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Embolic stroke

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https://www.readbyqxmd.com/read/29054914/flow-diversion-for-the-treatment-of-posterior-inferior-cerebellar-artery-aneurysms-a-novel-classification-and-strategies
#1
Visish M Srinivasan, Michael George Zaki Ghali, Oleg E Reznik, Jacob Cherian, Maxim Mokin, Travis M Dumont, John R Gaughen, Ramesh Grandhi, Ajit S Puri, Stephen R Chen, Jeremiah N Johnson, Peter Kan
BACKGROUND: The pipeline embolization device (PED) is frequently used in the treatment of anterior circulation aneurysms, especially around the carotid siphon, with generally excellent results. However, treatment of posterior inferior cerebellar artery (PICA) aneurysms with flow diversion (FD) has not been specifically described or discussed. While there are reports of treating PICA aneurysms using placement of FD stents in the vertebral artery, there are no reports of treating these lesions by placement of flow diverting stents in the PICA vessel itself...
October 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29053070/relationship-between-patient-safety-indicator-events-and-comprehensive-stroke-center-volume-status-in-the-treatment-of-unruptured-cerebral-aneurysms
#2
Chad W Washington, L Ian Taylor, Robert J Dambrino, Paul R Clark, Gregory J Zipfel
OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification. METHODS Using the 2002-2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29052104/anticoagulation-prescribing-patterns-in-patients-with-cancer
#3
Elaine Xiang, Tania Ahuja, Veronica Raco, Frank Cirrone, David Green, John Papadopoulos
Cancer is a known hypercoagulable state that leads to an increased risk of venous thromboembolism (VTE). Low molecular weight heparin remains the preferred anticoagulant for VTE in patients with cancer over vitamin K antagonist. However, the preferred anticoagulant in prevention of stroke and systemic embolism in atrial fibrillation (AF) in patients with cancer has yet to be determined. The direct oral anticoagulants (DOACs) are increasingly being utilized; however their role in cancer has only recently been investigated...
October 19, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29049525/impact-of-the-haga-braincare-strategy-on-the-burden-of-haemodynamic-and-embolic-strokes-related-to-cardiac-surgery
#4
Friso Duynstee, Ruud W M Keunen, Agnes van Sonderen, Ali M Keyhan-Falsafi, Gerard J F Hoohenkerk, Gayleen Stephens, Erik Teeuws, Jan W K van Alphen, Dénes L J Tavy, Arne Mosch, Sebastiaan F T M de Bruijn, Hans van Overhagen, Frank E E Treurniet, Lucas C van Dijk, Paulien M van Kampen
OBJECTIVES: This study prospectively evaluates the impact of the Haga Braincare Strategy (HBS) on the occurrence of haemodynamic and embolic stroke in a cohort of patients who underwent coronay artery bypass grafting (CABG), valve replacement of a combination of both types of surgery between 2012 and 2015 at the Haga Teaching Hospitals. METHODS: The HBS is a dual strategy based on a preoperative vascular work-up of the cerebral circulation by transcranial Doppler and a perioperative monitoring of the cerebral circulation by cerebral oximetry...
June 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049073/postoperative-outcomes-in-obstructive-sleep-apnea-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis-of-comparative-studies
#5
Mahesh Nagappa, George Ho, Jayadeep Patra, Jean Wong, Mandeep Singh, Roop Kaw, Davy Cheng, Frances Chung
BACKGROUND: Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29047304/real-world-comparison-of-all-cause-hospitalizations-hospitalizations-due-to-stroke-and-major-bleeding-and-costs-for-nonvalvular-atrial-fibrillation-patients-prescribed-oral-anticoagulants-in-a-us-health-plan
#6
Alpesh Amin, Allison Keshishian, Lien Vo, Qisu Zhang, Oluwaseyi Dina, Chad Patel, Kevin Odell, Jeffrey Trocio
AIMS: Compare the risk of all-cause hospitalization and hospitalizations due to stroke/systemic embolism (SE) and major bleeding as well as associated health care costs for nonvalvular atrial fibrillation (NVAF) patients initiating apixaban, dabigatran, rivaroxaban, or warfarin. MATERIALS AND METHODS: NVAF patients initiating apixaban, dabigatran, rivaroxaban, or warfarin were selected from the OptumInsight Research Database from 01JAN2013-30SEP2015. Propensity score matching (PSM) was performed between apixaban and each oral anticoagulant...
October 19, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29046977/carotid-angioplasty-and-stenting-and-embolic-protection
#7
REVIEW
Enrico Giordan, Giuseppe Lanzino
PURPOSE OF REVIEW: We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues. RECENT FINDINGS: Randomized trials have demonstrated a progressive decrease of periprocedural strokes after CAS. Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. This is especially true after the age of 70 and immediately after a presenting symptomatic event...
October 18, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29046468/-a-case-of-dural-arteriovenous-fistula-that-developed-21-months-after-cerebral-venous-sinus-thrombosis
#8
Motonori Ishii, Takashi Yamanouchi, Ryosuke Oshima, Masaki Sato, Tomoyuki Noda, Hideki Maki, Akira Kito
A 56-year-old man experienced a sudden onset of left hemiparesis. The computed tomography(CT)scan revealed a lobar hemorrhage in the right fronto-parietal lobe. After his admission, deep vein thrombosis was detected in his left lower limb, and angiograms taken on the 36th day of hospitalization revealed cerebral venous sinus thrombosis. Anticoagulant treatment was induced. After 21 months, he experienced a sudden onset of left hemiparesis again. The CT scan revealed a new lobar hemorrhage in the right frontal lobe, and angiograms revealed that two dural arteriovenous fistulas(dAVF)developed in the superior sagittal sinus(SSS)and the left transverse-sigmoid sinus...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29044023/-may-thurner-syndrome-with-ischemic-cerebrovascular-accident-and-permeable-oval-foramen
#9
José A Arroyo, Sebastián Villate, Gustavo A Ortiz
The association of cerebral ischemic attack with patent foramen ovale has not been extensively studied, and frequently the site of origin of embolism is not detected despite routine studies. We present the case of a young patient with ischemic stroke and permeable oval foramen in the context of May Thurner syndrome. The May Thurner syndrome is an entity scarcely studied in the medical literature and it has also been infrequently related to ischemic vascular cerebral accident, but in patients with permeable oval foramen without evidence of the emboligen source, it is interesting to rule it out as a cause of paradoxical embolism...
2017: Medicina
https://www.readbyqxmd.com/read/29043564/the-ucp2-866g-a-polymorphism-could-be-considered-as-a-genetic-marker-of-different-functional-prognosis-in-ischemic-stroke-after-recanalization
#10
I Díaz-Maroto Cicuéndez, E Fernández-Díaz, J García-García, J Jordán, I Fernández-Cadenas, J Montaner, G Serrano-Heras, T Segura
Recent studies based on experimental animal models of stroke have suggested that uncoupling protein 2 (UCP2), an inner mitochondrial membrane protein that is thought to regulate energy metabolism and reduce reactive oxygen species generation, provides protection against reperfusion damage. We aimed to investigate whether -866G/A polymorphism in the promoter of the UCP2 gene, which enhances its transcriptional activity, is associated with functional prognosis in patients with embolic ischemic stroke after early recanalization...
October 17, 2017: Neuromolecular Medicine
https://www.readbyqxmd.com/read/29040773/treatment-outcomes-of-a-randomized-trial-of-unruptured-brain-arteriovenous-malformation-eligible-unruptured-brain-arteriovenous-malformation-patients
#11
Min Lang, Nina Z Moore, Peter A Rasmussen, Mark D Bain
BACKGROUND: The guideline for treating unruptured brain arteriovenous malformations (ubAVMs) remains controversial. A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) reported lower risk of stroke or death with conservative management compared to interventional treatment. There were numerous limitations to the study, including short follow-up period and disproportionate number of patients treated with surgery and embolization. OBJECTIVE: To evaluate whether treatment of ARUBA-eligible patients have acceptable outcomes at our institution...
October 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29040554/frailty-syndrome-an-emerging-clinical-problem-in-the-everyday-management-of-clinical-arrhythmias-the-results-of-the-european-heart-rhythm-association-survey
#12
Stefano Fumagalli, Tatjana S Potpara, Torben Bjerregaard Larsen, Kristina H Haugaa, Dan Dobreanu, Alessandro Proclemer, Nikolaos Dagres
The age of patients presenting with complex arrhythmias is increasing. Frailty is a multifaceted syndrome characterized by an increased vulnerability to stressors and a decreased ability to maintain homeostasis. The prevalence of frailty is associated with age. The aims of this European Heart Rhythm Association (EHRA) EP Wire survey were to evaluate the proportion of patients with frailty and its influence on the clinical management of arrhythmias. A total of 41 centres-members of the EHRA Electrophysiology Research Network-in 14 European countries completed the web-based questionnaire in June 2017...
October 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29038080/a-stent-retrieving-into-an-aspiration-catheter-with-proximal-balloon-asap-technique-a-technique-of-mechanical-thrombectomy
#13
Shunsaku Goto, Tomotaka Ohshima, Kojiro Ishikawa, Taiki Yamamoto, Shinji Shimato, Toshihisa Nishizawa, Kyozo Kato
PURPOSE: The best technique for the first attempt at mechanical thrombectomy for acute ischemic stroke is a still matter of debate. In this study, we evaluated the efficacy of a stent-retrieving into an aspiration catheter with proximal balloon (ASAP) technique that employs a series of thrombus extraction by withdrawing the stent retriever into the aspiration catheter, and continuous aspiration from the aspiration catheter in the first attempt. METHODS: We performed a retrospective analysis of 42 consecutive patients with acute ischemic stroke caused by occlusions in the anterior circulation, who were treated with the ASAP technique at our institution...
October 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29035298/molecular-docking-and-3d-pharmacophore-modeling-to-study-the-interactions-of-chalcone-derivatives-with-estrogen-receptor-alpha
#14
Muchtaridi Muchtaridi, Hasna Nur Syahidah, Anas Subarnas, Muhammad Yusuf, Sharon D Bryant, Thierry Langer
Tamoxifen is the most frequently used anti-estrogen adjuvant treatment for estrogen receptor-positive breast cancer. However, it is associated with an increased risk of several serious side-effects, such as uterine cancer, stroke, and pulmonary embolism. The 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone (ChalcEA) from plant leaves of Eugenia aquea, has been found to inhibit the proliferation of MCF-7 human breast cancer cells in a dose-dependent manner, with an IC50 of 74.5 μg/mL (250 μM). The aim of this work was to study the molecular interactions of new ChalcEA derivatives formed with the Estrogen Receptor α (ERα) using computer aided drug design approaches...
October 16, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/29034832/new-advances-in-atrial-fibrillation-management-the-role-of-apixaban
#15
Giuseppe Mc Rosano, Ilaria Spoletini, Walter Gianni, Cristiana Vitale
Prevention of stroke is a pivotal intervention in the management of patients with atrial fibrillation (AF) at increased risk of systemic embolism. Because of the difficulties of safely implementing Vitamin K Antagonists in all patients, there has been a growing interest in improving the pharmacological management of AF, with newer antithrombotic agents. The new oral anticoagulants (NOACs) have been developed to overcome the limitations and improve the efficacy of the conventional oral anticoagulant drugs. Among the NOACs, apixaban - a very specific antagonist of activated factor Xa - has pharmacokinetic and pharmacodynamic properties that allow significant efficacy in AF management...
October 12, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/29034496/clinical-impact-of-the-microembolic-signal-burden-during-catheter-ablation-for-atrial-fibrillation-just-a-lot-of-noise
#16
Christian von Bary, Thomas Deneke, Thomas Arentz, Anja Schade, Heiko Lehrmann, Susanne Schwab-Malek, Sabine Fredersdorf, Dobri Baldaranov, Lars Maier, Felix Schlachetzki
OBJECTIVES: Microembolic signal detection by transcranial Doppler ultrasonography may be considered a surrogate for cerebral events during invasive cardiac procedures. However, the impact of the microembolic signal count during pulmonary vein isolation on the clinical outcome is not well evaluated. We investigated the effect of the microembolic signal count on the occurrence of new silent cerebral embolism measured by diffusion-weighted imaging (DWI)-magnetic resonance imaging (MRI), changes in neuropsychological testing, and the occurrence of clinical events during long-term follow-up after pulmonary vein isolation...
October 16, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29031497/patent-foramen-ovale-and-the-risk-of-cerebral-infarcts-in-acute-pulmonary-embolism-a-prospective-observational-study
#17
David Vindiš, Martin Hutyra, Daniel Šaňák, Michal Král, Eva Čecháková, Simona Littnerová, Tomáš Adam, Jan Přeček, Štěpán Hudec, Markéta Ječmenová, Miloš Táborský
BACKGROUND: Pulmonary embolism (PE) is associated with a risk of consecutive paradoxical embolism with brain infarction through a patent foramen ovale (PFO). The aims of this study were to assess the rate of new ischemic brain lesions (IBLs) using magnetic resonance imaging (MRI) during a 12-month follow-up period with anticoagulation and to evaluate the potential relationship with the presence of PFO on transesophageal echocardiography (TEE). SUBJECTS AND METHODS: Seventy-eight patients with acute PE underwent baseline contrast TEE with brain MRI...
October 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29029334/effect-of-long-term-hydroxychloroquine-on-vascular-events-in-patients-with-systemic-lupus-erythematosus-a-database-prospective-cohort-study
#18
Chung-Yuan Hsu, Yu-Sheng Lin, Yu-Jih Su, Hsing-Fen Lin, Ming-Shyan Lin, Ya-Jhu Syu, Tien-Tsai Cheng, Shan-Fu Yu, Jia-Feng Chen, Tien-Hsing Chen
Objectives: The incidence of thromboembolism in patients with SLE is higher than that in the general population. HCQ, widely used to treat lupus, may have vascular protective effects. The aim of this study was to determine whether long-term HCQ exposure is associated with decreased thromboembolism risk in SLE. Methods: We designed a prospective cohort study within an SLE population based on the National Health Insurance Research Database in Taiwan. We divided participants into HCQ and control groups according to HCQ prescription during the first year...
September 27, 2017: Rheumatology
https://www.readbyqxmd.com/read/29026412/the-role-of-manual-thrombectomy-in-cardiovascular-outcome-among-patients-with-total-cutoff-vessel-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#19
Alireza Khosravi, Davoud Rajabi, Masoud Pourmoghaddas, Afzal Roohi, Masoumeh Esmaeili
BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014...
March 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29025267/direct-oral-anticoagulants-in-cardioversion-a-review-of-current-evidence
#20
Caitlin M Gibson, Amanda N Basto, Meredith L Howard
OBJECTIVE: Direct oral anticoagulants (DOACs) are recommended for the prevention of stroke or systemic embolism in nonvalvular atrial fibrillation. Dabigatran, rivaroxaban, apixaban, and edoxaban represent possible alternatives to warfarin in the setting of cardioversion. A literature review was conducted to evaluate the safety and efficacy of DOAC use pericardioversion. DATA SOURCES: A PubMed and MEDLINE search through August 2017 was conducted using the following search terms alone or in various combinations: dabigatran, rivaroxaban, apixaban, edoxaban, betrixaban, DOAC, NOAC, TSOAC, cardioversion...
October 1, 2017: Annals of Pharmacotherapy
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