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https://www.readbyqxmd.com/read/29203731/mechanical-thrombectomy-and-rescue-therapy-for-intracranial-large-artery-occlusion-with-underlying-atherosclerosis
#1
BaiXue Jia, Lei Feng, David S Liebeskind, Xiaochuan Huo, Feng Gao, Ning Ma, Dapeng Mo, Xiaoling Liao, Chunjuan Wang, Xingquan Zhao, Yuesong Pan, Hao Li, Liping Liu, Yilong Wang, Yongjun Wang, Zhong-Rong Miao
OBJECTIVE: To investigate the safety and efficacy of mechanical thrombectomy plus rescue therapy for intracranial large artery occlusion (ILAO) with underlying intracranial atherosclerosis (ICAS). METHODS: Patients enrolled in the intervention group of EAST (Endovascular Therapy for Acute ischemic Stroke Trial) were analyzed. For underlying ICAS identified during the stent retrieval procedure, rescue treatment was required for those with (1) a degree of arterial stenosis >70% or (2) any degree of arterial with blood flow impairment or (3) evidence of re-occlusion...
December 4, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29122537/a-coil-placement-technique-to-treat-intracranial-aneurysm-with-incorporated-artery
#2
Chao-Bao Luo, Feng-Chi Chang, Chung-Jung Lin, Wan-Yuo Guo
BACKGROUND: Endovascular coil embolization is an accepted treatment option for intracranial aneurysms. However, the coiling of aneurysms with an incorporated artery (IA) poses a high risk of IA occlusion. Here we report our experience of endovascular coil placement using a technique that avoids IA occlusion in aneurysms with IAs. METHODS: Over a 6-year period, 185 patients harboring 206 intracranial aneurysms underwent endosaccular coiling. Forty-two of these patients with 45 aneurysms were treated by coil placement to avoid IAs occlusion...
November 6, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28970969/slower-eeg-alpha-generation-synchronization-and-flow-possible-biomarkers-of-cognitive-impairment-and-neuropathology-of-minor-stroke
#3
Jelena Petrovic, Vuk Milosevic, Miroslava Zivkovic, Dragan Stojanov, Olga Milojkovic, Aleksandar Kalauzi, Jasna Saponjic
BACKGROUND: We investigated EEG rhythms, particularly alpha activity, and their relationship to post-stroke neuropathology and cognitive functions in the subacute and chronic stages of minor strokes. METHODS: We included 10 patients with right middle cerebral artery (MCA) ischemic strokes and 11 healthy controls. All the assessments of stroke patients were done both in the subacute and chronic stages. Neurological impairment was measured using the National Institute of Health Stroke Scale (NIHSS), whereas cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) and MoCA memory index (MoCA-MIS)...
2017: PeerJ
https://www.readbyqxmd.com/read/28965106/safety-and-efficacy-of-aneurysm-treatment-with-web-in-the-cumulative-population-of-three-prospective-multicenter-series
#4
Laurent Pierot, Jacques Moret, Xavier Barreau, Istvan Szikora, Denis Herbreteau, Francis Turjman, Markus Holtmannspötter, Anne-Christine Januel, Vincent Costalat, Jens Fiehler, Joachim Klisch, Jean-Yves Gauvrit, Werner Weber, Hubert Desal, Stéphane Velasco, Thomas Liebig, Luc Stockx, Joachim Berkefeld, Andrew Molyneux, James Byrne, Laurent Spelle
BACKGROUND: Flow disruption with the WEB is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown a low complication rate with good efficacy. PURPOSE: To report clinical and anatomical results of the WEB treatment in the cumulative population of three Good Clinical Practice (GCP) studies: WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm), French Observatory, and WEBCAST-2. METHODS: WEBCAST, French Observatory, and WEBCAST-2 are single-arm, prospective, multicenter, GCP studies dedicated to the evaluation of WEB treatment...
September 30, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28808606/middle-cerebral-artery-dissection-causing-subarachnoid-hemorrhage-and-cerebral-infarction-trapping-with-high-flow-bypass-preserving-the-lenticulostriate-artery
#5
Hideaki Ono, Tomohiro Inoue, Shinya Suematsu, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
BACKGROUND: Spontaneous intracranial arterial dissection (IAD) is an increasingly important cause of stroke, such as subarachnoid hemorrhage (SAH) and hemodynamic or thromboembolic cerebral ischemia. IAD usually occurs in the posterior circulation, and is relatively rare in the anterior circulation including the middle cerebral artery (MCA). Various surgical and endovascular methods to reduce blood flow in the dissected lesion have been proposed, but no optimum treatment has been established...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28627298/a-prospective-transcranial-doppler-ultrasound-based-evaluation-of-the-acute-and-cumulative-effects-of-sport-related-concussion-on-neurovascular-coupling-response-dynamics
#6
Alexander D Wright, Jonathan D Smirl, Kelsey Bryk, Paul van Donkelaar
Sport-related concussion has been shown to alter cerebral blood flow (CBF) both acutely and chronically, and may exert cumulative effects across multiple injuries. Such dysfunction may be mediated by trauma-induced deficits to CBF control mechanisms, though our understanding of these effects is limited, including dynamics of neurovascular coupling (NVC) responses (i.e., CBF responses to neurologic demand). A total of 179 junior-level contact sport athletes completed preseason testing; 42 reported never having experienced a concussion (Hx(-)) while 31 had endured three or more (Hx(3+))...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28619499/results-of-early-high-flow-bypass-and-trapping-for-ruptured-blood-blister-like-aneurysms-of-the-internal-carotid-artery
#7
Yuichiro Kikkawa, Toshiki Ikeda, Ririko Takeda, Hiroyuki Nakajima, Takeshi Ogura, Hidetoshi Ooigawa, Hiroki Kurita
OBJECTIVE: The aim of this study is to clarify the efficacy and safety of early surgery using trapping of the affected internal carotid artery (ICA) and high-flow bypass between the second portion of the middle cerebral artery and cervical external carotid artery with radial artery graft for ruptured blood blister-like aneurysms (BBAs) arising from the anterior wall of the ICA. METHODS: Medical charts of 16 consecutive patients (7 men and 9 women; mean, 59 years) with subarachnoid hemorrhage (World Federation of Neurosurgical Societies grade I, n = 2; grade II, n = 5; grade III, n = 2; grade IV, n = 4; grade V, n = 3) caused by ruptured BBA surgically treated between July 2010 and October 2015 were retrospectively reviewed...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28590505/carotid-endarterectomy-for-symptomatic-carotid-stenosis
#8
REVIEW
Saritphat Orrapin, Kittipan Rerkasem
BACKGROUND: Stroke is the third leading cause of death and the most common cause of long-term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of the Cochrane Review, originally published in 1999, and most recently updated in 2011. OBJECTIVES: To determine the balance of benefit versus risk of endarterectomy plus best medical management compared with best medical management alone, in people with a recent symptomatic carotid stenosis (i...
June 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28463182/hypoperfusion-induced-by-preconditioning-treadmill-training-in-hyper-early-reperfusion-after-cerebral-ischemia-a-laser-speckle-imaging-study
#9
Zhijie He, Hongyang Lu, Xiaojiao Yang, Li Zhang, Yi Wu, Wenxiu Niu, Li Ding, Guili Wang, Shanbao Tong, Jie Jia
Exercise preconditioning induces neuroprotective effects during cerebral ischemia and reperfusion, which involves the recovery of cerebral blood flow (CBF). Mechanisms underly-ing the neuroprotective effects of re-established CBF following ischemia and reperfusion are unclear. The present study investi-gated CBF in hyper-early stage of reperfusion by laser speckle contrast imaging, a full-field high-resolution optical imaging technique. Rats with or without treadmill training were subjected to middle cerebral artery occlusion followed by reperfusion...
April 27, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#10
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28250282/a-single-center-experience-with-coil-embolization-for-cerebral-aneurysms-greater-than-10-mm-in-the-internal-carotid-artery
#11
Kensuke Suzuki, Ryotaro Suzuki, Tomoji Takigawa, Nobuyuki Shimizu, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Kyoji Tsuda, Yosuke Kawamura, Issei Takano, Ryuta Nakae, Masaya Nagaishi, Yoshihiro Tanaka, Akio Hyodo
We investigated endovascular treatment for 10 mm or larger aneurysms in the internal carotid artery (IC), including the cavernous portion, the paraclinoid portion, and the posterior communication artery (PC). Between 2011 and 2014 at our hospital, there were 35 cases of aneurysms that were 10 mm or larger in the carotid artery. We analyzed these 35 cases retrospectively based on the size and location of the aneurysms, method of treatment, number of coils implanted, use of a stent, complications, rupture after treatment, ophthalmologic symptoms, and need for re-treatment...
May 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28100649/incidence-of-delivery-wire-recapture-failure-with-the-pipeline-flex-device
#12
Michael A Mooney, Karam Moon, Bradley A Gross, Andrew F Ducruet, Felipe C Albuquerque
BACKGROUND: The Pipeline Flex embolization device has several advantages over the first-generation Pipeline embolization device (Covidien, Dublin, Republic of Ireland). Despite these advantages, we have observed frequent difficulty in recapturing the device's delivery wire. OBJECTIVE: To prospectively document the incidence of failure to recapture the delivery wire. METHODS: We tracked our experience in patients undergoing endovascular treatment with a flow-diverting stent for cerebral aneurysms between 1 May and 30 September 2016...
January 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28007877/mechanical-reperfusion-with-leucocyte-filtered-blood-does-not-prevent-injury-following-global-cerebral-ischaemia
#13
Rickard P F Lindblom, Thomas Tovedal, Bo Norlin, Lars Hillered, Svetlana N Popova, Irina Alafuzoff, Stefan Thelin
Objectives: Prolonged global cerebral ischaemia leads to irreversible injury, often with lethal outcome. Brain injuries are partly caused by the uncontrolled reperfusion that occurs once the circulation is re-established. Recent animal experiments suggest that controlled reperfusion following lengthy ischaemia might prevent severe brain injury. This study aimed at further exploring cerebral alterations and outcome following prolonged global cerebral ischaemia and mechanically manipulated reperfusion...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27815557/whole-body-perfusion-for-hybrid-aortic-arch-repair-evolution-of-selective-regional-perfusion-with-a-modified-extracorporeal-circuit
#14
Philip Fernandes, Graham Walsh, Stephanie Walsh, Michael O'Neil, Jill Gelinas, Michael W A Chu
BACKGROUND: Patients undergoing hybrid aortic arch reconstruction require careful protection of vital organs. We believe that whole body perfusion with tailored dual circuitry may help to achieve optimal patient outcomes. METHODS: Our circuit has evolved from a secondary circuit utilizing a cardioplegia delivery device for lower body perfusion to a dual-oxygenator circuit. This allows individually controlled regional perfusion with ease of switching from secondary to primary circuit for total body flow...
April 2017: Perfusion
https://www.readbyqxmd.com/read/27793777/acute-and-chronic-triptan-exposure-neither-alters-rodent-cerebral-blood-flow-nor-worsens-ischemic-brain-injury
#15
Mirko Muzzi, Daniela Buonvicino, Francesco De Cesaris, Alberto Chiarugi
Although it is still debated whether vasoconstriction underlies migraine resolution by triptans, they are not recommended in patients at cardiovascular risk. However, relationship between stroke incidence and triptan use is unclear, and it is unknown whether acute or chronic use of these drugs worsens ischemic brain injury. To address this issue, we investigated the effect of clinically-relevant doses of the potent cerebral artery vasoconstrictor eletriptan on cerebral blood flow (CBF) and brain infarct volumes, as well as on expression of genes involved in cerebrovascular regulation...
January 6, 2017: Neuroscience
https://www.readbyqxmd.com/read/27542895/arterial-spin-labeling-pathologically-proven-superiority-over-conventional-mri-for-detection-of-high-grade-glioma-progression-after-treatment
#16
Eric Nyberg, Justin Honce, Bette K Kleinschmidt-DeMasters, Brian Shukri, Sarah Kreidler, Lidia Nagae
BACKGROUND: Standard of care for high-grade gliomas (HGGs) includes surgical debulking and adjuvant chemotherapy and radiation. Patients under treatment require frequent clinical and imaging monitoring for therapy modulation. Differentiating tumor progression from treatment-related changes can be challenging on conventional MRI, resulting in delayed recognition of tumor progression. Arterial spin labeling (ASL) may be more sensitive for tumor progression. MATERIALS AND METHODS: ASL and associated conventional MR images obtained in patients previously treated for HGGs and before biopsy or re-resection were reviewed by three neuroradiologists who were blinded to the histopathologic results...
October 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27357157/safety-and-efficacy-of-flow-re-direction-endoluminal-device-fred-in-the-treatment-of-cerebral-aneurysms-a-single-center-experience
#17
Francesco Briganti, Giuseppe Leone, Lorenzo Ugga, Mariano Marseglia, Domenico Solari, Ferdinando Caranci, Giuseppe Mariniello, Francesco Maiuri, Paolo Cappabianca
BACKGROUND: Experience with the endovascular treatment of cerebral aneurysms by the Flow Re-Direction Endoluminal Device (FRED) is still limited. The aim of this study is to discuss the results and complications of this new flow diverter device (FDD). METHODS: Between November 2013 and April 2015, 20 patients (15 female and five male) harboring 24 cerebral aneurysms were treated with FRED FDD in a single center. RESULTS: Complete occlusion was obtained in 20/24 aneurysms (83 %) and partial occlusion in four (17 %)...
September 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/26684772/re-treatment-rates-after-treatment-with-the-pipeline-embolization-device-alone-versus-pipeline-and-coil-embolization-of-cerebral-aneurysms-a-single-center-experience
#18
Min S Park, Michael Nanaszko, Matthew R Sanborn, Karam Moon, Felipe C Albuquerque, Cameron G McDougall
OBJECT The optimal strategy for use of the Pipeline Embolization Device (PED, ev3 Neurovascular) has not been clearly defined. The authors examined re-treatment rates after treatment with PED alone versus PED and adjunctive coil embolization (PED/coil). METHODS The authors retrospectively examined cerebral aneurysms treated with the PED from May 2011 to March 2014. Overall, 133 patients (25 men, 108 women; mean age 60.4 years, range 23-85 years) were treated for 140 aneurysms (mean size 11.8 ± 8.3 mm) requiring 224 PEDs (mean 1...
July 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26421591/delayed-collapse-of-a-pipeline-embolization-device
#19
Rafael A Vega, Grzegorz Brzezicki, John F Reavey-Cantwell
BACKGROUND: The Pipeline Embolization Device (PED) is a treatment modality for wide-neck complex intracranial aneurysms. There have been recent reports for the use of PEDs in dissecting pseudoaneurysms of the cervical carotid arteries. The use of this flow diversion technology has emerged as a promising alternative; however, there are various risks and complications that one should be aware of. OBJECTIVE: To report a rare postoperative complication, identified during follow-up, in a patient initially treated for an internal carotid artery dissection with multiple overlapping PEDs...
September 29, 2015: Neurosurgery
https://www.readbyqxmd.com/read/25862573/cerebral-microvascular-pericytes-and-neurogliovascular-signaling-in-health-and-disease
#20
REVIEW
Turgay Dalkara, Luis Alarcon-Martinez
Increases in neuronal activity cause an enhanced blood flow to the active brain area. This neurovascular coupling is regulated by multiple mechanisms: Adenosine and lactate produced as metabolic end-products couple activity with flow by inducing vasodilation. As a specific mechanism to the brain, synaptic activity-induced Ca(2+) increases in astrocytes, interneurons and neurons translate neuronal activity to vasoactive signals such as arachidonic acid metabolites and NO. K(+) released onto smooth muscle cells through Ca(2+)-activated K(+) channels on end-feet can also induce vasodilation during neuronal activity...
October 14, 2015: Brain Research
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