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https://www.readbyqxmd.com/read/27815557/whole-body-perfusion-for-hybrid-aortic-arch-repair-evolution-of-selective-regional-perfusion-with-a-modified-extracorporeal-circuit
#1
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...
November 3, 2016: Perfusion
https://www.readbyqxmd.com/read/27793777/acute-and-chronic-triptan-exposure-neither-alters-rodent-cerebral-blood-flow-nor-worsens-ischemic-brain-injury
#2
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...
October 26, 2016: 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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/25739332/effect-of-acute-high-intensity-resistance-exercise-on-optic-nerve-sheath-diameter-and-ophthalmic-artery-blood-flow-pulsatility
#8
W K Lefferts, W E Hughes, K S Heffernan
Exertional hypertension associated with acute high-intensity resistance exercise (RE) increases both intravascular and intracranial pressure (ICP), maintaining cerebrovascular transmural pressure. Carotid intravascular pressure pulsatility remains elevated after RE. Whether ICP also remains elevated after acute RE in an attempt to maintain the vessel wall transmural pressure is unknown. Optic nerve sheath diameter (ONSD), a valid proxy of ICP, was measured in 20 participants (6 female; 24 ± 4 yr, 24.2 ± 3...
December 2015: Journal of Human Hypertension
https://www.readbyqxmd.com/read/25689406/ventilation-onset-prior-to-umbilical-cord-clamping-physiological-based-cord-clamping-improves-systemic-and-cerebral-oxygenation-in-preterm-lambs
#9
Graeme R Polglase, Jennifer A Dawson, Martin Kluckow, Andrew W Gill, Peter G Davis, Arjan B Te Pas, Kelly J Crossley, Annie McDougall, Euan M Wallace, Stuart B Hooper
BACKGROUND: As measurement of arterial oxygen saturation (SpO2) is common in the delivery room, target SpO2 ranges allow clinicians to titrate oxygen therapy for preterm infants in order to achieve saturation levels similar to those seen in normal term infants in the first minutes of life. However, the influence of the onset of ventilation and the timing of cord clamping on systemic and cerebral oxygenation is not known. AIM: We investigated whether the initiation of ventilation, prior to, or after umbilical cord clamping, altered systemic and cerebral oxygenation in preterm lambs...
2015: PloS One
https://www.readbyqxmd.com/read/25370755/-individualized-surgical-treatment-of-complex-middle-cerebral-artery-aneurysms
#10
Zhenghui Sun, Chen Wu, Fuyu Wang, Zhe Xue, Bainan Xu, Dingbiao Zhou
OBJECTIVE: To summarize individualized surgical treatment strategies for complex middle cerebral artery (MCA) aneurysms. METHODS: Twenty patients with complex MCA aneurysms treated by microsurgery in Chinese People's Liberation Army General Hospital between December 2009 and November 2012 were retrospectively analyzed. There were 12 male and 8 female patients, with a mean age of 43 years (range: 14-58 years). Giant aneurysms (size > 2.5 cm) were found in 6 cases, wide-neck aneurysms in 7 cases and serpentine ones in 3 patients...
August 2014: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/25051964/flow-diverter-stents-for-unruptured-saccular-anterior-circulation-perforating-artery-aneurysms-safety-efficacy-and-short-term-follow-up
#11
Anna Luisa Kühn, Samuel Y Hou, Mary Perras, Christopher Brooks, Matthew J Gounis, Ajay K Wakhloo, Ajit S Puri
BACKGROUND: Anterior circulation perforating artery aneurysms including anterior choroidal artery and lenticulostriate artery aneurysms are rare. Injury to these vessels can lead to severe debilitating symptoms. OBJECTIVE: To present a new approach to treatment using flow diversion technology. METHODS: Patients treated with a Pipeline embolization device (PED) for perforator artery aneurysms at our institution between June 2012 and May 2013 were identified and included in our retrospective analysis...
September 2015: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/24678301/effect-of-acute-resistance-exercise-on-carotid-artery-stiffness-and-cerebral-blood-flow-pulsatility
#12
Wesley K Lefferts, Jacqueline A Augustine, Kevin S Heffernan
UNLABELLED: Arterial stiffness is associated with cerebral flow pulsatility. Arterial stiffness increases following acute resistance exercise (RE). Whether this acute RE-induced vascular stiffening affects cerebral pulsatility remains unknown. PURPOSE: To investigate the effects of acute RE on common carotid artery (CCA) stiffness and cerebral blood flow velocity (CBFv) pulsatility. METHODS: Eighteen healthy men (22 ± 1 yr; 23.7 ± 0.5 kg·m(-2)) underwent acute RE (5 sets, 5-RM bench press, 5 sets 10-RM bicep curls with 90 s rest intervals) or a time control condition (seated rest) in a randomized order...
2014: Frontiers in Physiology
https://www.readbyqxmd.com/read/24578280/use-of-flow-diverting-devices-in-fusiform-vertebrobasilar-giant-aneurysms-a-report-on-periprocedural-course-and-long-term-follow-up
#13
L Ertl, M Holtmannspötter, M Patzig, H Brückmann, G Fesl
BACKGROUND AND PURPOSE: Fusiform vertebrobasilar giant aneurysms are a rare (<1% of all intracranial aneurysms) but challenging aneurysm subtype. Little data are available on the natural history of this aneurysm subtype and the impact of the use of flow-diverting stents on the long-term clinical and imaging follow-up. In this article, we present our experience with the treatment of fusiform vertebrobasilar giant aneurysms by flow diverting stents. We aim to stimulate a discussion of the best management paradigm for this challenging aneurysm subtype...
July 2014: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/24438797/efficacy-complications-and-clinical-outcome-of-endovascular-treatment-for-intracranial-intradural-arterial-dissections
#14
Tiffany Y So, Peter J Mitchell, Richard J Dowling, Bernard Yan
OBJECTIVE: Intracranial intradural dissections are challenging to treat, and published data regarding treatment outcomes remains relatively limited. We retrospectively evaluated our experience with endovascular techniques in the treatment of intracranial intradural dissections, and describe the efficacy and clinical outcomes with treatment. METHODS: Between January 2003 and December 2011, 23 patients with 23 intracranial intradural arterial dissections underwent endovascular treatment at our institution...
February 2014: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/24354644/lack-of-secondary-microthrombosis-after-thrombin-induced-stroke-in-mice-and-non-human-primates
#15
M Gauberti, S Martinez de Lizarrondo, C Orset, D Vivien
BACKGROUND: Secondary microthrombosis is a major pathophysiologic mechanism leading to brain damage following transient mechanical vascular occlusion (TMVO), the most widely used experimental stroke model. Whether secondary microthrombosis also occurs in non-TMVO stroke models represents an important issue for clinical translation of antimicrothrombosis therapeutic strategies. OBJECTIVES: To assess the occurrence and the pathogenic role of secondary microthrombosis in two thrombin-induced stroke models in mice and non-human primates (Macaca mulatta)...
2014: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/24323302/characterisation-of-endothelin-1-induced-intrastriatal-lesions-within-the-juvenile-and-adult-rat-brain-using-mri-and-31p-mrs
#16
Raman Saggu
Improved non-invasive magnetic resonance (MR) characterisation of in vivo models of focal ischaemic insults such as transient ischaemic attack (TIA) and perinatal arterial ischaemic stroke (AIS) may assist diagnosis, outcome prediction and treatment design. The classic middle cerebral artery occlusion (MCAO) model of ischaemic stroke is well documented in MR studies but generates extensive and complex lesions involving an acute inflammatory response and de-occlusion that immediately restores circulation. By contrast, intrastriatal microinjection of the potent vasoconstrictor, endothelin-1 (ET-1), induces a focal, reversible and low-flow ischaemia in the absence of a typical inflammatory response, which gradually restores blood flow over several hours and may be more relevant to TIA and AIS pathology...
June 2013: Translational Stroke Research
https://www.readbyqxmd.com/read/24291333/round-window-membrane-intracochlear-drug-delivery-enhanced-by-induced-advection
#17
David A Borkholder, Xiaoxia Zhu, Robert D Frisina
Delivery of therapeutic compounds to the inner ear via absorption through the round window membrane (RWM) has advantages over direct intracochlear infusions; specifically, minimizing impact upon functional hearing measures. However, previous reports show that significant basal-to-apical concentration gradients occur, with the potential to impact treatment efficacy. Here we present a new approach to inner ear drug delivery with induced advection aiding distribution of compounds throughout the inner ear in the murine cochlea...
January 28, 2014: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/24238618/variability-of-the-autoregulation-index-decreases-after-removing-the-effect-of-the-very-low-frequency-band
#18
J W Elting, N M Maurits, M J H Aries
Dynamic cerebral autoregulation (dCA) estimates show large between and within subject variability. Sources of variability include low coherence and influence of CO2 in the very low frequency (VLF) band, where dCA is active. This may lead to unreliable transfer function and autoregulation index (ARI) estimates. We tested whether variability of the ARI could be decreased by suppressing the effect of the VLF band through filtering. We also evaluated whether filtering had any effect on mean group differences between healthy subjects and acute stroke patients...
May 2014: Medical Engineering & Physics
https://www.readbyqxmd.com/read/23977606/aortic-arch-elephant-trunk-procedure-with-sienna-tm-graft-and-endovascular-stenting-of-thoraco-abdominal-aorta-for-treatment-of-complex-chronic-dissection
#19
Randolph H L Wong, Max Baghai, Simon C H Yu, Malcolm J Underwood
Aneurismal dilatation of the remaining thoracic aorta after ascending aortic interposition grafting for type 'A' aortic dissection is not uncommon. For such complex cases, one treatment option is total arch replacement and elephant trunk procedure with the Sienna(TM) collared graft (Vascutek, Inchinnan, UK) technique followed by a staged thoracic endovascular aortic repair (TEVAR). The video illustrates our technique in a 56-year-old man with an extensive aortic arch and descending thoracic aortic dissecting aneurysm...
May 2013: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/23642925/veno-venous-perfusion-to-cool-and-rewarm-in-thoracic-and-thoracoabdominal-aortic-aneurysm-repair
#20
Christian A P Schmidt, Markus J Wilhelm, Dieter O Mayer, Zoran Rancic, Annette Bangemann, Christian Felix, Frank J Veith, Mario L Lachat
BACKGROUND: Femoro-femoral veno-arterial perfusion is an established circulatory support and cooling method for thoracic- and/or thoracoabdominal aortic aneurysm repair. However, retrograde perfusion through femoral arteries can lead to retrograde cerebral embolization and neurologic dysfunction after surgery. To avoid these complications, we have established a femoro-femoral veno-venous perfusion technique and evaluated its safety and effectiveness in elective and nonelective patients...
July 2013: Journal of Vascular Surgery
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