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https://www.readbyqxmd.com/read/29193196/extracranial-and-intracranial-ultrasonographic-findings-in-posterior-circulation-infarction
#1
Hsin-Yi Chi, Chung-Fu Hsu, An-Chih Chen, Chun-Hung Su, Han-Hwa Hu, Wen-Mei Fu
OBJECTIVES: Patients with posterior circulation infarction are at higher risk of early recurrent stroke, especially those with vertebrobasilar stenosis or hypoplasia. The clinical presentations of this condition vary over a broad range, making diagnosis and treatment a challenge. Hemodynamic changes and stenosis detected by ultrasonography (US) are sensitive and important indicators for further evaluation. In this study, we correlated extracranial and intracranial US characteristics with brain magnetic resonance imaging (MRI) in patients with posterior circulation infarction...
November 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29191532/the-incidence-and-risk-factors-of-in-stent-restenosis-for-vertebrobasilar-artery-stenting
#2
Dai Zheng, Zhu Mingyue, Shi Wei, Li Min, Chen Wanhong, Dai Qiliang, Jiang Yongjun, Liu Xinfeng
BACKGROUND AND OBJECTIVES: In-stent restenosis (ISR) remains a challenge for vertebrobasilar artery stenting (VBAS). We aimed to investigate the incidence and risk factors of ISR. METHODS: This was a retrospective study. From July 28, 2005 to July 30, 2015, patients who received VBAS with an angiographic follow-up at 6-12 months after surgery were enrolled. The clinical and angiographic issues were recorded and analyzed. RESULTS: In total, 283 patients with 335 stents were incorporated into the study...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29184342/risk-factors-vascular-lesion-distribution-outcome-and-recurrence-of-strokes-due-to-intracranial-atherosclerosis-one-year-data-from-hyderabad-stroke-registry
#3
Raghu Ram, Subhash Kaul, Suvarna Alladi, Jabeen S Afshan, T Surya Prabha, Abhijeet Kohat, Swetha Tandra, Jyotsna Y Rani
Background: Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke in Asian countries and probably in India. Aim: The aim of this study was to describe the risk factors, distribution of vascular lesions, recurrence and outcome of stroke due to ICAS. Methodology: A total of 100 consecutive patients of ischemic stroke due to ICAS were enrolled prospectively from January 1, 2015, to December 31, 2015, and followed for 1 year for treatment compliance and recurrence...
October 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29171492/-brainstem-auditory-evoked-potentials-in-neurophysiological-assessment-of-brain-stem-dysfunction-in-patients-with-atherostenosis-of-vertebral-arteries
#4
M Yu Maksimova, Zh N Sermagambetova, S I Skrylev, P A Fedin, A Yu Koshcheev, V L Shchipakin, I A Sinicyn
AIM: To assess brain stem dysfunction in patients with hemodynamically significant stenosis of vertebral arteries (VA) using short latency brainstem auditory evoked potentials (BAEP). MATERIAL AND METHODS: The study group included 50 patients (mean age 64±6 years) with hemodynamically significant extracranial VA stenosis. RESULTS: Patients with hemodynamically significant extracranial VA stenosis had BAEP abnormalities including the elongation of interpeak intervals I-V and peak V latency as well as the reduction of peak I amplitude...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29118803/multimodal-therapy-for-non-superacute-vertebral-basilar-artery-occlusion
#5
Xiongjun He, Liang Zhang, Juan Yang, Hui Zheng, Kaifeng Li, Yajie Liu
Objective: The aim of this study was to evaluate the feasibility and safety of multimodal therapy for patients with non-superacute vertebral basilar artery occlusion. Method: We performed a retrospective analysis of multimodal therapy for patients with vertebral basilar artery occlusion. All patients who were beyond the time window to receive intravenous thrombolysis and who had deterioration of symptoms after drug treatment received small-balloon dilatation of the occlusive artery to estimate vascular occlusion aetiology...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29100856/recanalization-after-extracranial-dissection-effect-of-antiplatelet-compared-with-anticoagulant-therapy
#6
Preethi Ramchand, Michael T Mullen, Aaron Bress, Robert Hurst, Scott E Kasner, Brett L Cucchiara, Steven R Messé
BACKGROUND: Cervical arterial dissection is a leading cause of stroke in young patients, yet optimal management remains controversial. Existing studies focusing on recurrent stroke were underpowered to demonstrate differences between antithrombotic strategies. Vessel recanalization is a more prevalent outcome and is potentially clinically important. We aimed to assess recanalization rates with anticoagulation compared with antiplatelet therapy. METHODS: We studied a single-center retrospective cohort of patients with extracranial carotid or vertebral artery dissection...
October 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#7
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29084065/recent-advances-in-the-management-of-symptomatic-vertebral-artery-stenosis
#8
Anna M Drazyk, Hugh S Markus
PURPOSE OF REVIEW: Vertebrobasilar stenosis accounts for 20% of posterior circulation strokes and is associated with high risk of early stroke recurrence. We review data from randomized controlled trials examining whether stenting may reduce this risk, including the recently published Vertebral Artery Ischaemia Stenting Trial (VIST). RECENT FINDINGS: VIST and VAST (Vertebral Artery Stenting Trial), having recruited both intracranial and extracranial vertebral stenosis and showed a low rate of perioperative stroke for extracranial (0 and 2%, respectively), but a higher rate for intracranial stenosis (15 and 22%, respectively)...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29057349/clinical-evaluation-of-microendoscopy-assisted-extreme-lateral-interbody-fusion
#9
Tomohide Segawa, Hirohiko Inanami, Hisashi Koga
BACKGROUND: Extreme lateral interbody fusion (XLIF) has rapidly become a popular operative procedure for lumbar canal stenosis and scoliosis. This approach provides direct access to the lateral aspect of the disc with minimal disruption of spinal structures, including ligaments and muscles. However, it involves risk of injuries to the lumbar nerve plexus, segmental artery and intestinal tract because of the limited surgical field. This study aimed to clarify the benefit of using a microendoscope to prevent these injuries...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29043386/use-of-a-re-entry-device-in-left-subclavian-occlusion-case-series
#10
Wiliam Rhodri Thomas, Christopher Chick, Nimit Goyal
PURPOSE: To describe the use of a re-entry catheter in the endovascular treatment of left subclavian stenosis. MATERIALS AND METHODS: We present three patients where initial attempts at re-vascularisation using standard techniques were unsuccessful. An OUTBACK catheter was employed to facilitate re-entry in these patients. RESULTS: True lumen re-entry was achieved in all patients, leading to successful treatment of all stenoses. There was a lack of filling of the left vertebral artery post-angioplasty in one patient; this was not clinically significant...
October 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29018650/surgical-treatment-of-rotational-vertebral-artery-syndrome-induced-by-spinal-tumor-a-case-report-and-literature-review
#11
Shoichi Haimoto, Yusuke Nishimura, Masahito Hara, Yuu Yamamoto, Toshiki Fukuoka, Ryuichi Fukuyama, Toshihiko Wakabayashi, Howard J Ginsberg
Vertebrobasilar insufficiency (VBI) provoked by physiological head rotation is known as rotational vertebral artery syndrome (RVAS) or Bow Hunter syndrome. RVAS most often occurs at C1-2 level with head rotation and presents with symptoms of VBI. Several previously published studies have reported RVAS at subaxial sites (V2 segment), however, tumor-induced RVAS has never been reported. The authors report the first case of RVAS at V2 segment due to compression from a spinal tumor. A 71-year-old man presented with symptoms of dizziness provoked by head rotation or neck extension...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/28967590/a-case-of-intrathoracic-carotid-bifurcation-without-klippel-feil-syndrome
#12
Ryo Itabashi, Yukako Yazawa, Yuya Shigehatake, Eisuke Furui
BACKGROUND: Intrathoracic carotid bifurcation is a rare vascular anomaly, with only 8 cases reported. This vascular anomaly was recently correlated with Klippel-Feil syndrome, a rare congenital disorder involving fusion of the cervical vertebrae. METHODS: A 70-year-old deaf mute man was admitted to our department because of right hemiparesis and right sensory disturbance. He displayed no abnormalities associated with Klippel-Feil syndrome. Diffusion-weighted imaging revealed acute multiple infarcts in bilateral hemispheres...
September 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28965152/high-incidence-of-progressive-stenosis-in-aberrant-left-subclavian-artery-with-right-aortic-arch
#13
Mamoru Muraoka, Hazumu Nagata, Yuichiro Hirata, Kiyoshi Uike, Eiko Terashi, Eiji Morihana, Masayuki Ochiai, Yasuyuki Fujita, Kiyoko Kato, Kenichiro Yamamura, Shouichi Ohga
Right aortic arch with aberrant left subclavian artery (RAA/aLSCA) is a rare aortic arch anomaly. The clinical association of aLSCA stenosis with RAA/aLSCA has not yet been fully elucidated. The aim of this study was to investigate the diagnosis, incidence, management and outcome of aLSCA stenosis in infants with prenatally diagnosed RAA/aLSCA. Ten fetuses who were diagnosed as having RAA/aLSCA in Kyushu University Hospital between January 2011 and December 2014 were enrolled. The maternal and child medical records were reviewed to investigate sex, gestational age at the fetal diagnosis, gestational age and body weight at birth, the findings of computed tomography (CT), Doppler ultrasonography of the vertebral artery and angiography, and the complications and outcomes of aLSCA stenosis...
September 30, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28943421/rotational-vertebral-artery-dissection-secondary-to-anomalous-entrance-into-transverse-foramen
#14
Stephen A Johnson, Andrew F Ducruet, Jonathan B Bellotte, Charles E Romero, Robert M Friedlander
BACKGROUND: Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery. Most cases reported in the literature have been attributed to osteophytic compression, either from the occipital condyle or within the transverse foramen. However, vertebral artery dissection secondary to motion in the setting of anomalous anatomy has not been reported. CASE DESCRIPTION: To the authors' knowledge, rotational vertebral artery occlusion and dissection secondary to anomalous entrance into the transverse foramen have never been reported...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28935292/clinical-significance-of-reversal-of-flow-in-the-vertebral-artery-identified-on-cerebrovascular-duplex-ultrasound
#15
Aleksandra Policha, Melissa Baldwin, Victoria Lee, Mark A Adelman, Caron Rockman, Todd Berland, Neal S Cayne, Thomas S Maldonado
BACKGROUND: Reversal of flow in the vertebral artery (RFVA) is an uncommon finding on cerebrovascular duplex ultrasound examination. The clinical significance of RFVA and the natural history of patients presenting with it are poorly understood. Our objective was to better characterize the symptoms and outcomes of patients presenting with RFVA. METHODS: A retrospective review was performed of all cerebrovascular duplex ultrasound studies performed at our institution between January 2010 and January 2016 (N = 2927 patients)...
September 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28891898/vascular-anomalies-of-posterior-fossa-and-their-implications
#16
Rajani Singh, Raj Kumar, Arushi Kumar
Posterior fossa houses very vital and sensitive structures namely midbrain, pons, medulla, and cerebellum. These structures are irrigated by vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries. Parts of brain located in posterior fossa control important parts of body so any variation pertaining to stenosis, atresia, hypoplasia, fenestration, agenesis, and duplication in the arteries supplying these parts alter the irrigation pattern culminating into various morbid and mortal neurologic disorders...
November 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28885101/association-between-the-maximal-distance-of-atrial-septal-protrusion-and-cryptogenic-stroke
#17
Keisuke Tokunaga, Masahiro Yasaka, Takahiro Kuwashiro, Seiji Gotoh, Asako Nakamura, Go Takaguchi, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Yasushi Okada
Background and purpose Previous studies have suggested that atrial septal aneurysm is a potential risk factor for cerebral embolism. However, the association between the level of atrial septal protrusion and cerebral embolism is still unclear. The purpose of the present study was to assess the association between the maximal distance of atrial septal protrusion and cryptogenic stroke. Methods A total of 588 consecutive acute ischemic stroke patients (70 ± 11 (mean ± SD) years, 401 men) who underwent transesophageal echocardiography were enrolled...
December 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28860903/a-novel-flow-diverter-tubridge-for-the-treatment-of-recurrent-aneurysms-a-single-center-experience
#18
Yongxin Zhang, Qing-Hai Huang, Yibin Fang, Pengfei Yang, Yi Xu, Bo Hong, Jianmin Liu
OBJECTIVE: The Tubridge flow diverter (FD) is a novel device aimed at reconstructing the parent artery and occluding complex aneurysms. Retreatment of recurrent aneurysms using the FD is challenging. We report our initial experience in the repair of aneurysm recurrence with the FD. MATERIALS AND METHODS: A database was reviewed prospectively, and 8 patients with 8 recurrent aneurysms (mean size, 16.7 mm) were identified. Four aneurysms had previously ruptured. The previous aneurysm treatment consisted of coiling in 1 aneurysm and single-stent-assisted coiling in 7 aneurysms...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28846540/determinants-of-long-term-outcome-in-patients-after-percutaneous-stent-assisted-management-of-symptomatic-subclavian-or-innominate-artery-stenosis-or-occlusion
#19
Tadeusz Przewlocki, Leszek Wrotniak, Anna Kablak-Ziembicka, Piotr Pieniazek, Agnieszka Roslawiecka, Daniel Rzeznik, Marcin Misztal, Wojciech Zajdel, Rafał Badacz, Andrzej Sokolowski, Mariusz Trystula, Piotr Musialek, Krzysztof Zmudka
AIMS: Incidence and determinants of restenosis and adverse events after endovascular management (PTA±stent) of the subclavian/innominate artery (SA/IA) stenosis/occlusion remain unclear due to relatively short-term follow-up or limited size of prior studies. This large-scale, long-term prospective study investigated safety, efficacy, and prognosis after SA/IA PTA±stent. METHODS AND RESULTS: The study involved 411 consecutive patients with symptomatic SA/IA stenosis/occlusion; 393 after successful PTA±stent were followed annually for up to 16 (minimum 1) years...
August 29, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28843759/hybrid-technique-for-the-treatment-of-refractory-vertebrobasilar-insufficiencies
#20
Xia Lu, Yan Ma, Bin Yang, Peng Gao, Yabing Wang, Liqun Jiao
BACKGROUND: Tortuous or occluded vertebral arteries (VAs) can make the endovascular treatment of vertebrobasilar insufficiency impractical. Bypass surgery is an option, but a craniotomy of the posterior fossa is complicated when physiologic vessels must be abandoned. We report 3 cases of refractory vertebrobasilar insufficiency with different presentations requiring problematic approaches in which the patients were treated by different hybrid strategies. CASE DESCRIPTION: Patient 1 had severe stenosis of right VA ostium with right V1 segment tortuosity and was treated by right VA ostium transposition during which the proximal subclavian artery was blocked by a balloon guide catheter...
November 2017: World Neurosurgery
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