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Stroke routing

Kaushik Parsha, Osman Mir, Nikunj Satani, Bing Yang, Waldo Guerrero, Zhuyong Mei, Chunyan Cai, Peng R Chen, Adrian Gee, Patrick J Hanley, Jaroslaw Aronowski, Sean I Savitz
BACKGROUND AIMS: Extensive animal data indicate that mesenchymal stromal cells (MSCs) improve outcome in stroke models. Intra-arterial (IA) injection is a promising route of delivery for MSCs. Therapeutic effect of MSCs in stroke is likely based on the broad repertoire of secreted trophic and immunomodulatory cytokines produced by MSCs. We determined the differential effects of exposing MSCs to different types of clinically relevant vehicles, and/or different additives and passage through a catheter relevant to IA injections...
November 14, 2016: Cytotherapy
Bapi Gorain, Hira Choudhury, Rakesh Kumar Tekade, Saumen Karan, P Jaisankar, Tapan Kumar Pal
Poor aqueous solubility and unfavourable de-esterification of olmesartan medoxomil (a selective angiotensin II receptor blocker), results in low oral bioavailability of less than 26%. Improvement of oral bioavailability with prolonged pharmacodynamics activity of olmesartan in Wistar rats had been approached by nanoemulsification strategy in our previous article [Colloid Surface B, 115, 2014: 286]. In continuation to that work, we herewith report the biodistribution behaviour and 28-day repeated dose sub-chronic toxicity of olmesartan medoxomil nanoemulsion in Wistar rats following oral administration...
December 2016: Regulatory Toxicology and Pharmacology: RTP
Paulo Henrique Rosado-de-Castro, Felipe Gonçalves de Carvalho, Gabriel Rodriguez de Freitas, Rosalia Mendez-Otero, Pedro Moreno Pimentel-Coelho
Stroke is the second leading cause of mortality worldwide, causing millions of deaths annually, and is also a major cause of disability-adjusted life years. Hemorrhagic stroke accounts for approximately 10 to 27% of all cases and has a fatality rate of about 50% in the first 30 days, with limited treatment possibilities. In the past two decades, the therapeutic potential of bone marrow-derived cells (particularly mesenchymal stem cells and mononuclear cells) has been intensively investigated in preclinical models of different neurological diseases, including models of intracerebral hemorrhage and subarachnoid hemorrhage...
2016: Stem Cells International
Emil Zeynalov, Susan M Jones, J Paul Elliott
Stroke is one of the major causes of morbidity and mortality in the world. Stroke is complicated by brain edema and other pathophysiological events. Among the most important players in the development and evolution of stroke-evoked brain edema is the hormone arginine-vasopressin and its receptors, V1a and V2. Recently, the V1a and V2 receptor blocker conivaptan has been attracting attention as a potential drug to reduce brain edema after stroke. However, animal models which involve conivaptan applications in stroke research need to be modified based on feasible routes of administration...
2016: Journal of Visualized Experiments: JoVE
Tingting Chen, Ninghua Liu, Jinxuan Liu, Xiaoying Zhang, Zhen Huang, Yuhui Zang, Jiangning Chen, Lei Dong, Junfeng Zhang, Zhi Ding
OBJECTIVE: The skin is an important immunological barrier of the body as well as an optimal route for vaccine administration. Gua Sha, which involves press-stroke treatment of the skin, is an effective folk therapy, widely accepted in East Asia, for various symptoms; however, the mechanisms underlying its therapeutic effects have not been clarified. We investigated the influence of Gua Sha on the immunological features of the skin. METHODS: Gua Sha was performed on BALB/c mice and the effects were evaluated using anatomical, histological, and cytometric methods as well as cytokine determination locally and systemically...
2016: PeerJ
Y Inatomi, M Nakajima, T Yonehara, Y Ando
OBJECTIVES: To investigate clinical characteristics of ipsilateral hemiparesis in ischemic stroke patients. MATERIALS AND METHODS: Patients with acute ischemic stroke were prospectively examined. Ipsilateral hemiparesis was defined as hemiparesis ipsilateral to recent stroke lesions. Patients with ipsilateral hemiparesis were examined with functional neuroimaging studies including transcranial magnetic stimulation (TMS) and functional MRI. RESULTS: Of 8360 patients, ipsilateral hemiparesis was detected in 14 patients (0...
September 26, 2016: Acta Neurologica Scandinavica
Aditya Muralidharan, Karthy Thiagarajan, Raymond Van Ham, Thomas G Gleason, Suresh Mulukutla, John T Schindler, Vinodh Jeevanantham, Parthasarathy D Thirumala
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving safe method with decreasing incidence of perioperative stroke. There is a void in literature concerning the impact of stroke after TAVI in predicting 30-day stroke-related mortality. The primary aim of this meta-analysis was to determine whether perioperative stroke increases risk of stroke-related mortality after TAVI. Online databases, using relevant keywords, and additional related records were searched to retrieve articles involving TAVI and stroke after TAVI...
October 1, 2016: American Journal of Cardiology
Robert H LeBlanc, Ruiya Chen, Magdy H Selim, Khalid A Hanafy
BACKGROUND: Subarachnoid hemorrhage (SAH) is a devastating disease that affects over 30,000 Americans per year. Previous animal studies have explored the therapeutic effects of deferoxamine (DFX) via its iron-chelating properties after SAH, but none have assessed the necessity of microglial/macrophage heme oxygenase-1 (HO-1 or Hmox1) in DFX neuroprotection, nor has the efficacy of an intracerebroventricular (ICV) administration route been fully examined. We explored the therapeutic efficacy of systemic and ICV DFX in a SAH mouse model and its effect on microglial/macrophage HO-1...
September 13, 2016: Journal of Neuroinflammation
Vinayak Bapat, Derk Frank, Ricardo Cocchieri, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Peter Bramlage, Cornelia Deutsch, Martin Thoenes, Mauro Romano
OBJECTIVES: The Registry of the Utilization of the TAo-TAVR approach using the Edwards SAPIEN Valve (ROUTE) was established to assess the effectiveness and safety of the use of transaortic (TAo) access for transcatheter aortic valve replacement (TAVR) procedures (NCT01991431). BACKGROUND: TAVR represents an alternative to surgical valve replacement in high-risk patients. Whereas the transfemoral access route is used commonly as the first-line approach, transapical access is an option for patients not suitable for transfemoral treatment mainly due to anatomic conditions...
September 12, 2016: JACC. Cardiovascular Interventions
Hasan Bushnaq, Dietrich Metz, Asen Petrov, Stefan Frantz, Ulrich Hofmann, Christoph Raspé, Hendrik Treede
OBJECTIVE: The standard procedure of transcatheter aortic valve implantation involves transfemoral access. Nevertheless, the use of this access route is limited by the vessel diameter, calcification, and tortuosity, making a subgroup of patients ineligible for peripheral access. We report the first use of direct aortic transcatheter aortic valve implantation with the Direct Flow Medical valve (Direct Flow Medical, Inc, Santa Rosa, Calif) in 15 patients at the Halle-Wittenberg University...
August 12, 2016: Journal of Thoracic and Cardiovascular Surgery
Jae Hoon Lee, Eun Hee Kam, Jeong Min Kim, So Yeon Kim, Eun Jeong Kim, So Yeong Cheon, Bon-Nyeo Koo
The interleukin-1 receptor antagonist (IL-1RA) is a potential stroke treatment candidate. Intranasal delivery is a novel method thereby a therapeutic protein can be penetrated into the brain parenchyma by bypassing the blood-brain barrier. Thus, this study tested whether intranasal IL-1RA can provide neuroprotection and brain penetration in transient cerebral ischemia. In male Sprague-Dawley rats, focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 1 h. The rats simultaneously received 50 mg/kg human IL-1RA through the intranasal (IN group) or intraperitoneal route (IP group)...
August 19, 2016: Biomolecules & Therapeutics
Aparna Karthikeyan, Radhika Patnala, Shweta P Jadhav, Ling Eng-Ang, S Thameem Dheen
The significance of microglia and astrocytes in neural development, in maintaining synaptic connections and homeostasis in the healthy brain is well established. Microglia are dynamic immune cells of the brain that elicit an immune response during brain damage and also participate in tissue repair and regeneration, while astrocytes contribute to the local inflammatory response by producing proinflammatory cytokines and resolving neuronal damage through production of anti-inflammatory cytokines and neurotrophic factors...
2016: Current Medicinal Chemistry
Francisco Moniche, Paulo Henrique Rosado-de-Castro, Irene Escudero, Elena Zapata, Francisco Javier de la Torre Laviana, Rosalia Mendez-Otero, Magdalena Carmona, Pilar Piñero, Alejandro Bustamante, Lucía Lebrato, Juan Antonio Cabezas, Alejandro Gonzalez, Grabriel R de Freitas, Joan Montaner
Background and Purpose. BM-MNC transplantation improves recovery in experimental models of ischemic stroke. Clinical trials are ongoing to test efficacy in stroke patients. However, whether cell dose is related to outcomes is not known. Methods. We performed a pooling data analysis of two pilot clinical trials with autologous BM-MNCs transplantation in ischemic stroke patients. Cell dose and route were analyzed to evaluate their relation to good outcome (m-Rankin scale [mRS] score 0-2) at 6 months. Results...
2016: Stem Cells International
Taichiro Imahori, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA...
July 2016: Journal of Korean Neurosurgical Society
Pascal Gervois, Esther Wolfs, Jessica Ratajczak, Yörg Dillen, Tim Vangansewinkel, Petra Hilkens, Annelies Bronckaers, Ivo Lambrichts, Tom Struys
Stroke is the second most common cause of death and is a major cause of permanent disability. Given the current demographic trend of an ageing population and associated increased risk, the prevalence of and socioeconomic burden caused by stroke will continue to rise. Current therapies are unable to sufficiently ameliorate the disease outcome and are not applicable to all patients. Therefore, strategies such as cell-based therapies with mesenchymal stem cell (MSC) or induced pluripotent stem cell (iPSC) pave the way for new treatment options for stroke...
July 21, 2016: Medicinal Research Reviews
Howard C Herrmann, Vinod H Thourani, Susheel K Kodali, Raj R Makkar, Wilson Y Szeto, Saif Anwaruddin, Nimesh Desai, Scott Lim, S Chris Malaisrie, Dean J Kereiakes, Steven Ramee, Kevin L Greason, Samir Kapadia, Vasilis Babaliaros, Rebecca T Hahn, Philippe Pibarot, Neil J Weissman, Jonathon Leipsic, Brian K Whisenant, John G Webb, Michael J Mack, Martin B Leon
BACKGROUND: In the initial PARTNER trial (Placement of Aortic Transcatheter Valves) of transcatheter aortic valve replacement for high-risk (HR) and inoperable patients, mortality at 1 year was 24% in HR and 31% in inoperable patients. A recent report of the 30-day outcomes with the low-profile SAPIEN 3 transcatheter aortic valve replacement system demonstrated very low rates of adverse events, but little is known about the longer-term outcomes with this device. METHODS: Between October 2013 and September 2014, 583 HR (65%) or inoperable (35%) patients were treated via the transfemoral (84%) or transapical/transaortic (16%) access route at 29 US sites...
July 12, 2016: Circulation
Michael J Lang, Ruihe Lin, Ashwini Dayal Sharan, Robert H Rosenwasser, Lorraine Iacovitti
INTRODUCTION: The presence of the blood-brain barrier (BBB) in vertebrates is a major limitation to the delivery of therapeutic agents into brain tissue. Mesenchymal stem cell (MSC) infusion has been shown to reduce stroke volume and improve recovery, but the BBB limits cellular engraftment. Sphenopalatine ganglion (SPG) stimulation has been shown to transiently increase BBB permeability. A rodent model was designed to test the hypothesis that SPG stimulation enhances the effect of MSC infusion...
August 2016: Neurosurgery
Diana Amantea, Michelangelo Certo, Francesco Petrelli, Giacinto Bagetta
Repurposing the macrolide antibiotic azithromycin has recently been suggested as a promising neuroprotective strategy for the acute treatment of ischemic stroke. Here, we aim at further characterizing the immunomodulatory properties of intraperitoneal (i.p.) administration of this drug and, more importantly, at assessing whether neuroprotection can also be achieved by the more clinically relevant intravenous (i.v.) route of administration in a mouse model of focal cerebral ischemia induced by transient (30-min) middle cerebral artery occlusion (MCAo)...
July 8, 2016: Assay and Drug Development Technologies
Takahiro Ota, Masayuki Sato, Tatsuo Amano, Yuji Matsumaru
The adoption of stent retrievers has significantly improved outcomes of intravenous treatment for acute stroke due to major artery occlusion, and reducing the time to recanalization may achieve further improvements. We reviewed reductions in "door-to-needle time" (DNT) and "picture-to-puncture time" (P2P), as the results of measures to consolidate stroke response capabilities in our hospital, and compared treatment outcomes in acute recanalization patients. We investigated DNT by the route of admission for 96 consecutive patients who received intravenous tissue plasminogen activator between July 2012 and June 2015...
July 5, 2016: Neurologia Medico-chirurgica
Berta Rodríguez-Frutos, Laura Otero-Ortega, María Gutiérrez-Fernández, Blanca Fuentes, Jaime Ramos-Cejudo, Exuperio Díez-Tejedor
Cell-based therapy has demonstrated safety and efficacy in experimental animal models of stroke, as well as safety in stroke patients. However, various questions remain regarding the therapeutic window, dosage, route of administration, and the most appropriate cell type and source, as well as mechanisms of action and immune-modulation to optimize treatment based on stem cell therapy. Various delivery routes have been used in experimental stroke models, including intracerebral, intraventricular, subarachnoid, intra-arterial, intraperitoneal, intravenous, and intranasal routes...
October 2016: Translational Stroke Research
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