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Stroke clinical outcomes

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https://www.readbyqxmd.com/read/29351610/orthotopic-branched-endovascular-aortic-arch-repair-in-patients-who-cannot-undergo-classical-surgery
#1
Martin Czerny, Bartosz Rylski, Julia Morlock, Holger Schröfel, Friedhelm Beyersdorf, Bertrand Saint Lebes, Olivier Meyrignac, Fatima Mokrane, Mario Lescan, Christian Schlensak, Constatijn Hazenberg, Trijntje Bloemert-Tuin, Sue Braithwaite, Joost van Herwaarden, Herve Rousseau
OBJECTIVES: Our goal was to assess the results after orthotopic branched endovascular aortic arch repair using a new double-branch endoprosthesis in patients with thoracic aortic disease affecting the aortic arch who cannot undergo classical surgery. METHODS: Within a 4-year period, 15 patients with thoracic aortic disease affecting the aortic arch were treated with the Bolton Relay plus double-branch endoprosthesis (Bolton Medical, Sunrise, FL, USA). We assessed clinical outcome, occurrence of endoleaks and the need for secondary interventions...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29351145/recent-evidence-on-early-mobilization-in-critical-ill-patients
#2
Kristina Fuest, Stefan J Schaller
PURPOSE OF REVIEW: To examine the benefits of early mobilization and summarize the results of most recent clinical studies examining early mobilization in critically ill patients followed by a presentation of recent developments in the field. RECENT FINDINGS: Early mobilization of ICU patients, defined as mobilization within 72 h of ICU admission, is still uncommon. In medical and surgical critically ill patients, mobilization is well tolerated even in intubated patients...
January 17, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29350878/perfusion-ct-in-posterior-circulation-stroke-predictors-and-prognostic-implications-of-focal-hypoperfusion
#3
Lars-Peder Pallesen, Dimitris Lambrou, Ashraf Eskandari, Jessica Barlinn, Kristian Barlinn, Heinz Reichmann, Vincent Dunet, Philippe Maeder, Volker Puetz, Patrik Michel
BACKGROUND: We aimed to determine predictors of focal hypoperfusion on CT Perfusion (CTP) in patients with acute posterior circulation stroke and its association with long-term outcome. METHODS: We selected patients with posterior circulation stroke from the Acute STroke Registry and Analysis of Lausanne (ASTRAL) who underwent CTP within 24 hours of stroke onset as part of the stroke imaging protocol. Hypoperfusion was defined as an area of visually well demarcated mean-transit-time (MTT) prolongation corresponding to an arterial territory on standard reconstruction CTP imaging maps...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350803/thrombectomy-outcomes-for-acute-stroke-patients-with-anterior-circulation-tandem-lesions-a-clinical-registry-and-an-update-of-systematic-review-with-meta-analysis
#4
Udi Sadeh-Gonik, Noam Tau, Tal Friehmann, Serge Bracard, René Anxionnat, Anne-Laure Derelle, Romain Tonnelet, Liang Lia, Sébastien Richard, Xavier Armoiry, Benjamin Gory
BACKGROUND AND PURPOSE: Although mechanical thrombectomy (MT) appears to be superior in stroke patients with extracranial carotid disease (ECD) compared to thrombolysis alone, the impact of emergent carotid stenting during MT remains unclear. We assessed the MT outcomes in anterior stroke patients with ECD, especially when combined with carotid stenting. METHODS: We performed a retrospective analysis of our registry and conducted an update of a systematic review and meta-analysis of MT studies with or without stenting for anterior circulation stroke with ECD published between November 2010 and April 2017...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#5
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350091/stent-assisted-coiling-of-cerebral-aneurysms-with-the-neuroform-atlas-stent
#6
Ferdi Cay, Ahmet Peker, Anıl Arat
Objectives The Neuroform Atlas stent (AS) is the smallest intracranial stent with an open-cell design. This study reports the first clinical experience with AS. Methods All intracranial aneurysms treated by stent-assisted coiling using a single AS in a single institution were retrospectively evaluated. Patient demographics, aneurysm characteristics, angles between the parent artery and stented branch, technical success, and clinical and angiographic follow-up were analyzed. Results Fifty-five consecutive aneurysms treated with AS-assisted coiling were included...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29349639/outcomes-in-syncope-research-a-systematic-review-and-critical-appraisal
#7
Monica Solbiati, Viviana Bozzano, Franca Barbic, Giovanni Casazza, Franca Dipaola, James V Quinn, Matthew J Reed, Robert S Sheldon, Win-Kuang Shen, Benjamin C Sun, Venkatesh Thiruganasambandamoorthy, Raffaello Furlan, Giorgio Costantino
Syncope is the common clinical manifestation of different diseases, and this makes it difficult to define what outcomes should be considered in prognostic studies. The aim of this study is to critically analyze the outcomes considered in syncope studies through systematic review and expert consensus. We performed a systematic review of the literature to identify prospective studies enrolling consecutive patients presenting to the Emergency Department with syncope, with data on the characteristics and incidence of short-term outcomes...
January 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29348677/the-proliferation-capacity-of-cultured-neural-stem-cells-promoted-by-csf-collected-from-sah-patients-correlates-to-clinical-outcome
#8
Yun-An Chen, Kuo-Chuan Wang, Der-Zen Liu, Tai-Horng Young, Li-Kai Tsai
Neurogenesis from endogenous neural stem cells (NSCs) might contribute to functional recovery after stroke based on animal studies; however, the relationship between neurogenesis and post-stroke outcome has rarely been demonstrated in humans. We prospectively collected cerebrospinal fluid (CSF) from 36 patients with subarachnoid hemorrhage (SAH). The CSF was added to the culture medium of the rat NSCs to test the effects on proliferation (proliferation index [PI], percentage of Ki-67 immunoreactive cells). We correlated the PI with functional outcome based on the modified Rankin Scale at 3 months post-SAH...
January 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29348020/autosomal-recessive-hypercholesterolemia-long-term-cardiovascular-outcomes
#9
Laura D'Erasmo, Ilenia Minicocci, Antonio Nicolucci, Paolo Pintus, Janine E Roeters Van Lennep, Luis Masana, Pedro Mata, Rosa Maria Sánchez-Hernández, Pablo Prieto-Matos, Josè T Real, Juan F Ascaso, Eduardo Esteve Lafuente, Miguel Pocovi, Francisco J Fuentes, Sandro Muntoni, Stefano Bertolini, Cesare Sirtori, Laura Calabresi, Chiara Pavanello, Maurizio Averna, Angelo Baldassare Cefalu, Davide Noto, Adolfo Arturo Pacifico, Giovanni Mario Pes, Mariko Harada-Shiba, Enzo Manzato, Sabina Zambon, Alberto Zambon, Anja Vogt, Marco Scardapane, Barbara Sjouke, Renato Fellin, Marcello Arca
BACKGROUND: Autosomal recessive hypercholesterolemia (ARH) is a rare lipid disorder characterized by premature atherosclerotic cardiovascular disease (ASCVD). There are sparse data for clinical management and cardiovascular outcomes in ARH. OBJECTIVES: Evaluation of changes in lipid management, achievement of low-density lipoprotein cholesterol (LDL-C) goals and cardiovascular outcomes in ARH. METHODS: Published ARH cases were identified by electronic search...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29348010/early-outcomes-with-the-evolut-pro-repositionable-self-expanding-transcatheter-aortic-valve-with-pericardial-wrap
#10
John K Forrest, Abeel A Mangi, Jeffrey J Popma, Kamal Khabbaz, Michael J Reardon, Neal S Kleiman, Steven J Yakubov, Daniel Watson, Susheel Kodali, Isaac George, Peter Tadros, George L Zorn, John Brown, Robert Kipperman, Sara Saul, Hongyan Qiao, Jae K Oh, Mathew R Williams
OBJECTIVES: This study sought to evaluate the Medtronic Evolut PRO Transcatheter Aortic Valve System in patients with severe symptomatic aortic stenosis. BACKGROUND: A next-generation self-expanding transcatheter aortic valve was designed with an external pericardial wrap with the intent to reduce paravalvular leak while maintaining the benefits of a low-profile, self-expanding, and repositionable supra-annular valve. METHODS: The Medtronic Evolut PRO Clinical Study included 60 patients undergoing transcatheter aortic valve replacement with the Evolut PRO valve at 8 investigational sites in the United States...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29346126/complete-revascularization-for-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#11
Gani Bajraktari, Haki Jashari, Pranvera Ibrahimi, Fernando Alfonso, Fisnik Jashari, Gjin Ndrepepa, Shpend Elezi, Michael Y Henein
INTRODUCTION: Despite the recent findings in randomized clinical trials (RCTs) with limited sample sizes and the updates in clinical guidelines, the current available data for the complete revascularization (CR) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) at the time of primary percutaneous coronary intervention (PCI) are still contradictory. AIM: The aim of this meta-analysis of the existing RCTs was to assess the efficacy of the CR versus revascularization of infarct-related artery (IRA) only during primary PCI in patients with STEMI and multivessel disease (MVD)...
January 17, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29345529/effects-of-telestroke-on-thrombolysis-times-and-outcomes-a-meta-analysis
#12
Alireza Baratloo, Leila Rahimpour, Abdelrahman Ibrahim Abushouk, Saeed Safari, Chung Wing Lee, Ali Abdalvand
OBJECTIVE: Telestroke systems are tools, used to provide an advanced stroke care in regions without sufficient neurologic services. We performed this meta-analysis to assess the effects of telemedicine on treatment times and clinical outcomes of acute stroke care. METHODS: A literature search of PubMed, SCOPUS, and Cochrane CENTRAL was conducted for original studies investigating telemedicine applications in acute stroke care. Dichotomous data on treatment outcomes were pooled as odds ratios (ORs), while continuous data on thrombolysis times were pooled as mean differences (MDs) with 95% confidence interval (CI), using RevMan software (version 5...
January 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29345016/evaluation-of-the-implementation-of-a-24-hour-stroke-thrombolysis-emergency-treatment-for-patients-with-acute-ischemic-stroke
#13
Jun Zhao, Xingqiang Li, Yingchun Liang, Liang Zhao, Xinping Zhang, Yunlin Liu
AIMS AND OBJECTIVES: To assess the trends of intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) among patients with acute ischemic stroke (AIS) admitted to our hospital between 2012 and 2014 and investigate the effects of a 24-hours (h) stroke thrombolysis emergency treatment on the intra-hospital clinical data and outcomes of these patients treated with IV rt-PA thrombolysis. BACKGROUND: Although pre-notification of stroke by emergency medical services have been endorsed by the national recommendations and implemented in some developed countries, the development in China is limited...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29344950/systematic-review-and-meta-analysis-of-left-ventricular-endocardial-pacing-in-advanced-heart-failure-clinically-efficacious-but-at-what-cost
#14
Adam Graham, Rui Providenica, Shohreh Honarbakhsh, Neil Srinivasan, Vinit Sawhney, Ross Hunter, Pier Lambiase
INTRODUCTION: Cardiac resynchronization using a left ventricular (LV) epicardial lead placed in the coronary sinus is now routinely used in management of heart failure patients. LV endocardial pacing is an alternative when this is not feasible, with outcomes data sparse. OBJECTIVE: To review the available evidence on the efficacy and safety of endocardial LV pacing via meta-analysis. METHODS: EMBASE, MEDLINE and COCHRANE databases with the search term "endocardial biventricular pacing" or "endocardial cardiac resynchronization" or "left ventricular endocardial" or "endocardial left ventricular"...
January 18, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29344794/ticagrelor-for-secondary-prevention-of-atherothrombotic-events-after-myocardial-infarction-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#15
REVIEW
Xavier G L V Pouwels, Robert Wolff, Bram L T Ramaekers, Anoukh Van Giessen, Shona Lang, Steve Ryder, Gill Worthy, Steven Duffy, Nigel Armstrong, Jos Kleijnen, Manuela A Joore
The National Institute for Health and Care Excellence (NICE) invited AstraZeneca, the manufacturer of ticagrelor (Brilique®), to submit evidence on the clinical and cost effectiveness of ticagrelor 60 mg twice daily (BID) in combination with low-dose aspirin [acetylsalicylic acid (ASA)] compared with ASA only for secondary prevention of atherothrombotic events in patients with a history of myocardial infarction (MI) and who are at increased risk of atherothrombotic events. Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Maastricht University Medical Centre+, was commissioned as the evidence review group (ERG)...
January 18, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29343588/modeling-the-impact-of-interhospital-transfer-network-design-on-stroke-outcomes-in-a-large-city
#16
Neal S Parikh, Abhinaba Chatterjee, Iván Díaz, Ankur Pandya, Alexander E Merkler, Gino Gialdini, Benjamin R Kummer, Saad A Mir, Michael P Lerario, Matthew E Fink, Babak B Navi, Hooman Kamel
BACKGROUND AND PURPOSE: We sought to model the effects of interhospital transfer network design on endovascular therapy eligibility and clinical outcomes of stroke because of large-vessel occlusion for the residents of a large city. METHODS: We modeled 3 transfer network designs for New York City. In model A, patients were transferred from spoke hospitals to the closest hub hospitals with endovascular capabilities irrespective of hospital affiliation. In model B, which was considered the base case, patients were transferred to the closest affiliated hub hospitals...
January 17, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29343137/hybrid-aortic-arch-and-frozen-elephant-trunk-reconstruction-bridging-the-gap-between-conventional-and-total-endovascular-arch-repair
#17
Sabin J Bozso, Abigail White, Jeevan Nagendran, Michael C Moon, Michael W A Chu
Novel endovascular techniques hope to offer patients aortic arch repair with reduced morbidity compared to conventional arch surgery; however, current endovascular strategies remain challenged by the proximal seal zone, higher stroke rates, long-term durability and select anatomy. Hybrid arch repair offers patients a less invasive alternative that can treat more distal aorta than conventional arch repair yet still be performed via standard sternotomy. Areas Covered: This review will discuss the current evidence and future development of hybrid aortic arch and frozen elephant trunk reconstruction...
January 18, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29342299/benefit-of-left-atrial-appendage-electrical-isolation-for-persistent-and-long-standing-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
Jorge Romero, Gregory F Michaud, Ricardo Avendano, David F Briceño, Saurabh Kumar, Juan Carlos Diaz, Sanghamitra Mohanty, Chintan Trivedi, Carola Gianni, Domenico Della Rocca, Riccardo Proietti, Laura Perrotta, Stefano Bordignon, Julian K R Chun, Boris Schmidt, Mario Garcia, Andrea Natale, Luigi Di Biase
Aims: The long-term outcomes of left atrial appendage electrical isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results: A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed...
January 12, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#19
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29340574/effect-of-general-anesthesia-and-conscious-sedation-during-endovascular-therapy-on-infarct-growth-and-clinical-outcomes-in-acute-ischemic-stroke-a-randomized-clinical-trial
#20
Claus Z Simonsen, Albert J Yoo, Leif H Sørensen, Niels Juul, Søren P Johnsen, Grethe Andersen, Mads Rasmussen
Importance: Endovascular therapy (EVT) is the standard of care for select patients who had a stroke caused by a large vessel occlusion in the anterior circulation, but there is uncertainty regarding the optimal anesthetic approach during EVT. Observational studies suggest that general anesthesia (GA) is associated with worse outcomes compared with conscious sedation (CS). Objective: To examine the effect of type of anesthesia during EVT on infarct growth and clinical outcome...
January 16, 2018: JAMA Neurology
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