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Selective cerebral perfusion

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https://www.readbyqxmd.com/read/28790269/-brain-protection-for-shaggy-aorta-during-aortic-arch-surgery
#1
Kenji Okada
Although short and long-term outcomes of aortic surgeries have been improving over the past decade, the procedure is likely to be asscociated with life-threatening complications such as neurological deficits caused by suboptimal brain protection or heavily diseased aorta. Contemporary strategies for brain protection are deep hypothermic arrest with or without retrograde cerebral perfusion retrograde cerebral perfusion or selective antegrade cerebral perfusion. At the moment, majority of evidences failed to show the superiority of selective antegrade cerebral perfusion to retrograde one...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28780765/is-more-than-one-hour-of-selective-antegrade-cerebral-perfusion-in-moderate-to-mild-systemic-hypothermic-circulatory-arrest-for-surgery-of-acute-type-a-aortic-dissection-safe
#2
Ali El-Sayed Ahmad, Nestoras Papadopoulos, Petar Risteski, Theresa Hack, Mahmut Ay, Anton Moritz, Andreas Zierer
No abstract text is available yet for this article.
August 6, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28760465/elective-aortic-arch-repair-factors-influencing-neurologic-outcome-in-791-patients
#3
Mariano Cefarelli, Giacomo Murana, Giuseppina G Surace, Sebastiano Castrovinci, Giuliano Jafrancesco, Johannes Christiaan Kelder, Patrick Klein, Uday Sonker, Wim J Morshuis, Robin H Heijmen
BACKGROUND: The aim of this study was to determine perioperative factors influencing neurologic outcome in a single-center cohort of patients undergoing elective aortic arch operations. METHODS: From January 2005 to June 2015, 791 consecutive patients received open aortic arch operations with either antegrade selective cerebral perfusion (ASCP) (636 patients [80.4%]) or deep hypothermic circulatory arrest (DHCA) (155 patients [19.6%]). Main indications were degenerative aneurysm (85%) and chronic postdissection aneurysm (9...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28750494/brain-pet-and-functional-mri-why-simultaneously-using-hybrid-pet-mr-systems
#4
Diego Cecchin, Alessandro Palombit, Marco Castellaro, Erica Silvestri, Franco Bui, Henryk Barthel, Osama Sabri, Maurizio Corbetta, Alessandra Bertoldo
INTRODUCTION: In the last 20 years growing attention has been devoted to multimodal imaging. The recent literature is rich of clinical and research studies that have been performed using different imaging modalities on both separate and integrated Positron Emission Tomography (PET) and Magnetic Resonance (MR) scanners. However, today, hybrid PET/MR systems measure signals related to brain structure, metabolism, neurochemistry, perfusion, and neuronal activity simultaneously, i.e. in the same physiological conditions...
July 27, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28744673/utilization-of-mr-angiography-in-perfusion-imaging-for-identifying-arterial-input-function
#5
Bora Buyuksarac, Mehmed Ozkan
OBJECTIVE: This research utilizes magnetic resonance angiography (MRA) to identify arterial locations during the parametric evaluation of concentration time curves (CTCs), and to prevent shape distortions in arterial input function (AIF). MATERIALS AND METHODS: We carried out cluster analysis with the CTC parameters of voxels located within and around the middle cerebral artery (MCA). Through MRA, we located voxels that meet the AIF criteria and those with distorted CTCs...
July 25, 2017: Magma
https://www.readbyqxmd.com/read/28730951/penumbra-and-re-canalization-acute-computed-tomography-in-ischemic-stroke-evaluation-practise-study-protocol
#6
Salwa El-Tawil, Joanna Wardlaw, Ian Ford, Grant Mair, Tom Robinson, Lalit Kalra, Keith W Muir
Rationale Multimodal imaging, including computed tomography angiography and computed tomography perfusion imaging, yields additional information on intracranial vessels and brain perfusion and can differentiate between ischemic core and penumbra which may affect patient selection for intravenous thrombolysis. Hypothesis The use of multimodal imaging will increase the number of patients receiving intravenous thrombolysis and lead to better treatment outcomes. Sample size 400 patients. Methods and design PRACTISE is a prospective, multicenter, randomized, controlled trial in which patients presenting within 4...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28718260/cerebral-oximetry-use-for-cardiac-surgery
#7
Syed Shahmeer Raza, Farhan Ullah, Chandni, Edward Bruce Savage
BACKGROUND: Studies have shown maintaining good cerebral perfusion during Cardiac Surgeries is very important in terms of patient outcomes and reducing the hospital stay, which may have its financial and clinical implications. The aim of this review study was to determine the effectiveness of Cerebral Oximetry (Transcranial Near-Infrared Spectroscopy-NIRS to monitor cerebral oxygenation) for Cardiac Surgery and to propose a possible concluding remark about its potential applications, overall clinical value and whether to keep using it or not...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28709662/neonatal-aortic-arch-reconstruction-with-direct-splanchnic-perfusion-avoids-deep-hypothermia
#8
Muhammad Aanish Raees, Clinton D Morgan, Venessa L Pinto, Ashly C Westrick, Chevis N Shannon, Karla G Christian, Bret A Mettler, David P Bichell
BACKGROUND: Neonatal aortic arch reconstruction, typically performed with deep hypothermia and selective cerebral perfusion, leaves splanchnic organ protection dependent on hypothermia alone. A simplified method of direct in-field descending aortic perfusion during neonatal arch reconstruction permits the avoidance of deep hypothermia. We hypothesize that direct splanchnic perfusion at mild hypothermia provides improved or equivalent safety compared with deep hypothermia and may contribute to postoperative extracardiac organ recovery...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28672909/feasibility-of-dual-low-scheme-combined-with-iterative-reconstruction-technique-in-acute-cerebral-infarction-volume-ct-whole-brain-perfusion-imaging
#9
Tao Wang, Yi Gong, Yibing Shi, Rong Hua, Qingshan Zhang
The feasibility of application of low-concentration contrast agent and low tube voltage combined with iterative reconstruction in whole brain computed tomography perfusion (CTP) imaging of patients with acute cerebral infarction was investigated. Fifty-nine patients who underwent whole brain CTP examination and diagnosed with acute cerebral infarction from September 2014 to March 2016 were selected. Patients were randomly divided into groups A and B. There were 28 cases in group A [tube voltage, 100 kV; contrast agent, iohexol (350 mg I/ml), reconstructed by filtered back projection] and 31 cases in group B [tube voltage, 80 kV; contrast agent, iodixanol (270 mg I/ml), reconstructed by algebraic reconstruction technique]...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28671863/rethinking-the-paradigm-modern-approach-to-proximal-aortic-reconstruction-demonstrates-excellent-outcomes
#10
Jonathan M Hemli, Edward R R DeLaney, Kush R Dholakia, Dror Perk, Nirav C Patel, S Jacob Scheinerman, Derek R Brinster
BACKGROUND: Techniques for aortic surgery continue to evolve. A real-world snapshot of patients undergoing elective surgery for aneurysm in the modern era is helpful to assist in deciding the appropriate timing for intervention. We herein describe our experience with 100 consecutive patients who underwent primary elective surgery for aneurysm of the proximal thoracic aorta over a two-year period at a single institution. METHODS: The majority of our patients were male, mean age 61...
June 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671861/the-transcranial-doppler-sonography-for-optimal-monitoring-and-optimization-of-cerebral-perfusion-in-aortic-arch-surgery-a-case-series
#11
Tamer Ghazy, Ayham Darwisch, Torsten Schmidt, Phong Nguyen, Zuzana Fajfrova, Klaus Matschke, Utz Kappert
OBJECTIVE: To analyze the feasibility and advantages of transcranial doppler sonography (TCD) for monitoring and optimization of selective cerebral perfusion (SCP) in aortic arch surgery. METHODS: From April 2013 to April 2014, nine patients with extensive aortic pathology underwent surgery under moderate hypothermic cardiac arrest with unilateral antegrade SCP under TCD monitoring in our institution. Adequate sonographic window and visualization of circle of Willis were to be confirmed...
June 16, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28648533/recurrent-laryngeal-nerve-injury-and-swallowing-dysfunction-in-neonatal-aortic-arch-repair
#12
Kamal K Pourmoghadam, William M DeCampli, Mark Ruzmetov, James Kosko, Sami Kishawi, Michael O'Brien, Amanda Cowden, Kurt Piggott, Harun Fakioglu
BACKGROUND: We evaluated the incidence, clinical effect, and recovery rate of vocal cord dysfunction (VCD) and swallowing dysfunction in neonates undergoing aortic arch repair. METHODS: We retrospectively evaluated 101 neonates who underwent aortic arch reconstruction from 2008 to 2015. Direct flexible laryngoscopy was performed in 89 patients before initiation of postoperative oral feeding after Norwood (n = 63) and non-Norwood (n = 26) arch reconstruction. We defined VCD as immobility of vocal cords or their lack of coaptation and poor mobility...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#13
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#14
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28624894/suppression-of-tlr4-nf-%C3%AE%C2%BAb-signaling-pathway-improves-cerebral-ischemia-reperfusion-injury-in-rats
#15
Hang Zhao, Zhuo Chen, Li-Juan Xie, Gui-Feng Liu
The present study aimed to investigate the effects of the toll-like receptor 4 (TLR4)/nuclear factor-kappaB (NF-ҡB) signaling pathway in cerebral ischemia-reperfusion injury. A total of 125 male Sprague Dawley (SD) rats were selected for this study. Fifty SD rats were randomly divided into the control, sham injury, 0.5 h perfusion, 2 h perfusion, and 6 h perfusion groups to establish the model of ischemia-reperfusion. The rat brain injury model was established using the other 75 male SD rats, and different model groups with different treatments were established (15 rats per group): model control group (injected with 10 μL of saline solution), model + TAK-242 group (injected with resatorvid), model + PDTC group (injected with pyrrolidine dithiocarbamate), model + LPS group (injected with lipopolysaccharide), and sham injury group (incision to the neck skin and injected with 10 μL of saline solution for normal rats)...
June 17, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28616347/intraoperative-care-for-aortic-surgery-using-circulatory-arrest
#16
REVIEW
Félix Ezequiel Fernández Suárez, David Fernández Del Valle, Adrián González Alvarez, Blanca Pérez-Lozano
The total circulatory arrest (CA) is necessary to achieve optimal surgical conditions in certain aortic pathologies, especially in those affecting the ascending aorta and aortic arch. During this procedure it is necessary to protect all the organs of ischemia, especially those of the central nervous system and for this purpose several strategies have been developed. The first and most important protective method is systemic hypothermia. The degree of hypothermia and the route of application have been evolving and currently tend to use moderate hypothermia (MH) (20...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#17
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). Recently, however, the use of external ventricular drains (EVDs) and ICP monitors in TBI has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multi-modality monitoring system, we continuously monitored PbtO2 and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe TBI...
August 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28611933/monochorionic-triamniotic-triplet-pregnancy-complicated-by-twin-reversed-arterial-perfusion-sequence-case-report-and-literature-review
#18
Pingshan Pan, Guoyang Luo, Lu Tang, Jeanne D Rolle, Yuqin Qin, Quan Zeng, Jiangting Wei, Yuanfang Chen, Hongwei Wei
Background  Monochorionic-triamniotic pregnancies are rare and fraught with complications. Case  A case of monochorionic-triamniotic triplet pregnancy complicated by twin reversed arterial perfusion (TRAP) sequence is presented. The patient declined termination or selective fetal reduction. Triplet C was acardiac. At 24 weeks, triplet B developed polyhydramnios. At 30 weeks, polyhydramnios was seen in all three amniotic sacs, but without signs of fetal hydrops and with normal Doppler velocimetry measurements in the umbilical artery, middle cerebral artery, and ductus arteriosus of triplets A and B...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28598243/advances-in-arterial-spin-labelling-mri-methods-for-measuring-perfusion-and-collateral-flow
#19
Matthias Jp van Osch, Wouter M Teeuwisse, Zhensen Chen, Yuriko Suzuki, Michael Helle, Sophie Schmid
With the publication in 2015 of the consensus statement by the perfusion study group of the International Society for Magnetic Resonance in Medicine (ISMRM) and the EU-COST action 'ASL in dementia' on the implementation of arterial spin labelling MRI (ASL) in a clinical setting, the development of ASL can be considered to have become mature and ready for clinical prime-time. In this review article new developments and remaining issues will be discussed, especially focusing on quantification of ASL as well as on new technological developments of ASL for perfusion imaging and flow territory mapping...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28587332/three-dimensional-arterial-spin-labeling-imaging-and-dynamic-susceptibility-contrast-perfusion-weighted-imaging-value-in-diagnosing-glioma-grade-prior-to-surgery
#20
Hong Ma, Zizheng Wang, Kai Xu, Zefeng Shao, Chun Yang, Peng Xu, Xiaohua Liu, Chunfeng Hu, Xin Lu, Yutao Rong
The current study aimed to investigate whole-brain three-dimensional arterial spin labeling imaging (3D ASL) and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI), in regards to their diagnostic value of preoperative glioma grade. The parameter values obtained after correction will be correlated with the diagnostic value of 3D ASL and DSC-PWI perfusion. In the current study, 50 patients with gliomas confirmed by pathology were used, including 27 low-grade gliomas (LGGs) and 23 high-grade gliomas (HGGs)...
June 2017: Experimental and Therapeutic Medicine
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