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Carotid thrombus

Sergio Barros-Gomes, Abdullah El Sabbagh, Mackram F Eleid, Sunil V Mankad
Non-atherosclerotic myocardial infarction (MI) is an important but often misdiagnosed cause of acute MI. Furthermore, non-atherosclerotic MI with concomitant acute stroke and pulmonary embolism due to in-transit thrombus across a patent foramen ovale (PFO) is a rare but potentially fatal combination (1-3). Early detection of this clinical entity can facilitate delivery of targeted therapies and avoid poor outcome (1, 2). Here, we describe a 68-year-old female with hypertension, tobacco abuse, and chronic obstructive pulmonary disease presenting with facial droop, right arm weakness and aphasia...
August 11, 2018: Echo Research and Practice
Donny Hanjaya-Putra, Carolyn Haller, Xiaowei Wang, Erbin Dai, Bock Lim, Liying Liu, Patrick Jaminet, Joy Yao, Amy Searle, Thomas Bonnard, Christoph E Hagemeyer, Karlheinz Peter, Elliot L Chaikof
Despite advances in antithrombotic therapy, the risk of recurrent coronary/cerebrovascular ischemia or venous thromboembolism remains high. Dual pathway antithrombotic blockade, using both antiplatelet and anticoagulant therapy, offers the promise of improved thrombotic protection; however, widespread adoption remains tempered by substantial risk of major bleeding. Here, we report a dual pathway therapeutic capable of site-specific targeting to activated platelets and therapeutic enrichment at the site of thrombus growth to allow reduced dosing without compromised antithrombotic efficacy...
August 9, 2018: JCI Insight
Bo Yu, ZhenHua Liu, Chao Xue, JinCheng Liu, Jian Yang, ZhenXiao Jin, ShiQiang Yu, WeiXun Duan
OBJECTIVES: The aim of this study was to evaluate the safety and feasibility of total arch repair with open placement of a novel double-branched stent graft for acute Type A aortic dissection (TAAD). METHODS: We retrospectively analysed the effect of the double-branched stent graft for total aortic arch placement with acute TAAD from December 2013 to February 2015. The effectiveness of the open placement of the double-branched stent graft was estimated by complete thrombus obliteration of the false lumen surrounding it on computed tomography angiography...
August 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Nikolaos Tsilimparis, Konstantinos Spanos, E Sebastian Debus, Fiona Rohlffs, Tilo Kölbel
PURPOSE: To present the technique for removing mural thrombus from the ascending aorta using the AngioVac System. TECHNIQUE: The technique is demonstrated in a 66-year-old woman who presented with free-floating mural thrombus in the ascending aorta and was considered unsuitable for either open (comorbidities) or endovascular approaches (high risk of stroke). Because of the free-floating thrombus, the Angiovac system was suggested, although it is approved for only the venous system...
August 5, 2018: Journal of Endovascular Therapy
Craig Kilburg, M Yashar S Kalani, Min S Park
Occlusion of branch vessels is a known potential sequela of the treatment of intracranial aneurysms with flow diversion. We present a case of occlusion and distal reconstitution of the origin of the posterior communicating artery through a fusiform aneurysm of the internal carotid artery after flow diversion. A 56-year-old woman was incidentally found to have a large fusiform aneurysm of the posterior communicating segment of the internal carotid artery incorporating the origin of the posterior communicating artery...
July 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mariusz Hofman, Tomasz Jamróz, Izabela Jakutowicz, Paweł Jarski, Wilhelm Masarczyk, Marcin Niedbała, Nikodem Przybyłko, Damian Kocur, Jan Baron
Purpose: Complex intracranial aneurysms (CIA) are heterogenous group of intracranial vascular malformations. Due to its giant size, difficult location, broad neck, branches arising from the aneurysm, wall structure, calcification, presence of intraluminal thrombus or previous treatments it requires more careful approach. The aim of this study was to evaluate endovascular treatment results of CIA in our Department. Material and methods: In order to differentiate CIA from all the aneurysms, treated endovascularly in years 2008-2014, authors proposed their own qualification criteria...
2018: Polish Journal of Radiology
Timothy Hampton, Donal Walsh, Christos Tolias, David Fiorella
BACKGROUND: Flow-diverting stents have demonstrated great promise for the treatment of cerebral aneurysms; however, clinical experience with the devices remains very preliminary. We present two cases of spontaneous delayed complications-one fatal aneurysm rupture and one symptomatic increase in aneurysm volume-following the treatment of intradural aneurysms with the Pipeline Embolization Device (PED). PRESENTATION/INTERVENTION: Two patients with unruptured, intradural aneurysms of the carotid artery underwent uneventful treatment with the PED (eV3, Irvine, California, USA)...
July 2018: Journal of Neurointerventional Surgery
Mehmet Akif Topcuoglu, Eva A Rocha, Ahmer Khawdja Siddiqui, Brittany B Mills, Gisele S Silva, Lee H Schwamm, Glenn M Lamuraglia, Aneesh B Singhal
OBJECTIVE: To characterize isolated upper extremity (UE) weakness from stroke. METHODS: In our Get with the Guidelines-Stroke dataset (n = 7643), 87 patients (1.14%) had isolated UE weakness and underwent thorough stroke evaluation with diffusion-weighted magnetic resonance imaging and good-quality arterial imaging. We analyzed clinical-imaging features, etiology, management, and outcome. Since isolated UE weakness is typically associated with contralateral hand-knob area infarcts, patients were classified into Group-A (motor strip infarct) or Group-B (non-motor strip infarct)...
July 19, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Krishnan Ravindran, Marcello DiStasio, Roger Laham, Christopher S Ogilvy, Ajith J Thomas, Paul A VanderLaan, Abdulrahman Y Alturki
BACKGROUND: Endothelial cell coverage along the Pipeline embolization device (PED) is one of two primary proposed mechanisms of action of the device, along with induction of intra-aneurysmal thrombosis. The temporal course of endothelialization following device deployment is poorly understood in human patients. CASE DESCRIPTION: Here, the authors present a case of a 63-year-old female with a persistent aneurysm in the communicating segment of the internal carotid artery treated with a second PED, 14 months after the deployment of a 1st PED, who subsequently developed a fatal intraparenchymal hemorrhage 3 weeks post-implantation...
July 18, 2018: World Neurosurgery
Pil-Sung Yang, Hui-Nam Pak, Dong-Hyuk Park, Joonsang Yoo, Tae-Hoon Kim, Jae-Sun Uhm, Young Dae Kim, Hyo Suk Nam, Boyoung Joung, Moon-Hyoung Lee, Ji Hoe Heo
INTRODUCTION: Cardioembolic (CE) risks is usually considered as the main mechanism of ischemic stroke in non-valvular atrial fibrillation (NVAF) patients. However, a substantial number of ischemic strokes in NVAF patients are related to non-CE mechanisms. The aim of this study was to investigate the non-CE risk factors in ischemic stroke patients had NVAF. METHODS: We included 401 patients (65.6% male, 68.6 ± 9.6 years old) who had been hospitalized due to ischemic stroke and had a known or newly diagnosed NVAF...
2018: PloS One
Johannes Kaesmacher, Mattia Giarrusso, Felix Zibold, Pascal J Mosimann, Tomas Dobrocky, Eike Piechowiak, Sebastian Bellwald, Marcel Arnold, Simon Jung, Marwan El-Koussy, Pasquale Mordasini, Jan Gralla, Urs Fischer
BACKGROUND AND PURPOSE: Preinterventional reperfusion before endovascular treatment (ET) is a benefit of bridging with intravenous tPA (tissue-type plasminogen activator). However, detailed data on reperfusion quality and rates of obviating ET in a cohort of patients with immediate access to ET is lacking. Purpose of this analysis was to evaluate prevalence and quality of preinterventional reperfusion in mothership patients. METHODS: All mothership patients (n=627) from a prospective registry subjected to angiography with an intention to perform ET were reviewed...
July 9, 2018: Stroke; a Journal of Cerebral Circulation
Isabelle Claus, Bart Jacobs, Liesbeth De Groote, Willem Willaert
Extracranial carotid artery aneurysms (ECAA) are extremely rare, accounting for less than 1% of all peripheral artery aneurysms. The most common presentation is central neurologic dysfunction, typically due to embolization of thrombus from the aneurysm. Historically open surgical intervention is the treatment of choice for symptomatic ECAA. Recent data suggest that endovascular repair is a valuable alternative, with a high procedural success rate and relatively low complication rate. We present a case of an ECAA with symptoms of vision loss, successfully treated by endovascular covered stenting but complicated by late in stent thrombosis and cerebral infarction...
July 9, 2018: Acta Chirurgica Belgica
W Zhu, J A Buffa, Z Wang, M Warrier, R Schugar, D M Shih, N Gupta, J C Gregory, E Org, X Fu, L Li, J A DiDonato, A J Lusis, J M Brown, S L Hazen
BACKGROUND: Gut microbes play a critical role in the production of trimethylamine N-oxide (TMAO), an atherogenic metabolite that impacts platelet responsiveness and thrombosis potential. Involving both microbe and host enzymatic machinery, TMAO generation utilizes a metaorganismal pathway, beginning with ingestion of trimethylamine (TMA)-containing dietary nutrients such as choline, phosphatidylcholine and carnitine, which are abundant in a Western diet. Gut microbial TMA lyases use these nutrients as substrates to produce TMA, which upon delivery to the liver via the portal circulation, is converted into TMAO by host hepatic flavin monooxygenases (FMOs)...
July 7, 2018: Journal of Thrombosis and Haemostasis: JTH
Tae Jin Song, Il Kwon, Honglim Piao, Jee Eun Lee, Kyeo Rye Han, Yoonkyung Chang, Hyung Jung Oh, Hyun Jung Choi, Kyung Yul Lee, Yong Jae Kim, Ki Hwan Han, Ji Hoe Heo
PURPOSE: Abnormalities in hemostasis and coagulation have been suggested in chronic renal failure (CRF). In this study, we compared processes of thrombus formation between rats with CRF and those with normal kidney function. MATERIALS AND METHODS: CRF was induced by 5/6 ablation/infarction of the kidneys in Sprague-Dawley rats, and surviving rats after 4 weeks were used. Ferric chloride (FeCl₃)-induced thrombosis in the carotid artery was induced to assess thrombus formation...
August 2018: Yonsei Medical Journal
Bo Zhou, Dongliang Zhang, Xueqin Liu, Ran Zhuang, Yuan Zhang, Shuzhong Guo
Objective To study the regulatory effect of co-stimulatory molecule CD226 on platelet function in mice. Methods The 40-week-old CD226 knockout (CD226KO) mice were used as an experimental group and the wild wild-type (WT)C57BL/6 mice at the same age were designated as a control group. Caudal venous blood was taken for platelet counting. Tail tips of the mice were snipped for the bleeding time measurement. Ultrastructure of platelets was examined by transmission electron microscope. Carotid artery thrombosis model was established by the induction of ferric chloride in mice, to test the difference of platelet function in CD226KO and WT mice...
April 2018: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
Christoph Klatt, Irena Krüger, Saskia Zey, Kim-Jürgen Krott, Martina Spelleken, Nina Sarah Gowert, Alexander Oberhuber, Lena Pfaff, Wiebke Lückstädt, Kerstin Jurk, Martin Schaller, Hadi Al-Hasani, Jürgen Schrader, Steffen Massberg, Konstantin Stark, Hubert Schelzig, Malte Kelm, Margitta Elvers
Red blood cells (RBCs) influence rheology, release ADP, ATP and nitric oxide suggesting a role for RBCs in hemostasis and thrombosis. Here we provide evidence for a significant contribution of RBCs to thrombus formation. Anemic mice showed enhanced occlusion times upon injury of the carotid artery. A small population of RBCs was located to platelet thrombi and enhanced platelet activation by a direct cell contact via the FasL-FasR (CD95) pathway known to induce apoptosis. Activation of platelets in the presence of RBCs led to platelet FasL exposure that activated FasR on RBCs responsible for externalization of phosphatidylserine (PS) on the RBC membrane...
June 28, 2018: Journal of Clinical Investigation
Ryan C Turner, Brandon P Lucke-Wold, Sohyun Boo, Charles L Rosen, Cara L Sedney
Chiropractic cervical manipulation is a common practice utilized around the world. Most patients are never cleared medically for manipulation, which can be devastating for those few who are at increased risk for dissections. The high velocity thrust used in cervical manipulation can produce significant strain on carotid and vertebral vessels. Once a dissection has occurred, the risk of thrombus formation, ischemic stroke, paralysis, and even death is drastically increased. In this case report, we highlight a case of a 32-year-old woman who underwent chiropractic manipulation and had vertebral artery dissection with subsequent brainstem infarct...
2018: Biomedical research and reviews
Xuemei Fan, Conghui Wang, Panlai Shi, Wen Gao, Jianmin Gu, Yan Geng, Wenlong Yang, Ningbo Wu, Yang Wang, Yanyan Xu, Xue Chen, Lin Zhang, Kemin Wang, Bing Su, Junling Liu
MAPKs play important roles in platelet activation. However, the molecular mechanisms by which MAPKs are regulated in platelets remain largely unknown. Real-time polymerase chain reaction and western blot data showed that MEKK3, a key MAP3K family member, was expressed in human and mouse platelets. Then, megakaryocyte/platelet-specific MEKK3-deletion ( MEKK3 -/- ) mice were developed to elucidate the platelet-related function(s) of MEKK3. We found that agonist-induced aggregation and degranulation were reduced in MEKK3 -/- platelets in vitro...
June 26, 2018: Blood Advances
Enrico Baria, Gabriella Nesi, Raffaella Santi, Vincenza Maio, Daniela Massi, Carlo Pratesi, Riccardo Cicchi, Francesco S Pavone
Coronary heart disease is the most common type of heart disease caused by atherosclerosis. In fact, an arterial wall lesion centered on the accumulation of cholesterol-rich lipids and the accompanying inflammatory response generates a plaque, whose rupture may result in a thrombus with fatal consequences. Plaque characterization for assessing the severity of atherosclerosis is generally performed through standard histopathological examination based on hematoxylin/eosin staining, which is operator-dependent and requires relatively long procedures...
June 22, 2018: Journal of Biophotonics
Neasa Fitzpatrick, Ronan Motyer, Brian Gibney, Sharon Duffy, Sean Murphy, Paul O'Brien, Daniel Ryan, John Thornton
Carotid artery free-floating thrombus (FFT) is a rare but clinically significant cause of embolic stroke. Treatment has historically been confined to carotid surgery or best medical therapy, with neither option proved to be superior. However, recent advancements in endovascular interventions have heralded a new age of innovative management strategies for vascular disease. We present three distinct cases of stroke secondary to carotid artery FFT, successfully treated with stent retriever endovascular thrombectomy...
June 20, 2018: Journal of Neurointerventional Surgery
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