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Acute occlusion

Gerónimo Fernández, Ana Moraga, María I Cuartero, Alicia García-Culebras, Carolina Peña-Martínez, Jesús M Pradillo, Macarena Hernández-Jiménez, Silvia Sacristán, M Irene Ayuso, Rafael Gonzalo-Gobernado, David Fernández-López, M Elena Martín, María A Moro, Victor M González, Ignacio Lizasoain
Since Toll-like receptor 4 (TLR4) mediates brain damage after stroke, development of TLR4 antagonists is a promising therapeutic strategy for this disease. Our aim was to generate TLR4-blocking DNA aptamers to be used for stroke treatment. From a random oligonucleotide pool, we identified two aptamers (ApTLR#1R, ApTLR#4F) with high affinity for human TLR4 by systematic evolution of ligands by exponential enrichment (SELEX). Optimized truncated forms (ApTLR#1RT, ApTLR#4FT) were obtained. Our data demonstrate specific binding of both aptamers to human TLR4 as well as a TLR4 antagonistic effect...
June 15, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
E Jambon, A Hocquelet, F Petitpierre, Y Le Bras, C Marcelin, V Dubuisson, N Grenier, F Cornelis
PURPOSE: To compare intervention duration and fluoroscopy time for proximal embolization of splenic arteries in acute trauma using the Penumbra occlusion device (POD® ), coils or Amplatzer™ vascular plug (AVP). MATERIAL AND METHODS: A total of 29 patients with splenic injury without vascular injury who were treated by proximal splenic artery embolization using POD® (n=12), coils (n=9) or AVP (n=8) were retrospectively included. There were 25 men and 4 women with a median age of 34 years (range: 10-69 years)...
June 14, 2018: Diagnostic and Interventional Imaging
Yasir Abdul, Mohammed Abdelsaid, Weiguo Li, R Clinton Webb, Jennifer C Sullivan, Guangkuo Dong, Adviye Ergul
Diabetes increases the risk of occurrence and poor functional recovery after ischemic stroke injury. Previously, we have demonstrated greater hemorrhagic transformation (HT), edema, and more severe functional deficits after stroke in diabetic animals that also presented with cerebral vasoregression and endothelial cell death in the recovery period. Given that Toll-like receptor 4 (TLR-4) activation in microvascular endothelial cells triggers a robust inflammatory response, we hypothesized that inhibition of TLR-4 signaling prevents endothelial cell death and improves outcomes after stroke...
June 16, 2018: Molecular Neurobiology
Victor Alfonso Jimenez Diaz, Jose Antonio Baz Alonso, Oscar Estevez Ojea, Alexandre Serantes Combo, Carlos Manuel Rodriguez Paz, Andres Iñiguez Romo
No abstract text is available yet for this article.
June 7, 2018: JACC. Cardiovascular Interventions
Nitin Goyal, Konark Malhotra, Muhammad F Ishfaq, Georgios Tsivgoulis, Christopher Nickele, Daniel Hoit, Adam S Arthur, Andrei V Alexandrov, Lucas Elijovich
INTRODUCTION: Debate continues about the optimal anesthetic management for patients undergoing endovascular treatment (ET) of acute ischemic stroke due to emergent large vessel occlusion. OBJECTIVE: To compare, using current evidence, the clinical outcomes and procedural characteristics among patients undergoing general anesthesia (GA) and local or monitored anesthesia (non-GA). METHODS: We performed a systematic review and meta-analysis of all available studies that involved the use of stent retrievers for ET (stentriever group)...
June 15, 2018: Journal of Neurointerventional Surgery
Mariana Ingolotti, Enrique Alfonso Roig Melo-Granados, Pedro Mario González-Madrigal, Humberto Ruiz García
PURPOSE: To report a case of central retinal artery occlusion in a patient with macular telangiectasia Type 2 using multimodal imaging. METHODS: Observational case report. RESULTS: A 58-year-old woman who presented with acute painless unilateral vision loss was diagnosed with central retinal artery occlusion in her right eye with macular telangiectasia Type 2 findings in both eyes. Fundus examination revealed retinal whitening with unusual cherry-red spot plus small crystalline deposits in the temporal macula...
June 13, 2018: Retinal Cases & Brief Reports
Maria G Tektonidou
Kidney damage is a well-recognized complication of the antiphospholipid syndrome (APS), either primary or systemic lupus erythematosus (SLE)-associated APS. Kidney involvement in APS involves a variety of manifestations, such as renal artery thrombosis or stenosis, renal vein thrombosis, allograft loss due to thrombosis after kidney transplantation, and injury to the renal microvasculature, also known as APS nephropathy. Biopsy in patients with APS nephropathy includes acute thrombotic microangiopathy lesions and chronic intrarenal vascular lesions such as interlobular fibrous intimal hyperplasia, arterial and arteriolar recanalizing thrombosis, fibrous arterial occlusion, and focal cortical atrophy...
2018: Frontiers in Immunology
P B García Jurado, E Roldán Romero, M E Pérez Montilla, R Valverde Moyano, I M Bravo Rey, F Delgado Acosta, F A Bravo-Rodríguez
INTRODUCTION: Haemorrhagic transformation is a major complication of acute ischaemic stroke (AIS). We sought to determine the predictors and clinical impact of intracranial haemorrhage (ICH) after revascularisation therapy. METHODS: We conducted a retrospective, single-centre study including 235 patients with AIS who underwent intravenous recombinant tissue plasminogen activator (IV-rtPA) therapy and/or endovascular treatment. A binary logistic regression model was used to determine the variables associated with ICH, parenchymal haematomas (PH), modified Rankin Scale (mRS) scores, and mortality...
June 11, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
R F Galiano Blancart, G Fortea, A Pampliega Pérez, S Martí, V Parkhutik, A V Sánchez Cruz, C Soriano, D Geffner Sclarsky, M T Pérez Saldaña, N López Hernández, I Beltrán, A Lago Martín
INTRODUCTION: Cortical subarachnoid haemorrhage (cSAH) has multiple aetiologies. No prospective study has reported the long-term progression of the condition. The objective of this study is to describe the clinical and aetiological characteristics of patients with cSAH and to gain insight into prognosis. METHODS: We performed a prospective, observational, multi-centre study. Data on clinical and radiological variables were collected; during a one-year follow-up period, we recorded data on mortality, dependence, rebleeding, and the appearance of dementia...
June 11, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Yuchen Hou, Nga Lei Tam, Zhicheng Xue, Xuzhi Zhang, Bing Liao, Jie Yang, Shunjun Fu, Yi Ma, Linwei Wu, Xiaoshun He
RATIONALE: Hepatic vein occlusive disease (HVOD) is a rare complication after liver transplantation, which is characterized by nonthrombotic, fibrous obliteration of the small centrilobular hepatic veins by connective tissue and centrilobular necrosis in zone 3 of the acini. HVOD after solid organ transplantation has been reported; recently, most of these reports with limited cases have documented that acute cell rejection and immunosuppressive agents are the major causative factors. HVOD is relatively a rare complication of liver transplantation with the incidence of approximately 2%...
June 2018: Medicine (Baltimore)
Georgios Sideris, Nikolaos Magkoutis, Sebastian Voicu, Chantal Kang, Michel Bonneau, Demetris Yannopoulos, Claire Bal Dit Sollier, Jean-Guillaume Dillinger, Natacha Berge, Philippe Brouland, Patrick Henry, Ludovic Drouet
AIMS: We sought to develop a reproducible animal model for acute myocardial infarction (AMI) in adult atherosclerosis-prone pigs. METHODS AND RESULTS: A coil was placed in the right coronary artery or the left anterior descending artery in 26 downsized spontaneously hypercholesterolemic pigs and left untreated until thrombotic occlusion. Then, we crossed the thrombotic occlusion with a guidewire, followed by pre-dilatation, thrombus visualization with Optical Coherence Tomography (OCT) imaging and, finally, deployment of a stent and repeated OCT...
June 12, 2018: EuroIntervention
Peter McMeekin, Philip White, Martin A James, Christopher I Price, Darren Flynn, Gary A Ford
Introduction: Endovascular thrombectomy is a highly effective treatment for acute ischemic stroke due to large arterial occlusion. Routine provision will require major changes in service configuration and workforce. An important first step is to quantify the population of stroke patients that could benefit. We estimated the annual UK population suitable for endovascular thrombectomy using standard or advanced imaging for patient selection. Patients and methods: Evidence from randomised control trials and national registries was combined to estimate UK stroke incidence and define a decision-tree describing the endovascular thrombectomy eligible population...
December 2017: European stroke journal
Anna Holthenrich, Volker Gerke
Endothelial cells serve as gatekeepers of vascular hemostasis and local inflammatory reactions. They can rapidly respond to changes in the environment, caused, for example, by blood vessel injury, tissue damage or infection, by secreting in a strictly regulated manner factors regulating these processes. These factors include adhesion receptors for circulating leukocytes and platelets, P-selectin and von-Willebrand factor (VWF) that are stored in specialized secretory granules of endothelial cells, the Weibel-Palade bodies (WPB)...
June 13, 2018: International Journal of Molecular Sciences
Francisco Antunes Dias, Daniel Giansante Abud, Octavio Marques Pontes-Neto
Basilar artery occlusion (BAO) ischemic stroke is a relatively rare condition with high morbidity and mortality rates. To date, the best acute reperfusion therapy for BAO has still not been established, mainly due to the lack of randomized controlled trials in this field. In this article, we review the history of BAO diagnosis and treatment, and the impact of modern technological resources on the clinical evolution and prognosis of BAO over time. Furthermore, we describe historical events and nonmedical literature descriptions related to BAO...
May 2018: Arquivos de Neuro-psiquiatria
Yuanyuan Ran, Zongjian Liu, Shuo Huang, Jiamei Shen, Fengwu Li, Wenxiu Zhang, Chen Chen, Xiaokun Geng, Zhili Ji, Huishan Du, Xiaoming Hu
Splenectomy before or immediately after stroke provides early brain protection. This study aims to explore the effect of splenectomy on long-term neurological recovery after stroke, which is currently lacking in the field. Adult male rats were randomized into splenectomy or sham groups and then subjected to 90 min of middle cerebral artery occlusion (MCAO). Spleen was removed right upon reperfusion or 3d after MCAO. Infarct volume, neurological functions, and peripheral immune cell populations were assessed up to 28d after stroke...
June 2018: Aging and Disease
Caroline Pin-Barre, Christophe Pellegrino, Frédéric Laurin, Jérôme Laurin
The purpose of the present study was to examine the contribution of group III and IV metabosensitive afferents at spinal and supraspinal levels in rats subjected to middle cerebral artery occlusion (MCAO) with reperfusion during the acute phase. Animals were randomized in Control ( n = 23), SHAM ( n = 18), MCAO-D1 ( n = 10), and MCAO-D7 ( n = 20) groups. Rats performed the Electrical Von Frey and the Adhesive removal tests before the surgery and at day 1 (D1), D3, and D7 after MCAO. Animals were subjected to electrophysiological recordings including the responses of group III/IV metabosensitive afferents to combinations of chemical activators and the triceps brachii somatic reflex activity at D1 or D7...
2018: Frontiers in Physiology
Lakshmi Sudha Prasanna Karanam, Narendra Reddy Busireddy, Sridhar Reddy Baddam, Kiran Makineni, Vijaya Paidimukkala, P Raghavasarma
Aim: Acute arterial occlusions after total knee arthroplasty (TKA) are rare but very serious complication. We present a series of 9 patients who underwent endovascular recanalisation for acute thrombotic occlusion following TKA in our institution. The present series determine the importance of early diagnosis and role of early intervention for good clinical outcome in these cases. Methods: From 2013 to 2016, a total of 9 patients (3 male and 6 female) presented with acute popliteal thrombosis following TKA...
April 2018: Journal of Clinical Orthopaedics and Trauma
Digvijaya Navalkele, Amelia Boehme, Karen Albright, Cindy Leissinger, Laurie Schluter, Melissa Freeman, Stacy Drury, Ramy El Khoury, T Mark Beasley, Sheryl Martin-Schild
We conducted a prospective serial laboratory cohort study to assess the correlation of factor VIII (FVIII) levels in response to thrombolysis in patients with large vessel occlusion (LVO) and acute ischemic stroke (AIS). Patients with AIS with anterior circulation LVO were eligible for enrollment if treated within 4.5 hours from last seen normal with intravenous tissue plasminogen activator (tPA). Patients (n = 29) had a mean age of 71 years and median National Institute of Health Stroke Scale of 14. Baseline pre-tPA FVIII was not significantly correlated with clot burden score (-0...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
Bimmer E Claessen, Jose P S Henriques
No abstract text is available yet for this article.
June 8, 2018: EuroIntervention
Wolfgang G Kunz, Myriam G Hunink, Konstantinos Dimitriadis, Thomas Huber, Franziska Dorn, Felix G Meinel, Bastian O Sabel, Ahmed E Othman, Maximilian F Reiser, Birgit Ertl-Wagner, Wieland H Sommer, Kolja M Thierfelder
Purpose To determine the impact of patient age on the cost-effectiveness of endovascular therapy (EVT) in addition to standard care (SC) in large-vessel-occlusion stroke for patients aged 50 to 100 years in the United States. Materials and Methods A decision-analytic Markov model was used to estimate direct and indirect lifetime costs and quality-adjusted life years (QALYs). Age-dependent input parameters were obtained from the literature. Deterministic and probabilistic sensitivity analysis for age at index stroke were used...
June 12, 2018: Radiology
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