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Spinal cord ischaemia

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https://www.readbyqxmd.com/read/28040765/classification-and-outcomes-of-extended-arch-repair-for-acute-type-a-aortic-dissection-a-systematic-review-and-meta-analysis
#1
REVIEW
Holly N Smith, Munir Boodhwani, Maral Ouzounian, Richard Saczkowski, Alexander J Gregory, Eric J Herget, Jehangir J Appoo
OBJECTIVES: Distal extent of repair in patients undergoing surgery for acute Type A aortic dissection (ATAAD) is controversial. Emerging hybrid techniques involving open and endovascular surgery have been reported in small numbers by select individual centres. A systematic review and meta-analysis was performed to investigate the outcomes following extended arch repair for ATAAD. A classification system is proposed of the different techniques to facilitate discussion and further investigation...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27995263/outpatient-management-of-transient-ischaemic-attack
#2
Victor Weng Keong Loh, Derek Tuck Loong Soon, Leonard Leong Litt Yeo
Stroke is a significant cause of death and disability in Singapore; in 2014, it was the fourth most common cause of death. Transient ischaemic attack (TIA) is defined as a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without evidence of acute infarction. The diagnosis of TIA/acute stroke needs to be considered in all patients who present with sudden focal neurological dysfunction. Prompt referral for assessment, neuroimaging and intervention provides the best chance for neurological recovery and/or minimising further neurological damage...
December 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27957787/macrophage-polarization-a-key-event-in-the-secondary-phase-of-acute-spinal-cord-injury
#3
Xiangyi Kong, Jun Gao
Acute spinal cord injury (SCI) has become epidemic in modern society. Despite advances made in the understanding of the pathogenesis and improvements in early recognition and treatment, it remains a devastating event, often producing severe and permanent disability. SCI has two phases: acute and secondary. Although the acute phase is marked by severe local and systemic events such as tissue contusion, ischaemia, haemorrhage and vascular damage, the outcome of SCI are mainly influenced by the secondary phase...
December 13, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27735984/life-satisfaction-in-patients-with-and-without-spinal-cord-ischemia-after-advanced-endovascular-therapy-for-extensive-aortic-disease-at-mid-term-follow-up
#4
Irma Mehmedagic, Stefan Santén, Sophie Jörgensen, Stefan Acosta
OBJECTIVE: Advanced endovascular aortic repair can be used to treat patients with extensive and complex aortic disease who are at risk of spinal cord ischaemia. The aim of this study was to compare whether life satisfaction differs between patients with and without spinal cord ischaemia at mid-term follow-up. DESIGN: Nested case-control study. PATIENTS: Among patients undergoing advanced endovascular aortic repair between 2009 and 2012, 18 patients with spinal cord ischaemia and 33 without were interviewed at home...
November 11, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27443830/spinal-cord-ischaemia-after-complex-aortic-procedures
#5
EDITORIAL
M J H M Jacobs, G W H Schurink, B M E Mees
No abstract text is available yet for this article.
September 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27354467/repair-of-adult-aortic-coarctation-by-resection-and-interposition-grafting
#6
Afram Yousif, Geoffrey Kloppenburg, Wim J Morshuis, Robin Heijmen
OBJECTIVES: Aortic coarctation presenting during adult life most frequently represents cases of re-coarctation, following previous transcatheter or surgical therapy, or missed cases of native coarctation. In the area of evolving endovascular therapy, we believe that there is still a place for durable open repair by means of resection and interposition grafting. We, therefore, evaluated our results in adult patients with primary aortic coarctation or complications of a previous coarctation repair...
October 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27307484/spinal-cord-ischaemia-after-radical-pleurectomy-decortication-operation-for-mesothelioma
#7
Erkan Kaba, Mehmet Oğuzhan Özyurtkan, Levent Onat, Kemal Ayalp
Radical pleurectomy/decortication was performed in a patient with malignant pleural mesothelioma. During the surgery, the left subclavian artery was injured, and repaired via resection and anastomosis. However, the patient was diagnosed with paraplegia following extubation. After deliberate investigations, the mechanism of injury to the critical vascular zone of the spinal cord was determined. Here, we aim to draw attention to possible similar injuries.
December 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27229666/total-aortic-arch-repair-risk-factor-analysis-and-follow-up-in-199-patients
#8
Andreas Martens, Erik Beckmann, Tim Kaufeld, Julia Umminger, Felix Fleissner, Nurbol Koigeldiyev, Heike Krueger, Jakob Puntigam, Axel Haverich, Malakh Shrestha
OBJECTIVES: Aortic arch surgery is associated with substantial perioperative risks. New prostheses as well as novel perfusion techniques have been developed to reduce the risks of these procedures. The routine application of these new techniques warrants reassessment of risk factors of aortic arch repair. METHODS: Between April 2010 and December 2015, 199 patients [61% male, median age 63 years (interquartile range 52-70 years)] underwent total aortic arch repair in our institution...
May 26, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27174550/low-flow-lower-body-perfusion-for-spinal-protection-in-a-frozen-elephant-trunk-simulation-model
#9
Peter Lukas Haldenwang, Lorine Häuser, Nora Prochnow, Damian Ziebura, Andreas Baumann, Magdalena Sikole, Marcus Schlömicher, Inge Schmitz, Hildegard Christ, Justus Thomas Strauch
OBJECTIVES: The frozen elephant trunk (FET) procedure using isolated selective cerebral perfusion (SCP) at moderate hypothermia is associated with an increased risk for spinal cord ischaemia. The aim of this study was to evaluate the benefit of a combined selective cerebral and low-flow lower body perfusion (CLBP) in a porcine model. METHODS: Twenty pigs (46 ± 5 kg) were cooled on cardiopulmonary bypass (CPB) to 28°C. After aortic clamping and occlusion of the thoracic segmental arteries (TSAT4-T13), a pressure-controlled SCP (50 mmHg) was established for 90 min...
May 12, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27161043/glyt1-inhibitor-nfps-exerts-neuroprotection-via-glyr-alpha1-subunit-in-the-rat-model-of-transient-focal-cerebral-ischaemia-and-reperfusion
#10
Baosheng Huang, Qingsong Xie, Xiaocheng Lu, Tengda Qian, Shuai Li, Ronglan Zhu, Wan Yu, Gong Chen, Zheng Chen, Xinlong Xu, Tianlu Wang, Lixin Li
BACKGROUND/AIMS: Glycine is a strychnine-sensitive inhibitory neurotransmitter in the central nervous system (CNS), especially in the spinal cord, brainstem, and retina. The objective of the present study was to investigate the potential neuroprotective effects of GlyT1 inhibitor N [3-(4'-fluorophenyl)-3-(4'-phenylphenoxy) propyl] sarcosine (NFPS) in the rat model of experimental stroke. METHODS: In vivo ischaemia was induced by transient middle cerebral artery occlusion (tMCAO)...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27119426/revascularisation-of-the-left-subclavian-artery-for-thoracic-endovascular-aortic-repair
#11
REVIEW
Shahin Hajibandeh, Shahab Hajibandeh, Stavros A Antoniou, Francesco Torella, George A Antoniou
BACKGROUND: Controversy exists as to whether revascularisation of the left subclavian artery (LSA) confers improved outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Even though preemptive revascularisation of the LSA has theoretical advantages, including a reduced risk of ischaemic damage to vital organs, such as the brain and the spinal cord, it is not without risks. Current practice guidelines recommend routine revascularisation of the LSA in patients undergoing elective TEVAR where achievement of a proximal seal necessitates coverage of the LSA, and in patients who have an anatomy that compromises perfusion to critical organs...
April 27, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26956707/repair-of-complicated-type-b-dissection-with-an-aberrant-right-subclavian-artery
#12
Jun-Ming Zhu, Rui-Dong Qi, Yong-Min Liu, Jun Zheng, Xiao-Yan Xing, Li-Zhong Sun
OBJECTIVES: An aberrant right subclavian artery (ARSA) is one of most common congenital anomalies, but the coexistence of type B dissection and an ARSA is extremely rare. Repair of type B dissection poses a technical challenge due to an ARSA. We retrospectively reviewed our experience of surgical treatment of a complicated type B dissection with an ARSA. METHODS: From August 2010 to March 2014, 7 patients with chronic type B dissection with an ARSA underwent the stented elephant trunk procedure under hypothermic cardiopulmonary bypass in our centre...
June 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/26873043/endovascular-repair-or-open-repair-for-ruptured-abdominal-aortic-aneurysm-a-cochrane-systematic-review
#13
REVIEW
S A Badger, D W Harkin, P H Blair, P K Ellis, F Kee, R Forster
OBJECTIVES: Emergency endovascular aneurysm repair (eEVAR) may improve outcomes for patients with ruptured abdominal aortic aneurysm (RAAA). The study aim was to compare the outcomes for eEVAR with conventional open surgical repair for the treatment of RAAA. SETTING: A systematic review of relevant publications was performed. Randomised controlled trials (RCTs) comparing eEVAR with open surgical repair for RAAA were included. PARTICIPANTS: 3 RCTs were included, with a total of 761 patients with RAAA...
February 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/26798758/temporary-perfusion-branches-to-decrease-spinal-cord-ischemia-in-the-endovascular-treatment-of-thoraco-abdominal-aortic-aneurysms-based-on-a-presentation-at-the-2013-veith-symposium-november-19-23-2013-new-york-ny-usa
#14
Parveen Jayia, Jason Constantinou, Hamish Hamilton, Krassi Ivancev
BACKGROUND: Spinal cord ischemia (SCI) is one of the most feared complications following the repair of thoraco- abdominal aortic aneurysms (TAAA). Endovascular repair of TAAA is now possible with branched stent grafts, but spinal cord ischaemia rates are still unacceptably high. A number of techniques have been utilized to reduce these levels, however, SCI remains a challenge to endovascular repair of TAAA. The use of sac perfusion branches aims to reduce the incidence of this catastrophic complication...
April 2015: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/26743575/cerebral-vasculitis-as-a-major-manifestation-of-rheumatoid-arthritis
#15
A Ozkul, A Yılmaz, A Akyol, N Kiylioglu
OBJECTIVE AND IMPORTANCE: Cerebral vasculitis (CV) is a rare described complication of rheumatoid arthritis (RA). Although the most frequent neurological manifestations of RA are peripheral neuropathy and cervical spinal cord compression due to subluxation of the cervical vertebrae, CV can be seen especially in patients with seropositive and long-standing RA. CLINICAL PRESENTATION: We report two cases of CV associated with RA. Both patients had no extraarticular manifestations and RA clinics were under control...
October 2015: Acta Clinica Belgica
https://www.readbyqxmd.com/read/26682901/total-tau-and-neurofilament-light-in-csf-reflect-spinal-cord-ischaemia-after-endovascular-aortic-repair
#16
Edyta Merisson, Niklas Mattsson, Henrik Zetterberg, Kaj Blennow, Andreas Pikwer, Irma Mehmedagic, Stefan Acosta, Jonas Åkeson
BACKGROUND: Repair of extensive aortic disease may be associated with spinal cord ischaemia (SCI). Here we test if levels of cerebrospinal fluid (CSF) biomarkers for neuronal injury are altered in patients with SCI after advanced endovascular repair in extensive aortic disease. METHODS: CSF was sampled for up to 48 h in ten patients undergoing endovascular aortic repair and analyzed for the axonal damage markers total-tau (T-tau) and neurofilament light (NFL). RESULTS: Six of ten patients developed SCI (clinically present within 3-6 h)...
February 2016: Neurochemistry International
https://www.readbyqxmd.com/read/26445100/ischaemic-concentrations-of-lactate-increase-trek1-channel-activity-by-interacting-with-a-single-histidine-residue-in-the-carboxy-terminal-domain
#17
Swagata Ghatak, Aditi Banerjee, Sujit Kumar Sikdar
The physiological metabolite, lactate and the two-pore domain leak potassium channel, TREK1 are known neuroprotectants against cerebral ischaemia. However, it is not known whether lactate interacts with TREK1 channel to provide neuroprotection. In this study we show that lactate increases TREK1 channel activity and hyperpolarizes CA1 stratum radiatum astrocytes in hippocampal slices. Lactate increases open probability and decreases longer close time of the human (h)TREK1 channel in a concentration dependent manner...
January 1, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/26386546/neuroprotective-strategies-can-prevent-permanent-paraplegia-in-the-majority-of-patients-who-develop-spinal-cord-ischaemia-after-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#18
S H Rossi, A Patel, P Saha, A Gwozdz, R Salter, P Gkoutzios, T Carrell, S Abisi, B Modarai
OBJECTIVES: Spinal cord ischaemia (SCI) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair is a devastating and unpredictable complication. This study describes a single unit's experience of SCI in patients who have had endovascular TAAA repair. METHODS: A prospectively maintained database of patients having endovascular TAAA repair using branched and fenestrated stent grafts between 2008 and 2014 at a single high volume centre was reviewed. Patients who developed neurological symptoms and signs related to SCI were identified and factors associated with onset and recovery of neurology were analysed...
November 2015: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26276838/thoracic-endovascular-repair-first-for-extensive-aortic-disease-the-staged-hybrid-approach%C3%A2
#19
Alessandro Vivacqua, Jay J Idrees, Douglas R Johnston, Edward G Soltesz, Lars G Svensson, Eric E Roselli
OBJECTIVES: Repair of extensive aortic disease carries a significant risk of death and morbidity, the most feared complication being spinal cord ischaemia. Objectives of this study are to characterize patients, describe repair methods and assess feasibility and safety of hybrid staged repair for treatment of extensive aortic disease. METHODS: From to 2001 to 2013, 22 patients underwent extensive aortic repair that included a thoracic endovascular aortic repair (TEVAR) first followed by an open completion repair extending through the visceral and infrarenal aorta for degenerative aneurysm and dissection...
March 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/26146201/a-review-of-the-endovascular-management-of-thoracic-aortic-pathology
#20
David Bell, Levi Bassin, Michael Neale, Peter Brady
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has recently gained popularity, but there is ongoing debate surrounding its safety and efficacy. We present 13 years of TEVAR experience at our institution. METHODS: Data from procedures performed between September 2000 and October 2013 were sourced. Eighty-one TEVARs were performed in 72 patients for various disorders of the thoracic aorta. RESULTS: The mean duration of follow-up was 62 months (range, 2-140 months)...
December 2015: Heart, Lung & Circulation
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