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https://www.readbyqxmd.com/read/28943516/interhospital-transfer-prior-to-thrombectomy-is-associated-with-delayed-treatment-and-worse-outcome-in-the-stratis-registry
#1
Michael T Froehler, Jeffrey L Saver, Osama O Zaidat, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P Klucznick, Diogo C Haussen, Frank R Hellinger, Dileep R Yavagal, Tom L Yao, David S Liebeskind, Ashutosh P Jadhav, Rishi Gupta, Ameer E Hassan, Coleman O Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G Nogueira, Ravi H Gandhi, Eric C Peterson, Shervin R Dashti, Curtis A Given, Brijesh P Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H McPherson, Peter Kvamme, Thomas J Grobelny, Muhammad S Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J Monteith, Robert D Ecker, Clemens M Schirmer, Eric Sauvageau, Alex Abou-Chebl, Colin P Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H Siddiqui, Travis M Dumont, Abdulnasser Alhajeri, M Asif Taqi, Khaled Asi, Jeffrey S Carpenter, Alan Boulos, Gaurav Jindal, Ajit S Puri, Rohan Chitale, Eric M Deshaies, David H Robinson, David F Kallmes, Blaise W Baxter, Mouhammad A Jumaa, Peter Sunenshine, Aniel Q Majjhoo, Joey D English, Shuichi Suzuki, Richard D Fessler, Josser E Delgado Almandoz, Jerry C Martin, Nils H Mueller-Kronast
Background -Endovascular treatment with mechanical thrombectomy (MT) is beneficial for acute stroke patients suffering a large vessel occlusion, though treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared to direct presentation. Methods -STRATIS was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke due to anterior-circulation large vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours...
September 24, 2017: Circulation
https://www.readbyqxmd.com/read/28940973/prediction-of-cerebral-infarction-and-patient-outcome-in-aneurysmal-subarachnoid-hemorrhage-comparison-of-new-and-established-radiographic-clinical-and-combined-scores
#2
Nora F Dengler, Jenny Sommerfeld, Dominik Diesing, Peter Vajkoczy, Stefan Wolf
BACKGROUND: There are numerous grading scales to describe the severity of aneurysmal subarachnoid hemorrhage (aSAH) and to predict outcome. Historically, outcome measures are heterogenous and comparability of grading scales is therefore limited. We designed this study to compare radiographic, clinical and combined grading systems in aSAH. METHODS: Data of 423 consecutive patients with aSAH were analyzed. Modified Fisher, Barrow Neurological Institute (BNI), Hunt and Hess, World Federations of Neurosurgeons (WFNS), VASOGRADE and HAIR scores were calculated from clinical and radiographic data or the combination of both...
September 23, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28939303/early-partial-recanalization-after-intravenous-thrombolysis-leads-to-prediction-of-favorable-outcome-in-cases-of-acute-ischemic-stroke-with-major-vessel-occlusion
#3
Jun Young Chang, Hyun Park, Se Young Jang, Seunguk Jung, Hee-Joon Bae, O-Ki Kwon, Moon-Ku Han
We investigated the association between early recanalization degree after intravenous thrombolysis (IVT), occurrence of hemorrhagic transformation, and functional outcome. We also evaluated whether recombinant tissue plasminogen activator (rTPA) dosing error could influence the outcome. Patients with ischemic stroke with major vessel occlusion (n=256) who underwent IVT were included. Recanalization status (no recanalization, partial recanalization, and complete recanalization) was confirmed by subsequent magnetic resonance or conventional angiography...
September 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28935354/anti-n-methyl-d-aspartate-receptor-encephalitis-in-children-of-central-south-china-clinical-features-treatment-influencing-factors-and-outcomes
#4
Ying Wang, Weixi Zhang, Jinghua Yin, Qianjin Lu, Fei Yin, Fang He, Jing Peng
BACKGROUND AND PURPOSE: We analyzed the clinical manifestations of children with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis in Central South China and the factors influencing the effectiveness of treatment. METHODS: A retrospective study of children (0-14years old) with anti-NMDAR encephalitis in Central South China was carried out from March 2014 to November 2016. Demographics, clinical features, treatment, outcome, and the factors influencing the effectiveness of treatment were reviewed...
September 11, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28933307/the-role-of-xanthine-oxidase-inhibitors-in-patients-with-history-of-stroke-a-systematic-review
#5
Sara R Britnell, Kelly A Chillari, Jamie N Brown
BACKGROUND: Xanthine oxidase inhibitors are commonly used to lower uric acid levels in patients with gout. Due to their effects on endothelial function, they have also been investigated for possible benefits for patients with cardiovascular disease. OBJECTIVE: To assess the efficacy and safety of xanthine oxidase inhibitors in the treatment of patients with history of stroke. METHODS: MEDLINE (1946-June 2017) and EMBASE (1947-June 2017) were queried using the search terms: "allopurinol" OR "febuxostat" OR "xanthine oxidase inhibitor" OR "xanthine oxidase/antagonists and inhibitors" AND "stroke" OR "cerebral infarction" OR "cerebrovascular accident"...
September 19, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28929697/-effects-of-berberine-on-serum-inflammatory-factors-and-carotid-atherosclerotic-plaques-in-patients-with-acute-cerebral-ischemic-stroke
#6
Ying Li, Pei Wang, Mei-Jing Chai, Fan Yang, Hong-Shan Li, Jing Zhao, Huan Wang, Dan-Dan Lu
This study aims to analyze the effect of berberine on serum inflammatory factors and carotid atherosclerotic plaques in ppatients with acute cerebral ischemic stroke(AIS). In the study, 120 patients with AIS were randomly divided into berberine group(n=60) and general group (n=60). The 60 cases in the general group were provided with general therapy according to the latest guidelines of diagnosis and treatment of AIS. The berberine group received berberine 300 mg(tid) in addition to the therapy of the general group...
November 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28929560/minocycline-and-matrix-metalloproteinase-inhibition-in-acute-intracerebral-hemorrhage-a-pilot-study
#7
J J Chang, M Kim-Tenser, B A Emanuel, G M Jones, K Chapple, A Alikhani, N Sanossian, W J Mack, G Tsivgoulis, A V Alexandrov, T Pourmotabbed
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 (MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. METHODS: Patients with acute onset (<12 h from symptom onset) ICH and small initial hematoma volume (<30 ml) were randomized to high-dose (10 mg/kg) intravenous minocycline or placebo...
September 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28927214/direct-anastomosis-using-occipital-artery-for-additional-revascularization-in-moyamoya-disease-after-combined-superficial-temporal-artery-middle-cerebral-artery-and-indirect-bypass
#8
Ken Kazumata, Hiroyasu Kamiyama, Hisayasu Saito, Katsuhiko Maruichi, Masaki Ito, Haruto Uchino, Naoki Nakayama, Satoshi Kuroda, Kiyohiro Houkin
BACKGROUND: The posterior cerebral artery (PCA) is involved in approximately 30% of moyamoya disease (MMD) cases. However, there have been insufficient reports describing revascularization techniques in the posterior portion of the brain, particularly of direct anastomosis. OBJECTIVE: To perform a technical assessment in patients with MMD who underwent either occipital artery (OA)-PCA bypass or OA-middle cerebral artery (MCA) bypass. METHODS: A total of 428 revascularization procedures in 368 patients were retrospectively assessed by reviewing clinical charts and radiological data...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28926782/enterprise-stent-in-recanalizing-non-acute-atherosclerotic-intracranial-internal-carotid-artery-occlusion
#9
Xiaofei Wang, Zhigang Wang, Yong Ji, Xuan Ding, Yizheng Zang, Chengwei Wang
OBJECTIVE: To investigate the safety and effectiveness of recanalization in non-acute occlusion of intracranial internal carotid arteries using the flexible Enterprise self-expanding stent. PATIENTS AND METHODS: From June 2014 to June 2016, 12 consecutive patients with non-acute occlusion of intracranial internal carotid arteries received endovascular recanalization with Enterprise stenting. All patients received medication for anti-platelet aggregation therapy before and after the operation...
June 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28926165/pre-stroke-physical-activity-is-associated-with-fewer-post-stroke-complications-lower-mortality-and-a-better-long-term-outcome
#10
Chi-Pang Wen, Chung-Hsiang Liu, Jiann-Shing Jeng, Shih-Pin Hsu, Chih-Hung Chen, Li-Ming Lien, An-Chih Chen, Jiunn-Tay Lee, Ping-Kun Chen, Chih-Shan Hsu, Chang-Ming Chern, Chien-Chung Chen, Ming-Chin Hsu, Kang Lu, Han-Jung Chen, Hao-Kuang Wang, Chih-Hsin Muo, Chung Y Hsu
BACKGROUND AND PURPOSE: Physical activity is associated with a reduced incidence of first-time stroke; however, few studies have examined the effect of pre-stroke physical activity on post-stroke complications and clinical outcomes. METHODS: A total of 39,835 cases of stroke registered in the nationwide stroke registry system of Taiwan between 2006 and 2009 were analyzed according to 5 levels of severity as determined by NIHSS (National Institutes of Health Stroke Scale) score upon hospital admission...
September 19, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28925479/relationship-between-lesion-patterns-of-single-small-infarct-and-early-neurological-deterioration-in-the-perforating-territory
#11
X-J Han
OBJECTIVE: To investigate the relationship between lesion patterns of single small infarct (SSI) in perforating territory of the vertebral-basilar artery and early neurological deterioration (end)/short-term functional outcome. PATIENTS AND METHODS: 126 patients with acute SSI in the perforating territory of the vertebral-basilar artery, admitted within 24 h after symptom onset, were recruited between August 2010 and May 2013. The patients were divided into proximal SSI and distal SSI according to the relationship between their lesion location and their parent artery...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28922886/intracranial-bypass-of-posterior-inferior-cerebellar-artery-aneurysms-indications-technical-aspects-and-clinical-outcomes
#12
David J Bonda, Mohamad Labib, Jeffrey M Katz, Rafael A Ortiz, David Chalif, Avi Setton, David J Langer, Amir R Dehdashti
BACKGROUND: For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique. OBJECTIVE: To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment. METHODS: Retrospective review of PICA aneurysms treated via intracranial bypass was performed...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28920538/fibrinolytic-for-treatment-of-intraventricular-hemorrhage-a-meta-analysis-and-systematic-review
#13
Alexandra Delaney Baker, Krissia Margarita Rivera Perla, Zhiyuan Yu, Rachel Dlugash, Radhika Avadhani, William Andrew Mould, Wendy Ziai, Richard E Thompson, Dimitre Staykov, Daniel F Hanley
Background Intraventricular hemorrhage is a significant cause of mortality and morbidity worldwide. Treating intraventricular hemorrhage with intraventricular fibrinolytic therapy via a catheter is becoming an increasingly utilized intervention. Aims This meta-analysis aimed to investigate the role of intraventricular fibrinolytic treatment in hypertensive intraventricular hemorrhage patients and evaluate the effect sizes for survival as well as level of function at differing time points. Summary of review PubMed, CNKI, VIP, and Wanfang were searched using the terms "IVH" and "IVH and ICH" for human studies with adult patients published between January 1950 and July 2016...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28919565/treatment-of-large-or-giant-cavernous-aneurysm-associated-with-a-persistent-trigeminal-artery-a-case-report-and-review-of-literature
#14
Tatsuya Ishikawa, Koji Yamaguchi, Hidenori Anami, Masatake Sumi, Tomomi Ishikawa, Takakazu Kawamata
BACKGROUND: Primitive trigeminal artery (PTA) is the most common anomaly of primitive carotid-basilar anastomosis and is associated with cerebrovascular anomalies, such as aneurysm. Large or giant cavernous aneurysm associated with PTA is rare, and the treatment strategies differ in comparison to large or giant aneurysm without PTA. In this article, we report an unusual case of a giant cavernous aneurysm associated with PTA and review treatment strategies for large or giant cavernous aneurysm associated with PTA...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28918086/confidence-in-the-use-of-direct-oral-anticoagulants-in-the-acute-phase-of-nonvalvular-atrial-fibrillation-related-ischemic-stroke-over-the-years-a-real-world-single-center-study
#15
Federico Moroni, Luca Masotti, Vieri Vannucchi, Raffaella Chiarelli, Cristiana Seravalle, Alessandra Pesci, Francesca Pallini, Silvia Puliti, Barbara Cimolato, Lamberto Fattorini, Cornelia Scerra, Francesca Ristori, Maria Letizia Imbalzano, Stefano Spolveri, Giancarlo Landini, Elisa Grifoni, Maurizio Paciaroni
BACKGROUD AND AIM: The use of direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) is controversial. The aims of our study were to analyze physicians' confidence in prescribing DOACs in NVAF-related AIS, the characteristics of patients receiving DOACs, and their 90-day prognosis. MATERIAL AND METHODS: Clinical records of consecutive patients admitted to our wards for NVAF-related AIS over the years 2014-2016 were reviewed...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28916667/cost-effectiveness-of-thrombectomy-in-patients-with-acute-ischemic-stroke-the-thrace-randomized-controlled-trial
#16
Hamza Achit, Marc Soudant, Kossar Hosseini, Aurélie Bannay, Jonathan Epstein, Serge Bracard, Francis Guillemin
BACKGROUND AND PURPOSE: The benefit of mechanical thrombectomy added to intravenous thrombolysis (IVT) in patients with acute ischemic stroke has been largely demonstrated. However, evidence of the economic incentive of this strategy is still limited, especially in the context of a randomized controlled trial. We aimed to analyze whether mechanical thrombectomy combined with IVT (IVMT) is cost-effective when compared with IVT alone. METHODS: Individual-level cost and outcome data were collected in the THRACE randomized controlled trial (Thrombectomie des Artères Cerébrales) including patients with acute ischemic stroke...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916664/safety-of-simultaneous-coronary-artery-bypass-grafting-and-carotid-endarterectomy-versus-isolated-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#17
Christian Weimar, Konstantinos Bilbilis, Jan Rekowski, Torulv Holst, Friedhelm Beyersdorf, Martin Breuer, Manfred Dahm, Anno Diegeler, Arne Kowalski, Sven Martens, Friedrich W Mohr, Jiri Ondrášek, Beate Reiter, Peter Roth, Ralf Seipelt, Markus Siggelkow, Gustav Steinhoff, Anton Moritz, Mathias Wilhelmi, Gerhard Wimmer-Greinecker, Hans-Christoph Diener, Heinz Jakob, Claudia Ose, Andre Scherag, Stephan C Knipp
BACKGROUND AND PURPOSE: The optimal operative strategy in patients with severe carotid artery disease undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety and efficacy of synchronous combined carotid endarterectomy and CABG as compared with isolated CABG. METHODS: Patients with asymptomatic high-grade carotid artery stenosis ≥80% according to ECST (European Carotid Surgery Trial) ultrasound criteria (corresponding to ≥70% NASCET [North American Symptomatic Carotid Endarterectomy Trial]) who required CABG surgery were randomly assigned to synchronous carotid endarterectomy+CABG or isolated CABG...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28914868/-combination-treatment-of-cerebral-arteriovenous-malformations-using-endovascular-and-microsurgical-techniques
#18
D M Galaktionov, A V Dubovoy, V S Kiselev, A O Sosnov, K S Ovsyannikov, A M Perfil'ev, A V Cherepanov
MATERIAL AND METHODS: The study included 40 patients with cerebral AVMs. In the study group, 14 (35%) patients underwent microsurgical resection without preliminary embolization (1st group), and 26 (65%) patients underwent combined treatment (endovascular embolization and microsurgical intervention, 2nd group). The first group included patients with S&M grade I-III AVMs, and the second group included patients with S&M grade II-V AVMs. Treatment outcomes were evaluated with allowance for completeness of AVM resection, operative blood loss, duration of surgery, changes in clinical and neurological impairments according to the modified Rankin scale, and rate of neurological and surgical complications...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28912883/tirofiban-facilitates-the-reperfusion-process-during-endovascular-thrombectomy-in-icas
#19
Hongchen Zhao, Jinhua Zhang, Danyan Gu, Zongjie Shi, Jie Pan, Yu Geng, Tianming Shi
The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Tirofiban was injected intra-arterially via a temporarily deployed Solitaire stent with continuous intravenous infusion for the subsequent 24 h; half of the conventionally recommended dose was employed...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912596/complete-reperfusion-is-required-for-maximal-benefits-of-mechanical-thrombectomy-in-stroke-patients
#20
Ángel Chamorro, Jordi Blasco, Antonio López, Sergio Amaro, Luis San Román, Laura Llull, Arturo Renú, Salvatore Rudilosso, Carlos Laredo, Victor Obach, Xabier Urra, Anna M Planas, Enrique C Leira, Juan Macho
A mTICI 2b or a mTICI 3 score are currently considered success following mechanical thrombectomy (MT) in acute stroke but is undetermined whether the two scores translate equivalent outcomes. We present a single-center, retrospective cohort of patients with anterior circulation stroke treated with MT and achieving a final mTICI score 2b or 3. A multimodal CT at baseline and a multimodal MRI at 24 hours assessed the growth of the infarct, and the modified Rankin Scale (mRS) assessed functional outcome at 90 days...
September 14, 2017: Scientific Reports
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