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Carotid thrombus

Bruno Bartolini, Francesco Puccinelli, Pascal J Mosimann, Steven D Hajdu, Louis Veunac, Patrik Michel, Guillaume Saliou
INTRODUCTION: A new generation of carotid artery stents that use a dual micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. We aimed to analyze the effectiveness and safety of the new Casper-RX stent in patients experiencing acute ischemic stroke with large vessel intracranial occlusion associated with a tandem lesion (another carotid occlusion or severe stenosis). METHODS: We retrospectively analyzed all consecutive patients treated with carotid Casper-RX stents from our stroke registry...
December 4, 2018: Journal of Neurointerventional Surgery
Christoph Reinhardt
The mutualistic gut microbiota does not only impact the development and function of various immune cell types, but it also influences the function of the hepatic vascular endothelium and prothrombotic platelet function. With germ-free mouse models, we have demonstrated that gut-derived microbial-associated molecular patterns could stimulate hepatic von Willebrand factor (VWF) synthesis and plasmatic VWF levels through Toll-like receptor-2 (TLR2), thus defining the extent of platelet deposition to the subendothelial matrix of the ligation-injured common carotid artery...
November 20, 2018: Hämostaseologie
Xiaopeng Tang, Mengrou Chen, Zilei Duan, James Mwangi, Pengpeng Li, Ren Lai
Antistasin, first identified as a potent inhibitor of the blood coagulation factor Xa, is a novel family of serine protease inhibitors. In this study, we purified a novel antistasin-type inhibitor from leech Poecilobdella manillensis called poecistasin. Amino acid sequencing of this 48-amino-acid protein revealed that poecistasin was an antistasin-type inhibitor known to consist of only one domain. Poecistasin inhibited factor XIIa, kallikrein, trypsin, and elastase, but had no inhibitory effect on factor Xa and thrombin...
October 26, 2018: Toxins
Qing-Fang Chen, Yu-Ying Liu, Chun-Shui Pan, Jing-Yu Fan, Li Yan, Bai-He Hu, Xin Chang, Quan Li, Jing-Yan Han
Background and Purpose- tPA (tissue-type plasminogen activator) is the only recommended intravenous thrombolytic agent for ischemic stroke. However, its application is limited because of increased risk of hemorrhagic transformation beyond the time window. T541 is a Chinese compound medicine with potential to attenuate ischemia and reperfusion injury. This study was to explore whether T541-benefited subjects underwent tPA thrombolysis extending the time window. Methods- Male C57BL/6 N mice were subjected to carotid artery thrombosis by stimulation with 10% FeCl3 followed by 10 mg/kg tPA with/without 20 mg/kg T541 intervention at 4...
September 2018: Stroke; a Journal of Cerebral Circulation
Pierre-Alexandre Laurent, Béatrice Hechler, Romain Solinhac, Ashraf Ragab, Cendrine Cabou, Typhaine Anquetil, Sonia Severin, Cécile V Denis, Pierre H Mangin, Bart Vanhaesebroeck, Bernard Payrastre, Marie-Pierre Gratacap
Objective- PI3Kα (phosphoinositide 3-kinase alpha) is a therapeutic target in oncology, but its role in platelets and thrombosis remains ill characterized. In this study, we have analyzed the role of PI3Kα in vitro, ex vivo, and in vivo in 2 models of arterial thrombosis. Approach and Results- Using mice selectively deficient in p110α in the megakaryocyte lineage and isoform-selective inhibitors, we confirm that PI3Kα is not mandatory but participates to thrombus growth over a collagen matrix at arterial shear rate...
September 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Yoshiyuki Morishima, Yuko Honda, Chikako Kamisato
BACKGROUND/AIMS: Stent thrombosis is a serious complication after percutaneous coronary intervention and femoropopliteal endovascular intervention. The aim of this study was to determine the antithrombotic effects of a direct factor Xa inhibitor edoxaban alone or in combination with antiplatelet agents in a rat model of stent thrombosis. METHODS: Stainless steel stents (4 stents per rat) were placed in an extracorporeal arteriovenous shunt. The shunt was inserted into the carotid artery and the jugular vein in each rat to circulate blood...
October 19, 2018: Pharmacology
Atsushi Masuyama, Tomoya Mita, Kosuke Azuma, Yusuke Osonoi, Kenichi Nakajima, Hiromasa Goto, Yuya Nishida, Takeshi Miyatsuka, Masako Mitsumata, Hirotaka Watada
Autophagy is considered as an evolutionarily conserved cellular catabolic process. Defective autophagy has been implicated in various human diseases, including cardiovascular diseases. Recently, we and others demonstrated that defective autophagy in vascular smooth muscle cells (SMCs) promotes the progression of atherosclerosis. In this study, we investigated the role of autophagy in SMCs on plaque instability in vivo. We generated mice with a defect atg7in which is an essential gene for autophagy, in SMCs by crossing Atg7f/f mice with transgelin (Tagln) Cre+/0 mice (Atg7cKO)...
November 10, 2018: Biochemical and Biophysical Research Communications
Marco Heestermans, Amber B Ouweneel, Jasmin Hassan, Meander Kloosterman, Pieter H Reitsma, Marion J J Gijbels, Bart J M van Vlijmen, Miranda van Eck
Silencing of anticoagulant protein C using RNA interference (siProc) evokes low incident but spontaneous atherothrombosis in the aortic root of apolipoprotein E-deficient (Apoe-/- ) mice. The aims of the current study were (1) to analyze if plaque characteristics or circulating factors could be linked to atherothrombosis susceptibility, (2) to increase the incidence of atherothrombosis by transiently increasing blood pressure, and (3) to direct atherothrombosis to an additional predefined vascular site by applying a semi-constrictive collar around the carotid artery...
October 10, 2018: Scientific Reports
Sergio Barros-Gomes, Abdallah El Sabbagh, Mackram F Eleid, Sunil V Mankrad
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, 2, 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...
December 1, 2018: Echo Research and Practice
Carola Marie Wieker, Katharina Harcos, Ulrich Ronellenfitsch, Serdar Demirel, Hans Bruijnen, Dittmar Böckler
OBJECTIVE: The objective of this study was to analyze the impact of completion digital subtraction angiography (cDSA) after carotid endarterectomy (CEA) on technical and early clinical results. METHODS: This retrospective study included consecutive patients undergoing CEA from January 2011 to January 2015. Routine cDSA was performed in all patients. Study end points were the incidence of pathologic findings on completion angiography necessitating intraoperative revision, type of revision, periprocedural stroke rate, mortality, morbidity, and recurrent stenosis rate during follow-up (median, 5 months; range, 0-39 months)...
October 3, 2018: Journal of Vascular Surgery
Ya-Hui Ge, Yan-Yan Chen, Gui-Sheng Zhou, Xin Liu, Yu-Ping Tang, Rui Liu, Pei Liu, Na Li, Jie Yang, Jing Wang, Shi-Jun Yue, Huiping Zhou, Jin-Ao Duan
Sipunculus nudus , an old marine species, has great potential for use as functional seafood due to its various bioactivities. Its potential antithrombotic activity pushed us to isolate the bio-active components bio-guided by tracking fibrinolytic activity. As a result, a novel protease named as SK (the kinase obtained from S. nudus ) was obtained, which possessed a molecular weight of 28,003.67 Da and 15 N-terminal amino acid sequences of PFPVPDPFVWDTSFQ. SK exerted inhibitory effects on thrombus formation through improving the coagulation system with dose-effect relationship within a certain range...
October 4, 2018: International Journal of Molecular Sciences
Jaeho Do, Jungwon Gwak, Jung Jin Rho, Kwangseung Lee, Muhammad Irfan, Man Hee Rhee, Dong Chung Kim
The inhibitory effects of taegeuk ginseng extract (TGE) on platelet aggregation and thrombus formation were investigated. The TGE significantly inhibited collagen- and adenosine 5'-diphosphate (ADP)-induced platelet aggregation in vitro in a dose-dependent manner. Also oral administration of TGE to rats significantly prevented ADP- and collagen-induced platelet aggregation ex vivo, but it did not affect the plasma coagulation system. The oral administration of TGE significantly delayed the occlusion of the carotid artery in ferrous chloride-treated rats in vivo...
September 29, 2018: Journal of Medicinal Food
Christoph Reinhardt
There is emerging evidence for the participation of toll-like receptor-2 (TLR2) expressed on platelets and endothelial cells in the setting of arterial thrombosis. In isolated human platelets, TLR2/1 activation was demonstrated to induce platelet activation, secretion, aggregation, adhesion to collagen coatings and the formation of platelet-leukocyte conjugates, whereas murine platelets were less sensitive to TLR2/1 stimulation. Also, endothelial cells can be activated by stimulation with TLR2 agonists, resulting in increased expression of adhesion molecules, synthesis of inflammatory mediators and Weibel-Palade body exocytosis...
September 27, 2018: Hämostaseologie
Anastasia Plotkin, Matthew G Bartley, Kathryn E Bowser, Jeniann A Yi, Gregory A Magee
The search for etiology of stroke in a young patient may present a diagnostic challenge. In rare cases, chronic trauma to the carotid artery may be the cause of cerebral thromboembolic events. The hyoid bone lies in close proximity to the carotid artery bifurcation, and anatomic variants have been implicated in carotid compression, stenosis, dissection, and pseudoaneurysm. We report a case of recurrent strokes in a 32 year-old woman due to an elongated hyoid bone causing thrombus formation in her right internal carotid artery (ICA) resulting in recurrent embolic strokes confirmed on diffusion-weighted magnetic resonance imaging (MRI)...
September 12, 2018: Annals of Vascular Surgery
Jie Liao, Xiaoting Ren, Bowen Yang, Hou Li, Yuexin Zhang, Zongning Yin
Lumbrokinase (LK) has strong fibrinolytic and thrombolytic activities, but it has a short half-life, can be easily inactivated, and may cause hemorrhage as a side effect. This study develops a potential thrombolytic therapy by fabricating N,N,N-Trimethyl Chitosan (TMC) nanoparticles modified with the cyclic Arg-Gly-Asp-Phe-Lys peptide (c-RGD) and loaded with LK (i.e. c-RGD-LK-NPs). The binding of c-RGD to platelet membrane GPIIb/IIIa receptors is expected to enable targeted delivery of the c-RGD-conjugated TMC to the thrombus...
October 8, 2018: Drug Development and Industrial Pharmacy
Xiaomiao Qiu, Weiting Wang, Zhuanyou Zhao, Shuangyong Sun, Lida Tang
Zifaxaban is an orally active, direct Factor Xa (FXa) inhibitor that is in development for the prevention and treatment of arterial and venous thrombosis. This study was conducted to investigate the biochemical and pharmacological activity of zifaxaban. In vitro activity was evaluated by enzyme, platelet aggregation, and clotting assays. In vivo effects were examined in venous thrombosis, arteriovenous-shunt thrombosis, carotid thrombosis, and bleeding models in rats. Zifaxaban competitively inhibits human FXa (IC50 = 11...
October 5, 2018: European Journal of Pharmacology
George M DeKornfeld, Julia Boll, Kenneth R Ziegler, Jonathan Ratcliff, Thomas C Naslund, C Louis Garrard, R James Valentine, John A Curci
An embolic event originating from thrombus on an otherwise un-diseased or minimally diseased proximal artery (Phantom Thrombus) is a rare but significant clinical challenge. All patients from a single center with an imaging defined luminal thrombus with a focal mural attachment site on an artery were evaluated retrospectively. We excluded all patients with underlying anatomic abnormalities of the vessel at the attachment site. Six patients with a mean age of 62.5 years were identified over a 2.5-year period...
August 19, 2018: Vascular Medicine
Kevin Carr, Dustin Tew, Luis Becerra, Kristina Siddall, Laurence Dubensky, Yafell Serulle
Free-floating thrombi of the common carotid artery (CCA) are a very rare cause of ischemic stroke. To date, only a few reports have been described in the academic literature. Revascularization is indicated due to the risk of thromboembolic disease and hemodynamic-related stroke syndromes. Medical treatment typically includes anticoagulation and, in some circumstances, open surgical thrombectomy is an additional option. Although rarely described in the literature, endovascular thrombectomy is a viable treatment alternative in these patients...
October 2018: Neuroradiology
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
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