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Embolic stroke

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https://www.readbyqxmd.com/read/29235900/treatment-and-discharge-patterns-among-patients-hospitalized-with-non-valvular-atrial-fibrillation-transitioning-from-the-inpatient-to-outpatient-setting
#1
Henry J Henk, Feng Cao, Kenneth Tuell, Kwanza Price, Prianka Singh, Jack Mardekian, Kevin Odell, Chad Patel, Wilson Tan, George H Sands, Shalabh Singhal, Jeffrey Trocio, Lien Vo
OBJECTIVE: To evaluate inpatient oral anticoagulant (OAC) treatment, discharge location, and post-discharge OAC treatment for patients hospitalized with non-valvular atrial fibrillation (NVAF). RESEARCH DESIGN AND METHODS: Retrospective study using claims data linked to hospital electronic health records (EHR). Patients (N = 2,484) were hospitalized with a primary (38%) or secondary (62%) diagnosis of AF without evidence of mitral valvular heart disease or valve replacement between January 2009 and September 2013...
December 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29225842/how-often-is-patent-foramen-ovale-an-innocent-bystander
#2
Francesco Versaci, Giampiero Vizzari, Domenico Sergi, Giuseppe Andò, Antonio Trivisonno, Francesco Romeo
Patent foramen ovale (PFO) is a risk factor for cryptogenetic stroke; its closure should be considered in selected patients. It is not always clear whether symptoms (presyncope, paresthesia) apparently due to paradoxical embolism are related with other cardiovascular disorders such as arrhythmias. Flecainide administration for post-PFO-closure supraventricular arrhythmias can unmask a latent undiagnosed Brugada syndrome.
December 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29225327/plasma-fibrin-clot-structure-and-thromboembolism-clinical-implications
#3
Michał Ząbczyk, Anetta Undas
Fibrin formed as a result of fibrinogen polymerization is a main protein component of a clot in a test tube and intravascular thrombi in vivo. Fibrin clot structure characterized by fibers diameter and pore size differs between healthy subjects and those with thromboembolic diseases, in part due to the quality and quantity of fibrinogen and the magnitude of thrombin generation. A key measure of plasma clot structure is its permeability, reflected by the Darcy constant, Ks. Reduced Ks is a typical feature of the prothrombotic fibrin clot phenotype, which is associated with faster formation of denser fibrin mesh, relatively resistant to lysis...
December 11, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29225254/observational-study-of-infective-endocarditis-at-a-community-based-hospital-dominance-of-elderly-patients-with-comorbidity
#4
Tomoo Nagai, Yoshiyuki Takase, Akira Hamabe, Hirotsugu Tabata
Objective The purpose of this study was to present the recent clinical profiles and the real-world management of infective endocarditis (IE). Methods All medical records of patients with IE were reviewed retrospectively for their clinical data, including clinical presentation, laboratory results, blood cultures, echocardiographic findings, treatments and complications. Using the clinical data collected, we calculated the EuroSCORE II, the European risk score for adult cardiac surgery, the Charlson Comorbidity Index as a surrogate of comordibity, and the Katz Index as a surrogate of frailty...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29223939/-papillary-fibroelastoma-retrospective-analysis-clinical-presentation-and-surgical-results
#5
Pamela Bobadilla, Carlos Vigliano, Jose H Casabé, Eduardo Guevara, Fabián Salmo, José Abud, Eduardo Dulbecco, Roberto R Favaloro
Papillary ibroelastomas are small benign intracardiac tumors known for their embolic potential. Since the introduction of echocardiography with improved resolution and transesophageal imaging techniques, they are being increasingly detected in clinical practice. In recent series, papillary fibroelastoma is considered the most frequent benign tumor of the heart. Our objective was to analyze characteristics and midterm surgical outcome of histologically-confirmed cases of papillary fibroelastoma. We conducted a retrospective study on patients with cardiac tumors submitted to surgical excision between June 1992 and February 2017...
2017: Medicina
https://www.readbyqxmd.com/read/29223872/relationship-between-thrombus-age-in-aspirated-coronary-material-and-mid-term-major-adverse-cardiac-and-cerebrovascular-events-in-patients-with-acute-myocardial-infarction
#6
Kensaku Nishihira, Yoshisato Shibata, Atsushi Yamashita, Nehiro Kuriyama, Yujiro Asada
BACKGROUND AND AIMS: Recent studies have shown that coronary thrombus histopathology is associated with impaired myocardial reperfusion and poor clinical outcome in patients with acute myocardial infarction (AMI). We sought to investigate the age of thrombi aspirated during percutaneous coronary intervention (PCI) in patients with AMI and evaluate the relationship between histopathologic findings and major adverse cardiac and cerebrovascular events (MACCEs) defined as all-cause death, stroke, or myocardial infarction within 6 months of PCI...
December 5, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29223441/edoxaban-for-the-management-of-elderly-japanese-patients-with-atrial-fibrillation-ineligible-for-standard-oral-anticoagulant-therapies-rationale-and-design-of-the-eldercare-af-study
#7
Ken Okumura, Gregory Y H Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita
Edoxaban-a non-vitamin K antagonist oral anticoagulant (NOAC)- 60-mg and 30-mg once-daily dose regimens are noninferior versus well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF patients, especially those considered ineligible for available oral anticoagulants. The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) study is a phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study that will compare the safety and efficacy of once-daily edoxaban 15 mg versus placebo in Japanese patients with NVAF ≥80 years of age who are considered ineligible for standard oral anticoagulant therapy...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222393/protect-proximal-balloon-occlusion-together-with-direct-thrombus-aspiration-during-stent-retriever-thrombectomy-evaluation-of-a-double-embolic-protection-approach-in-endovascular-stroke-treatment
#8
Christian Maegerlein, Sebastian Moench, Tobias Boeckh-Behrens, Manuel Lehm, Dennis M Hedderich, Maria Teresa Berndt, Silke Wunderlich, Claus Zimmer, Johannes Kaesmacher, Benjamin Friedrich
PURPOSE: Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique...
December 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#9
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221142/d-4f-increases-microrna-124a-and-reduces-neuroinflammation-in-diabetic-stroke-rats
#10
Ruizhuo Ning, Poornima Venkat, Michael Chopp, Alex Zacharek, Tao Yan, Xu Cui, Don Seyfried, Jieli Chen
D-4F is an apolipoprotein-A1 mimetic peptide that promotes anti-inflammatory effects. MicroRNA-124 is the most abundant brain-specific microRNA and has anti-inflammatory effects. In this study, we investigated the therapeutic efficacy and mechanisms of D-4F treatment of stroke in type one diabetes mellitus (T1DM) rats. Male Wistar rats were induced with T1DM, subjected to embolic middle cerebral artery occlusion and treated with PBS or D-4F (1 mg/kg i.p.) at 2, 24 and 48 hours after stroke (n=8/group). A battery of function tests, brain blood barrier (BBB) integrity, white matter changes and microRNA expression were evaluated in vivo and in vitro...
November 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29220421/optimal-dose-of-dabigatran-for-the-prevention-of-thromboembolism-with-minimal-bleeding-risk-in-korean-patients-with-atrial-fibrillation
#11
Ki Hong Lee, Hyung Wook Park, Nuri Lee, Dae Young Hyun, Jumin Won, Sung Sik Oh, Hyuk Jin Park, Yongcheol Kim, Jae Yeong Cho, Min Chul Kim, Doo Sun Sim, Hyun Joo Yoon, Nam Sik Yoon, Kye Hun Kim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Jong Chun Park, Jeong Gwan Cho
Aims: We aim to determine the optimal dose of dabigatran in Korean patients with atrial fibrillation (AF). Methods and results: We analysed 1834 patients with non-valvular AF, classified into a warfarin group (n = 990), dabigatran 150 mg group (D150, n = 294), and 110 mg group (D110, n = 550). The D110 group was further classified into patients concordant (co-D110, n = 367) and patients discordant (di-D110, n = 183) with guidelines to dose reduction...
December 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29220330/early-recurrence-and-major-bleeding-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation-treated-with-non-vitamin-k-oral-anticoagulants-raf-noacs-study
#12
Maurizio Paciaroni, Giancarlo Agnelli, Nicola Falocci, Georgios Tsivgoulis, Kostantinos Vadikolias, Chrysoula Liantinioti, Maria Chondrogianni, Paolo Bovi, Monica Carletti, Manuel Cappellari, Marialuisa Zedde, George Ntaios, Efstathia Karagkiozi, George Athanasakis, Kostantinos Makaritsis, Giorgio Silvestrelli, Alessia Lanari, Alfonso Ciccone, Jukka Putaala, Liisa Tomppo, Turgut Tatlisumak, Azmil H Abdul-Rahim, Kennedy R Lees, Andrea Alberti, Michele Venti, Monica Acciarresi, Cataldo D'Amore, Cecilia Becattini, Maria Giulia Mosconi, Ludovica Anna Cimini, Rossana Soloperto, Luca Masotti, Vieri Vannucchi, Gianni Lorenzini, Rossana Tassi, Francesca Guideri, Maurizio Acampa, Giuseppe Martini, Sung-Il Sohn, Simona Marcheselli, Nicola Mumoli, Maria Luisa De Lodovici, Giorgio Bono, Karen L Furie, Prasanna Tadi, Shadi Yaghi, Danilo Toni, Federica Letteri, Tiziana Tassinari, Odysseas Kargiotis, Enrico Maria Lotti, Yuriy Flomin, Michelangelo Mancuso, Miriam Maccarrone, Nicola Giannini, Fabio Bandini, Alessandro Pezzini, Loris Poli, Alessandro Padovani, Umberto Scoditti, Licia Denti, Domenico Consoli, Franco Galati, Simona Sacco, Antonio Carolei, Cindy Tiseo, Vanessa Gourbali, Giovanni Orlandi, Martina Giuntini, Alberto Chiti, Elisa Giorli, Gino Gialdini, Francesco Corea, Walter Ageno, Marta Bellesini, Giovanna Colombo, Serena Monaco, Mario Maimone Baronello, Theodore Karapanayiotides, Valeria Caso
BACKGROUND: The optimal timing to administer non-vitamin K oral anticoagulants (NOACs) in patients with acute ischemic stroke and atrial fibrillation is unclear. This prospective observational multicenter study evaluated the rates of early recurrence and major bleeding (within 90 days) and their timing in patients with acute ischemic stroke and atrial fibrillation who received NOACs for secondary prevention. METHODS AND RESULTS: Recurrence was defined as the composite of ischemic stroke, transient ischemic attack, and symptomatic systemic embolism, and major bleeding was defined as symptomatic cerebral and major extracranial bleeding...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29219944/minimally-invasive-surgical-pulmonary-embolectomy-a-potential-alternative-to-conventional-sternotomy
#13
Chetan Pasrija, Aakash Shah, Elliot Sultanik, Michael Rouse, Mehrdad Ghoreishi, Gregory J Bittle, Francesca Boulos, Bartley P Griffith, Zachary N Kon
OBJECTIVE: Surgical pulmonary embolectomy has gained increasing popularity over the past decade with multiple series reporting excellent outcomes in the treatment of submassive pulmonary embolism. However, a significant barrier to the broader adoption of surgical pulmonary embolectomy remains the large incision and long recovery after a full sternotomy. We report the safety and efficacy of using a minimally invasive approach to surgical pulmonary embolectomy. METHODS: All consecutive patients undergoing surgical pulmonary embolectomy for a submassive pulmonary embolism (2015-2017) were reviewed...
December 6, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29218790/embolic-strokes-of-undetermined-source-in-young-adults-baseline-characteristics-and-long-term-outcome
#14
Nicolas Martinez-Majander, Karoliina Aarnio, Jani Pirinen, Tuomas Lumikari, Tuomo Nieminen, Mika Lehto, Juha Sinisalo, Markku Kaste, Turgut Tatlisumak, Jukka Putaala
BACKGROUND: Embolic strokes of undetermined source (ESUS) is a recent entity, not yet thoroughly investigated in young stroke patients. We compared clinical characteristics and long-term risks of vascular events and all-cause mortality between young-onset ESUS and other etiological subgroups. METHODS: Among the 1008 patients aged 15 to 49 years with first-ever ischemic stroke in Helsinki Young Stroke Registry, we identified ESUS patients, and defined primary endpoints as recurrent stroke, composite vascular events, and all-cause mortality...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29217234/outcomes-following-three-factor-inactive-prothrombin-complex-concentrate-versus-recombinant-activated-factor-vii-administration-during-cardiac-surgery
#15
Patrick C Harper, Mark M Smith, Nathan J Brinkman, Melissa A Passe, Darrell R Schroeder, Sameh M Said, Gregory A Nuttall, William C Oliver, David W Barbara
OBJECTIVE: To compare outcomes following inactive prothrombin complex concentrate (PCC) or recombinant activated factor VII (rFVIIa) administration during cardiac surgery. DESIGN: Retrospective propensity-matched analysis. SETTING: Academic tertiary-care center. PARTICIPANTS: Patients undergoing cardiac surgery requiring cardiopulmonary bypass who received either rFVIIa or the inactive 3-factor PCC. INTERVENTIONS: Outcomes following intraoperative administration of rFVIIa (263) or factor IX complex (72) as rescue therapy to treat bleeding...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217087/evolution-of-simplified-frozen-elephant-trunk-repair-for-acute-debakey-type-i-dissection-midterm-outcomes
#16
Eric E Roselli, Jay J Idrees, Faisal G Bakaeen, Michael Z Tong, Edward G Soltesz, Stephanie Mick, Douglas R Johnston, Mathew J Eagleton, Venu Menon, Lars G Svensson
BACKGROUND: A modified technique for frozen elephant trunk (FET) repair of acute DeBakey type I dissection has evolved. Procedural modifications are described and midterm outcomes evaluated. METHODS: From 2009 to 2016, 72 patients with DeBakey type I dissection underwent emergency simplified FET. Mean age was 59 ± 15 years. Presentation included malperfusion (n = 22, 31%), rupture (n = 12, 16%), and aortic insufficiency (n = 42, 58%). Concomitant procedures included valve replacement (n = 9), root replacement (n = 11; valve sparing n = 6), cusp repair (n = 11), and valve resuspension (n = 21)...
December 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29216218/stroke-subtype-classification-by-geometrical-descriptors-of-lesion-shape
#17
Bastian Cheng, Christian Knaack, Nils Daniel Forkert, Renate Schnabel, Christian Gerloff, Götz Thomalla
BACKGROUND AND PURPOSE: Inference of etiology from lesion pattern in acute magnetic resonance imaging is valuable for management and prognosis of acute stroke patients. This study aims to assess the value of three-dimensional geometrical lesion-shape descriptors for stroke-subtype classification, specifically regarding stroke of cardioembolic origin. METHODS: Stroke Etiology was classified according to ASCOD in retrospectively selected patients with acute stroke...
2017: PloS One
https://www.readbyqxmd.com/read/29203731/mechanical-thrombectomy-and-rescue-therapy-for-intracranial-large-artery-occlusion-with-underlying-atherosclerosis
#18
BaiXue Jia, Lei Feng, David S Liebeskind, Xiaochuan Huo, Feng Gao, Ning Ma, Dapeng Mo, Xiaoling Liao, Chunjuan Wang, Xingquan Zhao, Yuesong Pan, Hao Li, Liping Liu, Yilong Wang, Yongjun Wang, Zhong-Rong Miao
OBJECTIVE: To investigate the safety and efficacy of mechanical thrombectomy plus rescue therapy for intracranial large artery occlusion (ILAO) with underlying intracranial atherosclerosis (ICAS). METHODS: Patients enrolled in the intervention group of EAST (Endovascular Therapy for Acute ischemic Stroke Trial) were analyzed. For underlying ICAS identified during the stent retrieval procedure, rescue treatment was required for those with (1) a degree of arterial stenosis >70% or (2) any degree of arterial with blood flow impairment or (3) evidence of re-occlusion...
December 4, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29203578/left-ventricular-thrombi-in-takotsubo-syndrome-incidence-predictors-and-management-results-from-the-geist-german-italian-stress-cardiomyopathy-registry
#19
Francesco Santoro, Thomas Stiermaier, Nicola Tarantino, Luisa De Gennaro, Christian Moeller, Francesca Guastafierro, Maria Francesca Marchetti, Roberta Montisci, Elena Carapelle, Tobias Graf, Pasquale Caldarola, Holger Thiele, Matteo Di Biase, Natale Daniele Brunetti, Ingo Eitel
BACKGROUND: Left ventricular (LV) thrombi during Takotsubo syndrome represent a potential complication and can be associated with cerebrovascular embolic events. The aim of this study was to evaluate the exact incidence, predictors, and management strategies of LV thrombi in patients with Takotsubo syndrome. METHODS AND RESULTS: We enrolled 541 consecutive patients in a multicenter international registry. Clinical features and echocardiographic data at admission, during hospitalization, and after 3 months were evaluated...
December 4, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29203211/qtc-interval-cardiovascular-events-and-mortality-in-patients-with-atrial-fibrillation
#20
Andreas Reusser, Steffen Blum, Stefanie Aeschbacher, Lucien Eggimann, Peter Ammann, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jürg Schläpfer, Samuel Manser, Tobias Reichlin, Michael Kühne, Christian Sticherling, Stefan Osswald, David Conen
BACKGROUND: A longer QTc interval has been associated with more adverse cardiovascular events and death in the general population. Little evidence is available on these relationships among patients with atrial fibrillation (AF). METHODS: We performed a prospective observational multicenter cohort study of 1413 patients with AF. A resting 12‑lead electrocardiogram (ECG) was performed at baseline. QT interval was corrected for heart rate using the Bazett formula (QTc)...
November 24, 2017: International Journal of Cardiology
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