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Transient ischaemic attack

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https://www.readbyqxmd.com/read/28902821/-outcomes-of-open-endovascular-operations-on-the-internal-carotid-artery-in-acute-stage-of-ischaemic-stroke
#1
A I Khripun, A D Priamikov, A B Mironkov, I N Tiurin, S A Asratian, V S Suriakhin, O V Simonov, O A Sazhina, V P Mikhaĭlenko
INTRODUCTION: The authors share their experience in diagnosis and treatment of patients with acute ischaemic stroke. PATIENTS AND METHODS: The study included a total of 33 patients. Of these, 20 patients (Study Group) were operated on at terms ranging from 2 to 7 days after onset of acute cerebral circulatory impairment. The Control Group was composed of 13 patients with ischaemic stroke, having refused surgical prevention of recurrent stroke. Both groups were matched by age, gender, level of neurological deficiency and size of cerebral ischaemic foci...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28893482/comparison-of-early-outcomes-and-restenosis-rate-between-carotid-endarterectomy-and-carotid-artery-stenting-using-propensity-score-matching-analysis
#2
Seon-Hee Heo, Kyoung-Won Yoon, Shin-Young Woo, Yang-Jin Park, Young-Wook Kim, Keon-Ha Kim, Chin-Sang Chung, Oh-Young Bang, Dong-Ik Kim
OBJECTIVE/BACKGROUND: Despite randomised evidence, the debate continues about the preferred treatment strategy for carotid stenosis in routine clinical practice. The aim of this study was to compare early outcomes and restenosis rates after carotid endarterectomy (CEA) and carotid stenting (CAS) in unselected patients using propensity score matching (PSM). METHODS: The 30 day incidence of major adverse clinical events (MACE; defined as stroke, transient ischaemic attack, myocardial infarction, or death) and procedure related complications, as well as restenosis rates during follow-up were compared between unselected patients undergoing CEA or CAS between January 2002 and December 2015 at a single institution...
September 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28851409/mobile-phones-in-cryptogenic-stroke-patients-bringing-single-lead-ecgs-for-atrial-fibrillation-detection-mobile-af-study-protocol-for-a-randomised-controlled-trial
#3
Roderick W Treskes, Willem Gielen, Marieke J Wermer, Robert W Grauss, Anouk P van Alem, Reza Alizadeh Dehnavi, Charles J Kirchhof, Enno T van der Velde, Arie C Maan, Ron Wolterbeek, Onno M Overbeek, Martin J Schalij, Serge A Trines
BACKGROUND: Recently published randomised clinical trials indicate that prolonged electrocardiom (ECG) monitoring might enhance the detection of paroxysmal atrial fibrillation (AF) in cryptogenic stroke or transient ischaemic attack (TIA) patients. A device that might be suitable for prolonged ECG monitoring is a smartphone-compatible ECG device (Kardia Mobile, Alivecor, San Francisco, CA, USA) that allows the patient to record a single-lead ECG without the presence of trained health care staff...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28831993/compassionate-use-of-the-pascal-transcatheter-mitral-valve-repair-system-for-patients-with-severe-mitral-regurgitation-a-multicentre-prospective-observational-first-in-man-study
#4
Fabien Praz, Konstantinos Spargias, Michael Chrissoheris, Lutz Büllesfeld, Georg Nickenig, Florian Deuschl, Robert Schueler, Neil P Fam, Robert Moss, Moody Makar, Robert Boone, Jeremy Edwards, Aris Moschovitis, Saibal Kar, John Webb, Ulrich Schäfer, Ted Feldman, Stephan Windecker
BACKGROUND: Severe mitral regurgitation is associated with impaired prognosis if left untreated. Using the devices currently available, transcatheter mitral valve repair (TMVr) remains challenging in complex anatomical situations. We report the procedural and 30-day results of the first-in-man study of the Edwards PASCAL TMVr system. METHODS: In this multicentre, prospective, observational, first-in-man study, we collected data from seven tertiary care hospitals in five countries that had a compassionate use programme in which patients underwent transcatheter mitral valve repair using the Edwards PASCAL TMVr system...
August 19, 2017: Lancet
https://www.readbyqxmd.com/read/28794051/papillary-fibroelastoma-diagnosed-through-multimodality-cardiac-imaging-a-rare-tumour-in-an-uncommon-location-with-review-of-literature
#5
Senthil Anand, Nicole Sydow, Rajesh Janardhanan
We describe the case of a woman presenting with transient ischaemic attack, who was found to have a papillary fibroelastoma arising from the aortic wall, an extremely rare location. We describe the multimodality imaging techniques used in diagnosing this patient and review the most recent literature on evaluation and management of patients with cardiac papillary fibroelastomas.
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28791591/age-related-differences-in-non-persistence-with-statin-treatment-in-patients-after-a-transient-ischaemic-attack
#6
Martin Wawruch, Dusan Zatko, Gejza Wimmer, Jan Luha, Sona Wimmerova, Petra Matalova, Peter Kukumberg, Jan Murin, Tomas Tesar, Beata Havelkova, Rashmi Shah
BACKGROUND AND OBJECTIVE: Non-persistence with secondary preventive measures, including medications such as statins, adversely affects the prospects of successful outcomes. This study was aimed at evaluating non-persistence with statin therapy in cohorts of young and elderly patients after a transient ischaemic attack (TIA) and identifying patient-associated characteristics that influence the risk for non-persistence. METHODS: The study cohorts included 797 adult patients who were initiated on statin therapy following a TIA diagnosis between 1 January 2010 and 31 December 2010...
August 8, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28782913/screening-with-doppler-ultrasound-for-carotid-artery-stenosis-in-patients-with-stroke-or-transient-ischaemic-attack
#7
Tatiana Kristensen, Peter Hovind, Helle K Iversen, Ulrik B Andersen
INTRODUCTION: Carotid endarterectomy of symptomatic internal carotid artery stenosis in patients with stroke or transient ischaemic attack reduces the risk of recurrent stroke, particularly if performed within 2 weeks from the first event. We evaluated the efficiency of a screening programme based on Doppler ultrasound in patients hospitalized with stroke or transient ischaemic attack in the stroke centre at Rigshospitalet, Glostrup, Denmark, concerning timeliness of referral to the vascular surgeon and performance of carotid endarterectomy according to national recommendations...
August 7, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28780550/improving-discharge-care-the-potential-of-a-new-organisational-intervention-to-improve-discharge-after-hospitalisation-for-acute-stroke-a-controlled-before-after-pilot-study
#8
Dominique A Cadilhac, Nadine E Andrew, Enna Stroil Salama, Kelvin Hill, Sandy Middleton, Eleanor Horton, Ian Meade, Sarah Kuhle, Mark R Nelson, Rohan Grimley
OBJECTIVE: Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. SETTING: Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28780236/tenecteplase-versus-alteplase-for-management-of-acute-ischaemic-stroke-nor-test-a-phase-3-randomised-open-label-blinded-endpoint-trial
#9
Nicola Logallo, Vojtech Novotny, Jörg Assmus, Christopher E Kvistad, Lars Alteheld, Ole Morten Rønning, Bente Thommessen, Karl-Friedrich Amthor, Hege Ihle-Hansen, Martin Kurz, Håkon Tobro, Kamaljit Kaur, Magdalena Stankiewicz, Maria Carlsson, Åse Morsund, Titto Idicula, Anne Hege Aamodt, Christian Lund, Halvor Næss, Ulrike Waje-Andreassen, Lars Thomassen
BACKGROUND: Tenecteplase is a newer thrombolytic agent with some pharmacological advantages over alteplase. Previous phase 2 trials of tenecteplase in acute ischaemic stroke have shown promising results. We aimed to investigate the safety and efficacy of tenecteplase versus alteplase in patients with acute stroke who were eligible for intravenous thrombolysis. METHODS: This phase 3, randomised, open-label, blinded endpoint, superiority trial was done in 13 stroke units in Norway...
August 2, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28759944/impact-of-health-utility-after-thrombotic-complications-following-total-hip-and-knee-arthroplasty
#10
Bikram Karmakar
BACKGROUND: Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life-threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient. METHODS: The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data...
July 31, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28756578/design-and-application-of-a-medication-assessment-tool-for-secondary-prevention-of-stroke
#11
Marise Gauci, Francesca Wirth, Liberato Camilleri, Lilian M Azzopardi, Anthony Serracino-Inglott
Background Optimisation of drug therapy is essential in the care of older persons and may be facilitated by application of medication assessment tools (MATs). Objective To design, psychometrically evaluate and apply an innovative MAT for secondary prevention of ischaemic stroke with particular relevance to older persons. Method Review criteria were selected from clinical practice guidelines and MAT-CVA was developed, validated and tested for reliability and feasibility. MAT-CVA was applied to 150 patients with a diagnosis of ischaemic stroke or transient ischaemic attack admitted to a rehabilitation hospital...
July 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28756388/drug-eluting-stents-in-clinical-routine-a-1-year-follow-up-analysis-based-on-german-health-insurance-administrative-data-from-2008-to-2014
#12
Elke Jeschke, Julia Searle, Christian Günster, Henning Thomas Baberg, Peter Dirschedl, Benny Levenson, Jürgen Malzahn, Thomas Mansky, Martin Möckel
OBJECTIVES: To describe the use of drug-eluting stents (DESs) in the largest population of statutory health insurance members in Germany, including newly developed bio-resorbable vascular scaffolds (BVSs), and to evaluate 1-year complication rates of DES as compared with bare metal stents (BMSs) in this cohort. DESIGN: Routine data analysis of statutory health insurance claims data from the years 2008 to 2014. SETTING: The German healthcare insurance Allgemeine Ortskrankenkasse covers approximately 30% of the German population and is the largest nationwide provider of statutory healthcare insurance in Germany...
July 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28754427/abnormally-high-ankle-brachial-index-is-associated-with-all-cause-and-cardiovascular-mortality-the-regicor-study
#13
A Velescu, A Clara, R Martí, R Ramos, S Perez-Fernandez, L Marcos, M Grau, I R Degano, J Marrugat, R Elosua
INTRODUCTION: The clinical significance of a high ankle brachial index (ABI) and its relationship to cardiovascular disease (CVD) and mortality is controversial. The aim of this study was to estimate the association between abnormally high ABI ≥ 1.4 and coronary heart disease (CHD), cerebrovascular disease, and all-cause mortality in a Mediterranean population without CVD. METHODS: A prospective population based cohort study of 6352 subjects was followed up for a median 6...
July 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28747411/stroke-of-the-inferiomedial-temporal-lobe-causing-word-agnosia
#14
Hardi Hassan, Huq Ehsanula, Mahendra Pattanshetti
A 69-year-old man presented with sudden loss of ability to recognise written words and remember the meaning of words and names. He could not name the town he lived in nor name his children. It was difficult for him to remember the meaning of concrete and abstract nouns. His speech fluency and understanding of casual talks were normal. He remembered that he had a conversation with his family that morning, but not the exact content. He was referred to the transient ischaemic attack clinic by his general practitioner as he scored low on the abbreviated mental test score...
July 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28733710/a-matched-case-control-study-on-early-and-late-results-of-carotid-endarterectomy-performed-in-young-patients
#15
Walter Dorigo, Aaron Fargion, Elena Giacomelli, Giulia Bassoli, Raffaele Pulli, Giovanni Pratesi, Gabriele Piffaretti, Carlo Pratesi
OBJECTIVE: The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS: From January 1996 to December 2014, 5893 consecutive CEAs were performed in our institution. Data concerning these interventions were prospectively inserted in a dedicated database. A retrospective analysis of that database was performed and 457 interventions performed in patients aged 60 or less were found (group 1)...
July 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28709561/factors-associated-with-need-for-revascularisation-in-non-coronary-arterial-occlusive-lesions-secondary-to-takayasu-s-arteritis
#16
C A Hinojosa, J E Anaya-Ayala, Z Gomez-Arcive, H Laparra-Escareno, A Torres-Machorro, R Lizola
OBJECTIVE/BACKGROUND: Takayasu's arteritis (TA) is rare inflammatory large vessel form of vasculitis. The objective of this study was to evaluate experience in the management of TA patients and to identify the influence of inflammatory markers and clinical variables associated with disease progression, worsening ischaemic symptoms, and the need for interventions. METHODS: Demographics, and laboratory and clinical variables in patients that required revascularisation procedures were compared with those who had adequate symptomatic control with medical management...
July 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28705843/headache-tia-and-subarachnoid-haemorrhage-dissecting-an-unusual-cause-for-stroke-like-symptoms
#17
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28682128/the-effects-of-centralisation-of-vascular-surgical-services-in-the-bath-bristol-and-weston-area-on-the-carotid-endarterectomy-pathway
#18
E Partridge, M Brooks, C Curd, V Davis, C Oates, D McGeeney
Introduction Patients who experience a transient ischaemic attack are at the highest risk of having a subsequent stroke immediately after their symptoms. A carotid endarterectomy should be performed on symptomatic, surgically suitable patients who present with a greater than 50% North American Symptomatic Carotid Endarterectomy Trial stenosis of the internal carotid artery within 2 weeks of their symptoms. This study aimed to determine whether the effectiveness of the carotid endarterectomy pathway has been impacted by the centralisation of vascular surgical services in the Bath, Bristol and Weston area...
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28674629/morbidity-outcomes-after-surgical-aortic-valve-replacement
#19
Andreas Auensen, Amjad Iqbal Hussain, Bjørn Bendz, Lars Aaberge, Ragnhild Sørum Falk, Marte Meyer Walle-Hansen, Jorun Bye, Johanna Andreassen, Jan Otto Beitnes, Kjell Arne Rein, Kjell Ingar Pettersen, Lars Gullestad
OBJECTIVE: In patients with mild to moderate operative risk, surgical aortic valve replacement (SAVR) is still the preferred treatment for patients with severe symptomatic aortic stenosis (AS). Aiming to broaden the knowledge of postsurgical outcomes, this study reports a broad set of morbidity outcomes following surgical intervention. METHODS: Our cohort comprised 442 patients referred for severe AS; 351 had undergone SAVR, with the remainder (91) not operated on...
2017: Open Heart
https://www.readbyqxmd.com/read/28674141/a-cohort-study-on-physician-documentation-and-the-accuracy-of-administrative-data-coding-to-improve-passive-surveillance-of-transient-ischaemic-attacks
#20
Amy Y X Yu, Hude Quan, Andrew D McRae, Gabrielle O Wagner, Michael D Hill, Shelagh B Coutts
BACKGROUND: Administrative health data are valuable in health research and disease surveillance, but have low to moderate sensitivity in identifying transient ischaemic attacks (TIA) in the emergency department (ED). We aimed to identify the predictors of coding accuracy for TIA. METHODS: The study population was obtained from two ongoing studies on the diagnosis of TIA, minor stroke and stroke mimic. ED charts were manually reviewed by a stroke neurologist to obtain the clinical diagnosis, patient characteristics and content of physician documentation...
July 2, 2017: BMJ Open
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