated with favorable clinical outcomes after successful and rapid recanalization in patients with acute ischemic stroke. This study aimed to evaluate the cost benefits and clinical outcomes at 1 year after intraarterial thrombectomy (IAT) by the rapidity of the successful recanalization. MATERIALS & METHODS: Clinical outcomes of and medical costs incurred by 230 patients with acute ischemic stroke who underwent IAT were compared by the rapidity from symptom onset to successful recanalization (2b/3 thrombolysis in cerebral infarction grade): ≤6-hr ( n  = 143), >6-hr ( n  = 31), and no-recanalization ( n  = 56)...
October 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28864605/radioembolization-of-colorectal-liver-metastases-indications-technique-and-outcomes
#10
REVIEW
F Edward Boas, Lisa Bodei, Constantinos T Sofocleous
Liver metastases are a major cause of death from colorectal cancer. Intraarterial therapy options for colorectal liver metastases include chemoinfusion via a hepatic arterial pump or port, irinotecan-loaded drug-eluting beads, and radioembolization using 90 Y microspheres. Intraarterial therapy allows the delivery of a high dose of chemotherapy or radiation into liver tumors while minimizing the impact on liver parenchyma and avoiding systemic effects. Specificity in intraarterial therapy can be achieved both through preferential arterial flow to the tumor and through selective catheter positioning...
September 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28634669/yttrium-90-y-90-resin-microsphere-therapy-for-patients-with-unresectable-hepatocellular-carcinoma-a-single-center-experience
#11
Semra İnce, Bülent Karaman, Engin Alagoz, Nuri Karadurmuş, Hüseyin Şan, Cemal Nuri Erçin, Nuri Arslan
BACKGROUND/AIM: Selective intraarterial radionuclide therapy (SIRT) with yttrium-90 (Y-90) resin microspheres presently has successful results in primary or metastatic inoperable liver tumors. This procedure, which is also known as radioembolisation, delivers high doses of radiation selectively to hepatic tumors while minimum healthy liver exposure. The aim of this study was to present our clinical experience of radiomicrosphere therapy for the treatment of patients with unresectable hepatocellular carcinoma (HCC)...
June 20, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28541962/use-of-femoral-artery-ultrasound-during-intraarterial-chemotherapy-for-children-under-10-kg-with-retinoblastoma
#12
Ryan S Kim, Mark J Dannenbaum, Michael W Lin, Maria E Bretana, Deborah L Brown, Amy C Schefler
PURPOSE: To demonstrate the safety and efficacy of intraarterial chemotherapy (IAC) in small infants (<10 kg) with retinoblastoma. METHODS: Retrospective, consecutive, observational case series of patients treated with IAC. Femoral arterial access was obtained using a micropuncture kit and ultrasound guidance, which enabled direct visualization. Melphalan (1.5-5.0 mg), topotecan (0.3-2.0 mg), and/or carboplatin (30-40 mg) were used. Patients underwent adjuvant therapies including laser, cryotherapy, and intravitreal melphalan if persistent disease or recurrence was observed...
May 23, 2017: Retina
https://www.readbyqxmd.com/read/28537788/the-precision-of-hepatic-arterial-infusion-scintigraphy-as-a-quantitative-biomarker-of-tumor-microvasculature
#13
Mark Dunphy, Neeta Pandit-Taskar, Josef J Fox, Nancy Kemeny
OBJECTIVE: Optimal clinical development of new cancer therapies targeting tumor vasculature requires new target-specific response assays. This clinical study examined the test-retest repeatability of SPECT as an in vivo assay of angiogenic hepatic tumor microvasculature using an intraarterial infusion of (99m)Tc-macroaggregated albumin (MAA) delivered via a hepatic artery infusion (HAI) pump. MATERIALS AND METHODS: Patients with primary or secondary cancerous liver tumors with HAI pump-catheter implants placed for HAI chemotherapy underwent hepatic SPECT after separate arterial infusions of 37 and 185 MBq of (99m)Tc-MAA via an HAI pump...
July 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28407278/prevention-and-treatment-of-complications-of-selective-internal-radiation-therapy-expert-guidance-and-systematic-review
#14
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 (or radioembolization) by intra-arterial injection of radioactive yttrium-90-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, thus limiting its effects to the site of delivery. However, the off-target diversion of yttrium-90 microspheres to tissues other than the tumor may lead to complications. The most prominent of these complications include radiation gastritis and gastrointestinal ulcers, cholecystitis, radiation pneumonitis, and radioembolization-induced liver disease, which may occur despite careful pretreatment planning...
September 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
#15
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
#16
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
#17
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...
August 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
#18
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
#19
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
#20
COMPARATIVE STUDY
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
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