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Selective cerebral perfusion

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https://www.readbyqxmd.com/read/28338432/dual-labeling-with-5-aminolevulinic-acid-and-fluorescein-for-fluorescence-guided-resection-of-high-grade-gliomas-technical-note
#1
Eric Suero Molina, Johannes Wölfer, Christian Ewelt, André Ehrhardt, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Fluorescence guidance with 5-aminolevulinic acid (5-ALA) helps improve resections of malignant gliomas. However, one limitation is the low intensity of blue light for background illumination. Fluorescein has recently been reintroduced into neurosurgery, and novel microscope systems are available for visualizing this fluorochrome, which highlights all perfused tissues but has limited selectivity for tumor detection. Here, the authors investigate a combination of both fluorochromes: 5-ALA for distinguishing tumor and fluorescein for providing tissue fluorescence of adjacent brain tissue...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28330412/early-asymmetric-cardio-cerebral-causality-and-outcome-after-severe-traumatic-brain-injury
#2
Lei Gao, Peter Smieleweski, Marek Czosnyka, Ari Ercole
The brain and heart are two vital systems in health and disease, increasingly recognised as a complex, interdependent network with constant information flow in both directions. After severe traumatic brain injury (TBI), the causal, directed interactions between the brain, heart and autonomic nervous system have not been well established. Novel methods are needed to probe unmeasured, potentially prognostic information in complex biological networks that are not revealed via traditional means. In this study, we examined potential bi-directional causality between intracranial pressure (ICP), mean arterial pressure (MAP) and heart rate (HR) and its relationship to mortality in a 24-hour period early after TBI...
March 23, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28314530/objective-analysis-of-midterm-outcomes-of-conventional-and-hybrid-aortic-arch-repair-by-propensity-score-matching
#3
Arudo Hiraoka, Genta Chikazawa, Toshinori Totsugawa, Kentaro Tamura, Atsuhisa Ishida, Taichi Sakaguchi, Hidenori Yoshitaka
OBJECTIVE: The aim of this study is to evaluate the objective outcomes of conventional total aortic arch repair (CTAR) and hybrid arch repair by using propensity-score matching to reduce selection bias. METHODS: Between January 2006 and April 2016, 470 consecutive patients underwent isolated aortic arch repair (excluding hemiarch or partial arch reconstruction, and cases with concomitant cardiac surgeries) at a single cardiovascular institute. We categorized 337 total aortic arch repair with antegrade cerebral perfusion under circulatory arrest as the CTAR group and 58 hybrid aortic arch repair (HAR) with thoracic endovascular aortic repair as the HAR group...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283606/predictive-value-of-rapid-assessed-perfusion-thresholds-on-final-infarct-volume-in-swift-prime-solitaire-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment
#4
Maxim Mokin, Elad I Levy, Jeffrey L Saver, Adnan H Siddiqui, Mayank Goyal, Alain Bonafé, Christophe Cognard, Reza Jahan, Gregory W Albers
BACKGROUND AND PURPOSE: Computed tomography perfusion imaging can estimate the size of the ischemic core, which can be used for the selection of patients for endovascular therapy. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) thresholds chosen to identify ischemic core influence the accuracy of prediction. We aimed to analyze the accuracy of various rCBV and rCBF thresholds for predicting the 27-hour infarct volume using RAPID automated analysis software from the SWIFT PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment) data...
March 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28274817/microvascular-nadph-oxidase-in-health-and-disease
#5
REVIEW
Yao Li, Patrick J Pagano
The systemic and cerebral microcirculation contribute critically to regulation of local and global blood flow and perfusion pressure. Microvascular dysfunction, commonly seen in numerous cardiovascular pathologies, is associated with alterations in the oxidative environment including potentiated production of reactive oxygen species (ROS) and subsequent activation of redox signaling pathways. NADPH oxidases (Nox) are a primary source of ROS in the vascular system and play a central role in cardiovascular health and disease...
March 5, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28255031/progressive-cortical-neuronal-damage-and-extracranial-intracranial-bypass-surgery-in-patients-with-misery-perfusion
#6
H Yamauchi, S Kagawa, Y Kishibe, M Takahashi, T Higashi
BACKGROUND AND PURPOSE: Misery perfusion may cause selective neuronal damage in atherosclerotic ICA or MCA disease. Bypass surgery can improve misery perfusion and may prevent neuronal damage. On the other hand, surgery conveys a risk for neuronal damage. The purpose of this retrospective study was to determine whether progression of cortical neuronal damage in surgically treated patients with misery perfusion is larger than that in surgically treated patients without misery perfusion or medically treated patients with misery perfusion...
March 2, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28222779/magnetic-resonance-imaging-for-cerebral-lesions-during-minimal-invasive-mitral-valve-surgery-study-protocol-for-a-randomized-controlled-trial
#7
Cristina Barbero, Davide Ricci, Erik Cura Stura, Augusto Pellegrini, Giovanni Marchetto, Suad ElQarra, Massimo Boffini, Roberto Passera, Maria Consuelo Valentini, Mauro Rinaldi
BACKGROUND: Recent data have highlighted a higher rate of neurological injuries in minimal invasive mitral valve surgery (MIMVS) compared with the standard sternotomy approach; therefore, the role of specific clamping techniques and perfusion strategies on the occurrence of this complication is a matter of discussion in the medical literature. The purpose of this trial is to prospectively evaluate major, minor and silent neurological events in patients undergoing right mini-thoracotomy mitral valve surgery using retrograde perfusion and an endoaortic clamp or a transthoracic clamp...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28211813/classification-of-depression-cognitive-disorders-and-co-morbid-depression-and-cognitive-disorders-with-perfusion-spect-neuroimaging
#8
Daniel G Amen, Pavitra Krishnamani, Somayeh Meysami, Andrew Newberg, Cyrus A Raji
BACKGROUND: Depression and cognitive disorders (CDs) are two common co-morbid afflictions that commonly present with overlapping symptoms. OBJECTIVE: To evaluate if perfusion neuroimaging with brain SPECT can distinguish persons with depression from those with CDs or both conditions. METHODS: Inclusion criteria were DSM-IV defined depression or CDs (Alzheimer's disease, vascular dementia, dementia not otherwise specified, and amnestic disorders not otherwise specified) including persons with both (total n = 4,541; 847 CDs, 3,269 depression, 425 with both)...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28210542/dynamic-association-between-perfusion-and-white-matter-integrity-across-time-since-injury-in-veterans-with-history-of-tbi
#9
Alexandra L Clark, Katherine J Bangen, Scott F Sorg, Dawn M Schiehser, Nicole D Evangelista, Benjamin McKenna, Thomas T Liu, Lisa Delano-Wood
OBJECTIVE: Cerebral blood flow (CBF) plays a critical role in the maintenance of neuronal integrity, and CBF alterations have been linked to deleterious white matter changes. Although both CBF and white matter microstructural alterations have been observed within the context of traumatic brain injury (TBI), the degree to which these pathological changes relate to one another and whether this association is altered by time since injury have not been examined. The current study therefore sought to clarify associations between resting CBF and white matter microstructure post-TBI...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28183839/mr-imaging-of-individual-perfusion-reorganization-using-superselective-pseudocontinuous-arterial-spin-labeling-in-patients-with-complex-extracranial-steno-occlusive-disease
#10
V Richter, M Helle, M J P van Osch, T Lindner, A S Gersing, P Tsantilas, H-H Eckstein, C Preibisch, C Zimmer
BACKGROUND AND PURPOSE: Patients with multiple stenoses or occlusions of the extracranial arteries require an individualized diagnostic approach. We evaluated the feasibility and clinical utility of a novel MR imaging technique for regional perfusion imaging in this patient group. MATERIALS AND METHODS: Superselective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients (10 women, 70...
February 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28168990/clinical-assessment-of-cerebral-hemodynamics-in-moyamoya-disease-via-multiple-inversion-time-arterial-spin-labeling-and-dynamic-susceptibility-contrast-magnetic-resonance-imaging-a-comparative-study
#11
Peng-Gang Qiao, Cong Han, Zhi-Wei Zuo, Yi-Tuo Wang, Josef Pfeuffer, Lian Duan, Tianyi Qian, Gong-Jie Li
BACKGROUND AND PURPOSE: For Moyamoya disease (MMD) patients, accurate hemodynamic assessment is critical for treatment selection and efficacy assessment. This study aims to investigate the clinical value of mTI-ASL in assessing the cerebral hemodynamics of MMD patients before and after revascularization, relative to DSC-MRI. MATERIALS AND METHODS: Forty-one MMD patients underwent mTI-ASL and DSC-MRI during blood perfusion. Quantitative parameters for the bilateral supply vessels of middle and anterior cerebral arteries, including DSC-TTP, DSC-CBF, ASL-BAT, and ASL-CBF were measured...
February 3, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28143434/combination-of-ivim-dwi-and-3d-asl-for-differentiating-true-progression-from-pseudoprogression-of-glioblastoma-multiforme-after-concurrent-chemoradiotherapy-study-protocol-of-a-prospective-diagnostic-trial
#12
Zhi-Cheng Liu, Lin-Feng Yan, Yu-Chuan Hu, Ying-Zhi Sun, Qiang Tian, Hai-Yan Nan, Ying Yu, Qian Sun, Wen Wang, Guang-Bin Cui
BACKGROUND: Standard therapy for Glioblastoma multiforme (GBM) involves maximal safe tumor resection followed with radiotherapy and concurrent adjuvant temozolomide. About 20 to 30% patients undergoing their first post-radiation MRI show increased contrast enhancement which eventually recovers without any new treatment. This phenomenon is referred to as pseudoprogression. Differentiating tumor progression from pseudoprogression is critical for determining tumor treatment, yet this capacity remains a challenge for conventional magnetic resonance imaging (MRI)...
February 1, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28132587/aortic-arch-reconstruction-deep-and-moderate-hypothermic-circulatory-arrest-with-selective-antegrade-cerebral-perfusion
#13
YanWen Wu, LiQiong Xiao, Ting Yang, Lei Wang, Xin Chen
OBJECTIVE: To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) with selective antegrade cerebral perfusion (SACP) during aortic arch surgery in adult patients and to offer the evidence for the detection of the temperature which provides best brain protection in the subjects who accept aortic arch reconstruction surgery. METHODS: A total of 109 patients undergoing surgery of the aortic arch were divided into the moderate hypothermic circulatory arrest group (Group I) and the deep hypothermic circulatory arrest group (Group II)...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28131431/the-standardized-concept-of-moderate-to-mild-%C3%A2-28%C3%A2-c-systemic-hypothermia-during-selective-antegrade-cerebral-perfusion-for%C3%A2-all-comers-in-aortic-arch-surgery-single-center-experience-in-587-consecutive-patients-over-a-15-year-period
#14
Ali El-Sayed Ahmad, Nestoras Papadopoulos, Petar Risteski, Anton Moritz, Andreas Zierer
BACKGROUND: Whether selective antegrade cerebral perfusion (ACP) during moderate-to-mild systemic hypothermia (≥28°C) is applicable to aortic arch surgery without restrictions including the emergency setting of an acute type A aortic dissection or extensive total arch procedures such as elephant and frozen elephant trunk techniques is an ongoing subject of controversy. METHODS: Between January 2000 and January 2015, 587 consecutive all-comers underwent aortic arch surgery at our institution uniformly applying selective ACP (unilateral: n = 393 [67%]; bilateral: n = 194 [33%]) during moderate-to-mild systemic hypothermia (28...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28122916/novel-approach-for-independent-control-of-brain-hypothermia-and-systemic-normothermia-cerebral-selective-deep-hypothermia-for-refractory-cardiac-arrest
#15
Chih-Hsien Wang, Yu-Ting Lin, Heng-Wen Chou, Yi-Chih Wang, Joey-Jen Hwang, John R Gilbert, Yih-Sharng Chen
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied...
January 25, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28122469/dexmedetomidine-for-refractory-intracranial-hypertension
#16
Kendra J Schomer, Christian M Sebat, Jason Y Adams, Jeremiah J Duby, Kiarash Shahlaie, Erin L Louie
Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28108436/novel-approach-for-independent-control-of-brain-hypothermia-and-systemic-normothermia-cerebral-selective-deep-hypothermia-for-refractory-cardiac-arrest
#17
Chih-Hsien Wang, Yu-Ting Lin, Heng-Wen Chou, Yi-Chih Wang, Joey-Jen Hwang, John R Gilbert, Yih-Sharng Chen
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied...
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28101162/correlation-between-high-perfusion-syndrome-and-stent-restenosis-after-stent-implantation
#18
Yingyi Li, Lingtao Tang, Dong Qi, Chunlei Wang, Suxia Zhang, Pengfei Hu, Yun Wang, Bogang Zhang, Kunxi Zhang
The present study was conducted to determine the correlation between high perfusion syndrome and stent restenosis after cerebral vascular stent implantation. A total of 146 patients diagnosed with cerebral vascular stenosis and stent implantation were selected. A total of 55 cases (37.67%) of cerebral hyperperfusion syndrome patients were diagnosed by xenon-enhanced computer tomography (Xe-CT) examination and clinical symptoms within 3 days after surgery and were chosen as the observation group. A total of 91 cases were selected as the control group...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28095458/sub-clinical-cognitive-decline-and-resting-cerebral-blood-flow-in-middle-aged-men
#19
Otto Mølby Henriksen, Naja Liv Hansen, Merete Osler, Erik Lykke Mortensen, Dorte Merete Hallam, Esben Thade Pedersen, Michael Chappell, Martin Johannes Lauritzen, Egill Rostrup
BACKGROUND: Although dementia is associated with both global and regional cerebral blood flow (CBF) changes, little is known about cerebral perfusion in the early pre-clinical stages of cognitive decline preceding overt cognitive dysfunction. The aim of this study was to investigate the association of early sub-clinical cognitive decline with CBF. MATERIALS AND METHODS: The study participants were recruited from a cohort of Danish men born in 1953. Based on a regression model we selected men who performed better (Group A, n = 94) and poorer (Group B, n = 95) on cognitive testing at age 57 than expected from testing at age 20...
2017: PloS One
https://www.readbyqxmd.com/read/28048545/we-de-207a-04-advances-in-radiological-neuro-endovascular-interventional-imaging
#20
S Rudin
1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA...
June 2016: Medical Physics
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