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Embolic stroke

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https://www.readbyqxmd.com/read/29908146/intravenous-xenogeneic-human-cardiosphere-derived-cell-extracellular-vesicles-exosomes-improves-behavioral-function-in-small-clot-embolized-rabbits
#1
Paul A Lapchak, Paul D Boitano, Geoffrey de Couto, Eduardo Marbán
Acute ischemic stroke is devastating to patients and their families because of few viable therapeutic options to promote recovery after reperfusion windows close. Recent breakthroughs in biotechnology have resulted in a reproducible patented process for the purification of extracellular vesicles (EVs) from human cardiosphere-derived cells (CDCs). Because CDC-EVs have many features potentially beneficial to treat acute ischemic stroke, CDC-EVs were evaluated in an established small-clot rabbit embolic stroke model, where clinically relevant end points were used to assess recovery in a more translational large animal model...
June 13, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29904830/migraine-and-cerebrovascular-disease-still-a-dangerous-connection
#2
Elio Clemente Agostoni, Marco Longoni
Migraine is a common type of headache in young adults, with an estimated prevalence of 4% before puberty and as high as 25% in women by their mid to late 30s. About one third of migraineurs experience transient neurological symptoms known as auras, which characterize a variant known as migraine with aura. Many evidences have shown an increased risk of vascular events in patients affected by migraine, particularly among women and among migraine patients with aura. Potential underlying mechanisms include endothelial dysfunction, hypercoagulability, platelet aggregation, vasospasm, cardiovascular risk factors, paradoxical embolism, spreading depolarization, shared genetic risk, use of non-steroidal anti-inflammatory drugs, and immobilization...
June 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29904305/successful-reperfusion-of-bilateral-middle-cerebral-artery-embolic-occlusions-using-stent-retriever-thrombectomy
#3
Austin Miller, Anthony Onofrio, Dion Graybeal, Osman Mir, Megan B Linebarger, Kennith F Layton
A 40-year-old woman presented to our stroke center for a left middle cerebral artery embolic occlusion. This was successfully treated with mechanical thrombectomy using a stent retriever and balloon guide catheter aspiration. The patient was discharged home in good condition on clopidogrel but returned 2 months later with a contralateral right middle cerebral artery embolic occlusion. This was also successfully treated, this time with a stent retriever and local aspiration (Sol-Arc technique). She was once again discharged in good condition but with warfarin and an implanted loop recorder...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29904298/acute-kidney-injury-and-undiagnosed-immunoglobulin-a-nephropathy-after-dabigatran-therapy
#4
Laurie Jansky, Pallavi Mukkamala, Deborah Jebakumar, Arundhati Rao, Tove M Goldson, Samuel N Forjuoh
Dabigatran, a new oral anticoagulant, is a direct thrombin inhibitor used as an alternative to warfarin to reduce the risk of stroke and systemic embolism with nonvalvular atrial fibrillation. We report a case of a man who resumed dabigatran after 6 weeks of prior therapy and began experiencing hematuria with worsening kidney function. Renal biopsy with immunofluorescence and electron microscopy showed mesangial deposits consistent with immunoglobulin A nephropathy. With discontinuation of dabigatran and addition of methylprednisolone, the gross hematuria cleared and urine output improved...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29900591/patterns-of-solid-particle-embolization-during-transcatheter-aortic-valve-implantation-and-correlation-with-aortic-valve-calcification
#5
Suneil K Aggarwal, Nicola Delahunty Rn, Leon J Menezes, Richard Perry, Bethany Wong, Markus Reinthaler, Muhiddin Ozkor, Michael J Mullen
OBJECTIVES: To evaluate solid embolization during transcatheter aortic valve implantation (TAVI) and correlate this with aortic valve calcification. BACKGROUND: There is a known stroke risk with TAVI, thought partly to be due to dislodgement of native aortic valve particles during implantation. However, to date there is little evidence that aortic valve calcification actually impacts embolic risk. METHODS: Transcranial Doppler (TCD) was performed on consecutive suitable patients undergoing TAVI, using hardware and software enabling differentiation between solid and gaseous emboli...
June 13, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29898848/oral-anti-xa-anticoagulation-after-trans-aortic-valve-implantation-for-aortic-stenosis-the-randomized-atlantis-trial
#6
Jean-Philippe Collet, Sergio Berti, Angel Cequier, Eric Van Belle, Thierry Lefevre, Pascal Leprince, Franz-Josef Neumann, Eric Vicaut, Gilles Montalescot
BACKGROUND: Antithrombotic treatment regimen following transcatheter aortic valve replacement (TAVR) is not evidence-based. Apixaban, a non-vitamin K direct anticoagulant (NOAC) was shown to be superior to VKA and superior to aspirin to prevent cardioembolic stroke in non-valvular atrial fibrillation. It may have the potential to reduce TAVR-related thrombotic complications including subclinical valve thrombosis along with a better safety than the standard of care. DESIGN: ATLANTIS is a multicenter, randomized, phase IIIb, prospective, open-label, superiority study comparing standard of care (SOC Group) versus an apixaban-based strategy (Anti-Xa Group) after successful TAVR (ClinicalTrials...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898836/impact-of-polyvascular-disease-on-patients-with-atrial-fibrillation-insights-from-rocket-af
#7
Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Keith A A Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
BACKGROUND: We investigated the impact of polyvascular disease in patients enrolled in ROCKET AF. METHODS: Cox regression models were used to assess clinical outcomes and treatment effects of rivaroxaban compared with warfarin in patients with atrial fibrillation and coronary, peripheral, or carotid artery disease, or any combination of the 3. RESULTS: A total of 655 (4.6%) patients had polyvascular disease (≥2 disease locations), and 3,391 (23...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898080/rescue-therapy-with-stent-retrievers-for-thromboembolism-during-endovascular-treatment-of-intracranial-aneurysms
#8
Zeferino Demartini Junior, Luana A Maranha Gatto, Gelson Luis Koppe, Tatiana F von Hertwig de Oliveira, Alexandre Novicki Francisco
Thromboembolism is the most frequent complication in endovascular treatment of intracranial aneurysms, causing disability and death. As stent retrievers have achieved high rates of arterial recanalization in the management of ischemic stroke, these devices were tested as rescue therapy of thromboembolism during aneurysm embolization. We retrospectively analyzed 10 consecutive patients with transprocedural arterial occlusion, treated with mechanical thrombectomy at a single center. Good angiographic recanalization was achieved in eight cases, mTICI 3, 2b and 2a in five, three and two patients, respectively, without additional complications or any deaths...
May 2018: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29897627/real-world-geographic-variations-in-the-use-of-cardiac-implantable-electronic-devices-the-panorama-2-observational-cohort-study
#9
Dirk Bastian, Iftikhar O Ebrahim, Ju-Yi Chen, Mien-Cheng Chen, Dejia Huang, Jin-Long Huang, Vadim A Kuznetsov, Bärbel Maus, Ajay M Naik, Koen J P Verhees, Ahmed R Al Fagih
BACKGROUND: Currently, several geographies around the world remain underrepresented in medical device trials. The PANORAMA 2 study was designed to assess contemporary region-specific differences in clinical practice patterns of patients with cardiac implantable electronic devices (CIEDs). METHODS: In this prospective, multicenter, observational, multi-national study, baseline and implant data of 4,706 patients receiving Medtronic CIEDs (either de novo device implants, replacements, or upgrades) were analyzed, consisting of: 54% implantable pulse generators (IPGs), 20...
June 13, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29893670/diagnosis-and-treatment-of-lambl-s-excrescence-on-the-aortic-valve
#10
Ren Chong-Lei, Jiang Sheng-Li, Wang Rong, Xiao Cang-Song, Wang Yao, Gao Chang-Qing
Our objective is to summarize our experience in the diagnosis and treatment of Lambl's excrescence (LE) on the aortic valve. Methods: The clinical data of 25 patients with LE admitted to our hospital from January 2010 to December 2014 were analyzed retrospectively. There were 17 males and 8 females, with the mean age of 55.7 ± 11.43 years (range: 30 to 70 years). Among the patients analyzed, eight also had cerebral embolism. All of the patients were diagnosed by transesophageal echocardiography (TEE). In seven cases, surgical treatment to remove the excrescence was successfully performed...
May 7, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29891030/the-history-of-proximal-carotid-protection-and-flow-reversal-to-prevent-stent-angioplasty-embolization
#11
Juan Parodi, Mark C Bates, Takao Ohki, Claudio Schönholz
Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physician-originated clinical research that transformed the safety of carotid stent angioplasty over the last 2 decades. Initial clinical application of carotid stenting suggested that proximal protection may be a better approach to prevent embolic stroke during the angioplasty procedure...
March 2018: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29891028/early-carotid-artery-stenting-after-onset-neurologic-symptoms
#12
Gianmarco de Donato, Francesco Setacci, Edoardo Pasqui, Domenico Benevento, Giancarlo Palasciano, Antonio Sterpetti, Luca di Marzo, Carlo Setacci
Multicenter clinical trials level 1 evidence favors the application of carotid endarterectomy in symptomatic patients, especially the in the elderly cohort. Carotid artery stenting has been proposed as a possible early alternative in selected patients after onset of ipsilateral neurologic symptoms. It is well known that treatment of acute stroke is time-dependent in patients with acute ischemic stroke caused by high-grade stenosis of the internal carotid artery, but intensive medical treatment in conjunction with intervention to improve stroke severity and clinical outcomes has not been established...
March 2018: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29889889/adipose-tissue-content-of-alpha-linolenic-acid-and-the-risk-of-ischemic-stroke-and-ischemic-stroke-subtypes-a-danish-case-cohort-study
#13
Christian Sørensen Bork, Stine Krogh Venø, Søren Lundbye-Christensen, Marianne Uhre Jakobsen, Anne Tjønneland, Philip C Calder, Kim Overvad, Erik Berg Schmidt
BACKGROUND: The plant-derived omega-3 fatty acid alpha-linolenic acid (ALA) may reduce the risk of cardiovascular disease. OBJECTIVE: We have investigated associations between the content of ALA in adipose tissue and the risk of ischemic stroke and its subtypes. METHODS: Incident cases of ischemic stroke among participants enrolled into the Danish Diet, Cancer and Health cohort (n = 57,053) were identified by linkage with the Danish National Patient Register...
2018: PloS One
https://www.readbyqxmd.com/read/29889459/-relationship-between-patent-foramen-ovale-and-cryptogenic-stroke-in-a-retrospective-hospital-based-study
#14
Péter Böjti, Noémi Eszter Bartha, Zsolt May, Dániel Bereczki, Szilvia Fülöp, Zoltán Szakács, Géza Szilágyi
Background and purpose: After routine workup, 23-25% of ischemic strokes etiology remains unknown, i.e. cryptogenic. However, according to international results pathogenic patent foramen ovale (PFO) reveals in 25% of these cases. Aim of our retrospective study to prove the substantial etiological role of PFO-related stroke (PFO-RS) in cryptogenic strokes (CS), and to identify age related differences in stroke etiology. Methods: All new ischemic strokes of 2014-2015 were classified by ASCOD (Atherosclerosis, Small-vessel disease, Cardiac pathology, Other, Dissection) phenotyping...
May 30, 2018: Ideggyógyászati Szemle
https://www.readbyqxmd.com/read/29887417/inflammation-and-atrial-electrical-remodeling-in-patients-with-embolic-strokes-of-undetermined-source
#15
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Andrea Lo Monaco, Giuseppe Martini
BACKGROUND: About one third of ischaemic strokes are classified as embolic strokes of undetermined source (ESUS). A silent atrial fibrillation (AF) may play a pathogenic role in these strokes and P wave dispersion (PWD), representing an electrocardiographic (ECG) predictor for paroxysmal AF, thereby a potential marker of covert cardioembolism, was found to be increased in cryptogenic stroke. Furthermore, current evidence links AF to inflammation: inflammatory markers, such as high-sensitive C-reactive protein (hsCRP), have been related to the development and persistence of AF, possibly by promoting atrial remodelling...
May 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29886716/updates-on-prevention-of-cardioembolic-strokes
#16
Mehmet Akif Topcuoglu, Liping Liu, Dong-Eog Kim, M Edip Gurol
Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism...
May 2018: Journal of Stroke
https://www.readbyqxmd.com/read/29884600/intracranial-haemorrhage-in-infective-endocarditis
#17
Erwan Salaun, Anissa Touil, Sandrine Hubert, Jean-Paul Casalta, Frédérique Gouriet, Emmanuelle Robinet-Borgomano, Emilie Doche, Nadia Laksiri, Caroline Rey, Cécile Lavoute, Sébastien Renard, Hervé Brunel, Anne-Claire Casalta, Julie Pradier, Jean-François Avierinos, Hubert Lepidi, Laurence Camoin-Jau, Alberto Riberi, Didier Raoult, Gilbert Habib
BACKGROUND: Although intracranial cerebral haemorrhage (ICH) complicating infective endocarditis (IE) is a critical clinical issue, its characteristics, impact, and prognosis remain poorly known. AIMS: To assess the incidence, mechanisms, risk factors and prognosis of ICH complicating left-sided IE. METHODS: In this single-centre study, 963 patients with possible or definite left-sided IE were included from January 2000 to December 2015. RESULTS: Sixty-eight (7%) patients had an ICH (mean age 57±13 years; 75% male)...
June 5, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29882061/combined-treatment-approach-to-cerebral-arteriovenous-malformation-in-pediatric-patients-stereotactic-radiosurgery-to-partially-onyx-embolized-avm
#18
Daniel Umansky, Benjamin W Corn, Ido Strauss, Natan Shtraus, Shlomi Constantini, Vladimir Frolov, Shimon Maimon, Andrew A Kanner
PURPOSE: Treatment of cerebral arteriovenous malformations (AVM)-the most common cause of stroke in the pediatric population-can be challenging due to the complexity of size, morphology, and location. There is a significant risk in comparison to AVM treatment among adults. Thus, AVM treatment in the pediatric population imposes unique challenges. Recent improvements include optimized catheter techniques and better embolization materials, such as Onyx, a non-adhesive liquid embolic agent used in the adult population...
June 7, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29880579/ischaemic-cardiomyopathy-and-embolic-stroke-in-a-young-adult-with-suspected-synthetic-cannabinoid-use
#19
Sumera Khan, Ahmad Hanif, Michael F Wilson
The incidence of cardiovascular disease is increasing in young adults. We are reporting a case of acute stroke in a young patient with severe ischaemic cardiomyopathy in the absence of traditional risk factors. After ruling out atherosclerotic disease, his presentation was attributed to synthetic cannabinoid use. We then discussed the typical barriers in early diagnosis and limitations of laboratory testing in this condition. Due to the increase in abuse of these synthetic drugs among young adults, there is a need for high clinical suspicion which can help with early recognition and improve morbidity and mortality associated with these chemicals...
June 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29880104/intracardiac-versus-transesophageal-echocardiographic-guidance-for-left-atrial-appendage-occlusion-the-laao-italian-multicenter-registry
#20
Sergio Berti, Luigi Emilio Pastormerlo, Gennaro Santoro, Elvis Brscic, Matteo Montorfano, Luigi Vignali, Paolo Danna, Claudio Tondo, Marco Rezzaghi, Gianpiero D'Amico, Amerigo Stabile, Salvatore Saccà, Giuseppe Patti, Antonio Rapacciuolo, Arnaldo Poli, Paolo Golino, Paolo Magnavacchi, Francesco Meucci, Bruno Pezzulich, Miroslava Stolcova, Giuseppe Tarantini
OBJECTIVES: This study sought to evaluate the feasibility, safety, and efficacy of intracardiac echocardiography (ICE)-guided versus transesophageal echocardiography (TEE)-guided left atrial appendage occlusion (LAAO) by the use of Amplatzer Cardiac Plug or Amulet devices included in a large Italian registry. BACKGROUND: TEE is widely used for LAAO procedure guidance. ICE may be a potential alternative imaging modality in LAAO. METHODS: Data from 604 LAAO procedures performed in 16 Italian centers were reviewed...
June 11, 2018: JACC. Cardiovascular Interventions
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