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Selective cerebral perfusion

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https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#1
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28414895/the-impact-of-ct-perfusion-threshold-on-predicted-viable-and-nonviable-tissue-volumes-in-acute-ischemic-stroke
#2
Xuya Huang, Dheeraj Kalladka, Bharath Kumar Cheripelli, Fiona Catherine Moreton, Keith W Muir
BACKGROUND AND PURPOSE: Perfusion imaging is used for patient selection in clinical practice and trials. Postprocessing and definitions of tissue viability are nevertheless not standardized. We compared the lesion volumes generated with two well-recognized perfusion tissue definitions in a single-center phase 2 thrombolysis study. METHODS: We analyzed perfusion imaging data from the Alteplase-Tenecteplase Trial Evaluation for Stroke Thrombolysis (ATTEST) study using two popular tissue viability thresholds (ischemic core definition: (1) cerebral blood volume < 2...
April 17, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#3
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28393738/surgical-management-of-postoperative-ductal-aneurysm-a-case-report
#4
Alaae Boutayeb, Loubna Mahfoudi, Said Moughil
We report the case of 24-year-old woman who presented with ductal aneurysm 7 years after a triple ligation of a patent ductus arteriosus. She underwent successful repair through median sternotomy and under moderate hypothermic circulatory arrest and selective cerebral perfusion.
April 10, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28389614/computed-tomographic-perfusion-selection-and-clinical-outcomes-after-endovascular-therapy-in-large-vessel-occlusion-stroke
#5
Mehdi Bouslama, Diogo C Haussen, Jonathan A Grossberg, Seena Dehkharghani, Meredith T Bowen, Leticia C Rebello, Nicolas A Bianchi, Michael R Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Different imaging paradigms have been used to select patients for endovascular therapy in stroke. We sought to determine whether computed tomographic perfusion (CTP) selection improves endovascular therapy outcomes compared with noncontrast computed tomography alone. METHODS: Review of a prospectively collected registry of anterior circulation stroke patients undergoing stent-retriever thrombectomy at a tertiary care center between September 2010 and March 2016...
April 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28377923/dynamic-susceptibility-contrast-magnetic-resonance-imaging-protocol-of-the-normal-canine-brain
#6
Krystina L Stadler, Anthony P Pease, Elizabeth A Ballegeer
Perfusion magnetic resonance imaging (MRI), specifically dynamic susceptibility MRI (DSC-MRI) is routinely performed as a supplement to conventional MRI in human medicine for patients with intracranial neoplasia and cerebrovascular events. There is minimal data on the use of DSC-MRI in veterinary patients and a DSC-MRI protocol in the veterinary patient has not been described. Sixteen normal dogs, 6 years or older were recruited for this study. The sample population included 11 large dogs (>11 kg) and 5 small dogs (<11 kg)...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28359507/a-novel-arterial-cannulation-technique-for-selective-regional-cerebral-perfusion
#7
Hyungtae Kim, Si Chan Sung, Kwang Ho Choi
A selective regional cerebral perfusion has been widely adopted for brain protection in neonatal or infant aortic arch surgeries. The anastomosis of the small polytetrafluoroethylene tube graft to the innominate artery has been used for the selective regional cerebral perfusion in many institutions. We have developed a specially designed cannula tip that allows bidirectional blood flow and provides secure positioning of the polytetrafluoroethylene tube graft at the innominate artery. Innominate artery cannulation using this device reduces arterial clamping time and permits us to perform the arterial cannulation in a much easier and secure manner...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28355763/-late-reoperations-after-repaired-stanford-type-a-aortic-dissection
#8
F H Huang, L P Li, C H Su, W Qin, M Xu, L M Wang, Y S Jiang, Z B Qiu, L Q Xiao, C Zhang, H W Shi, X Chen
Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28355758/-progress-and-challenge-of-stanford-type-a-aortic-dissection-in-china
#9
L Z Sun, J R Li
In recent 20 years, the rapid development of acute Stanford type A aortic dissection in China has been mainly due to three aspects: (1) the refined classification of aortic dissection based on Stanford classification, (2) right axillary artery canal and selective cerebral perfusion technology become basic cardiopulmonary bypass strategy for Stanford type A aortic dissection, and (3) total aortic arch replacement and descending aortic stent graft surgery (Sun's surgery) become the standard treatment of Stanford type A aortic dissection...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28344178/systemic-and-cerebral-concentration-of-nimodipine-during-established-and-experimental-vasospasm-treatment
#10
Walid Albanna, Miriam Weiss, Catharina Conzen, Hans Clusmann, Toni Schneider, Martin Reinsch, Marguerite Müller, Martin Wiesmann, Anke Höllig, Gerrit Alexander Schubert
BACKGROUND: Oral nimodipine is an established prophylactic agent for cerebral vasospasm after subarachnoid hemorrhage (SAH). In highly selected cases, intraarterial or intravenous application of nimodipine may be considered; optimum dosage and modality of application, however, remain a matter of debate. Analysis of nimodipine concentration in serum, CSF and cerebral microdialysate in context of currently effective dose and route of application (oral, IA, IV) is the purpose of this investigation...
March 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28338432/dual-labeling-with-5-aminolevulinic-acid-and-fluorescein-for-fluorescence-guided-resection-of-high-grade-gliomas-technical-note
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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