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Carotid stenosis, acute stroke,

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https://www.readbyqxmd.com/read/29136204/thrombolysis-is-an-independent-risk-factor-for-poor-outcome-after-carotid-revascularization
#1
Ananth K Vellimana, Chad W Washington, Chester K Yarbrough, Thomas K Pilgram, Brian L Hoh, Colin P Derdeyn, Gregory J Zipfel
BACKGROUND: Thrombolysis is the standard of care for acute ischemic stroke patients presenting in the appropriate time window. Studies suggest that the risk of recurrent ischemia is lower if carotid revascularization is performed early after the index event. The safety of early carotid revascularization in this patient population is unclear. OBJECTIVE: To evaluate the safety of carotid revascularization in patients who received thrombolysis for acute ischemic stroke...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#2
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29096569/association-between-procalcitonin-levels-and-carotid-atherosclerosis-in-acute-ischemic-stroke-patients
#3
Yun Zhang, Zhonglun Chen, Yufeng Tang, Wanying Shan, Ling Wang, Jian Shi, Qian Luo, Jinfeng Duan, Gelin Xu
BACKGROUND AND PURPOSES: Procalcitonin has been suggested as a new risk factor in atherosclerotic disease. However, whether procalcitonin levels are associated with the risk of carotid atherosclerosis remains unclear. This study aimed to investigate the relationship between procalcitonin levels and carotid atherosclerosis among patients with first-ever acute ischemic stroke. METHODS: Two hundred and thirty consecutive patients were prospectively enrolled in this study...
November 3, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29089282/safety-and-efficacy-of-the-new-micromesh-covered-stent-cguard-in-patients-undergoing-carotid-artery-stenting-early-experience-from-a-single-centre
#4
Renato Casana, Valerio Tolva, Andrea Odero, Chiara Malloggi, Aldo Paolucci, Fabio Triulzi, Vincenzo Silani
OBJECTIVE/BACKGROUND: Plaque protrusion through stent struts represents one of the principal causes of cerebral embolisation during carotid artery stenting (CAS) and the stent healing period. The aim of this study was to evaluate the safety (technical success) and efficacy (clinical success) of the CGuard stent system - a new nitinol stent covered by a closed-cell polyethylene terephthalate mesh designed to prevent embolic events. METHODS: Eighty-two consecutive patients who underwent CAS with CGuard from June 2015 were included in this study...
October 28, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29032862/endovascular-treatment-of-acute-tandem-occlusion-strokes-and-stenting-first-experience
#5
Süha Akpınar, Pınar Gelener
This study demonstrates the radiologic and clinical findings, etiologies and intervention strategy in 8 acute ischemic stroke patients with tandem occlusions. The mean age was 57 and mean NIHSS score was 19. Stent-assisted thrombectomy (SAT) was performed on all of the patients. Additionally, 6 patients underwent carotid artery stenting before SAT. Recanalization with TICI≥2b was attained in 7/8 patients. The 90thday median mRS was 2 and mortality was 1/8. The etiologies of the tandem occlusions were either extracranial high grade ICA stenosis/occlusion or cervical ICA dissection...
October 9, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29021359/increasing-prevalence-of-vascular-risk-factors-in-patients-with-stroke-a-call-to-action
#6
Fadar Oliver Otite, Nicholas Liaw, Priyank Khandelwal, Amer M Malik, Jose G Romano, Tatjana Rundek, Ralph L Sacco, Seemant Chaturvedi
OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States. METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time...
November 7, 2017: Neurology
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#7
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28987721/circulating-inflammation-resolving-lipid-mediators-rvd1-and-dha-are-decreased-in-patients-with-acutely-symptomatic-carotid-disease
#8
Hernan A Bazan, Yan Lu, Bokkyoo Jun, Zhide Fang, T Cooper Woods, Song Hong
BACKGROUND: Efficient biomarkers for early prediction and diagnosis of an acutely symptomatic carotid plaque rupture event are currently lacking, impairing the ability to diagnose and treat patients with an acute plaque rupture events in a timely fashion. Resolvins are endogenous inflammation-resolving lipid mediators that are induced by inflammatory insults. We hypothesized that resolvin and other lipid profiles in sera likely mark the process towards plaque rupture. METHODS: Circulating lipids associated with plaque rupture events were quantitatively profiled via targeted mediator-lipidomics using ultraperformance liquid chromatography tandem mass spectrometry in patients with acutely symptomatic and asymptomatic carotid disease...
October 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#9
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28982332/asymmetric-cerebrovascular-collateral-supply-affects-cognition-in-patients-with-unilateral-carotid-artery-stenosis
#10
Kuo-Lun Huang, Ting-Yu Chang, Chien-Hung Chang, Ho-Ling Liu, Yeu-Jhy Chang, Chi-Hung Liu, Ho-Fai Wong, Yi-Ming Wu, Tsong-Hai Lee, Meng-Yang Ho
BACKGROUND: The time to maximum of the residue function (TMax) has been employed to identify the penumbra in acute ischemic stroke. Cognitive impairment in patients with carotid artery stenosis (CAS) has been attributed to chronic cerebral hypoperfusion. The study aimed to examine whether cognitive impairment can be detected based on a preliminary TMax cutoff in patients with unilateral CAS. METHODS: Fifty unilateral CAS patients underwent dynamic susceptibility contrast MR perfusion...
October 5, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28975971/the-relationship-between-serum-cxcl16-level-and-carotid-vulnerable-plaque-in-patients-with-ischemic-stroke
#11
G Jin
OBJECTIVE: We investigated the relationship between the serum macrophage chemokine ligand 16 (CXCL16) levels and the vulnerable carotid plaque in patients with ischemic stroke. PATIENTS AND METHODS: We successively selected 118 cases of patients with an initial diagnosis of acute ischemic stroke (time of onset < 72 h), recorded risk factors, including gender, age, family history, smoking, body mass index, blood glucose levels, blood lipid levels, average systolic pressure and diastolic blood pressure (DBP) and homocysteine levels...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28967590/a-case-of-intrathoracic-carotid-bifurcation-without-klippel-feil-syndrome
#12
Ryo Itabashi, Yukako Yazawa, Yuya Shigehatake, Eisuke Furui
BACKGROUND: Intrathoracic carotid bifurcation is a rare vascular anomaly, with only 8 cases reported. This vascular anomaly was recently correlated with Klippel-Feil syndrome, a rare congenital disorder involving fusion of the cervical vertebrae. METHODS: A 70-year-old deaf mute man was admitted to our department because of right hemiparesis and right sensory disturbance. He displayed no abnormalities associated with Klippel-Feil syndrome. Diffusion-weighted imaging revealed acute multiple infarcts in bilateral hemispheres...
September 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28959490/abcd-2-risk-score-does-not-predict-the-presence-of-cerebral-microemboli-in-patients-with-hyper-acute-symptomatic-critical-carotid-artery-stenosis
#13
Mahmud Saedon, Charles E Hutchinson, Christopher H E Imray, Donald R J Singer
INTRODUCTION: ABCD(2) risk score and cerebral microemboli detected by transcranial Doppler (TCD) have been separately shown to the predict risk of recurrent acute stroke. We studied whether ABCD(2) risk score predicts cerebral microemboli in patients with hyper-acute symptomatic carotid artery stenosis. PARTICIPANTS AND METHODS: We studied 206 patients presenting within 2 weeks of transient ischaemic attack or minor stroke and found to have critical carotid artery stenosis (≥50%)...
June 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28958688/what-influenced-the-lesion-patterns-and-hemodynamic-characteristics-in-patients-with-internal-carotid-artery-stenosis-a-retrospective-study
#14
Jinjie Liu, Hong Wang, Meiyan Zhang, Xiaowen Sui, Furong Li, Zanhua Liu, Sibo Liu, Hongling Zhao
OBJECTIVES: This study aimed to explore the dynamic changes of lesion patterns and hemodynamic characteristics in patients with internal carotid artery stenosis (ICAS). PATIENTS AND METHODS: Patients who had suffered an acute ischemic stroke in the distribution of ipsilateral ICAS were included. Computed tomography (CT) and transcranial doppler ultrasound (TCD) were conducted to evaluate the degree of ICAS and the hemodynamic characteristics of the intracranial and extracranial arteries...
August 23, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28893252/association-between-carotid-plaque-characteristics-and-acute-cerebral-infarction-determined-by-mri-in-patients-with-type-2-diabetes-mellitus
#15
Beibei Sun, Xiao Li, Xiaosheng Liu, Xiaoqian Ge, Qing Lu, Xihai Zhao, Jun Pu, Jianrong Xu, Huilin Zhao
BACKGROUND: Type 2 diabetes mellitus (T2DM) might aggravate the carotid plaque vulnerability, and increase the risk for ischemic stroke. Few studies reported the acute stroke subtype with carotid plaque characteristics in T2DM patients. This study aimed to investigate the association between carotid plaque characteristics and acute cerebral infarct (ACI) lesion features determined by MRI in T2DM patients. METHODS: Patients with acute cerebrovascular syndrome in internal carotid artery territory were recruited...
September 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28885101/association-between-the-maximal-distance-of-atrial-septal-protrusion-and-cryptogenic-stroke
#16
Keisuke Tokunaga, Masahiro Yasaka, Takahiro Kuwashiro, Seiji Gotoh, Asako Nakamura, Go Takaguchi, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Yasushi Okada
Background and purpose Previous studies have suggested that atrial septal aneurysm is a potential risk factor for cerebral embolism. However, the association between the level of atrial septal protrusion and cerebral embolism is still unclear. The purpose of the present study was to assess the association between the maximal distance of atrial septal protrusion and cryptogenic stroke. Methods A total of 588 consecutive acute ischemic stroke patients (70 ± 11 (mean ± SD) years, 401 men) who underwent transesophageal echocardiography were enrolled...
December 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28882090/stenosis-length-of-middle-cerebral-artery-and-branch-atheromatous-disease-associated-infarct
#17
Jian Wang, Yujie Wang, Zijia Chai, Yue Xin, Jialiang Wang, Jianting Qiu
ABSRACT Background: We analyzed the relationship between the characteristics of branch atheromatous disease associated infarct (BAI) and stenosis length (SL) of relevant middle cerebral artery (MCA) M1 segment. METHODS: 95 patients with BAI were recruited from 1024 consecutive acute ischemic stroke patients. Among them, 59 patients (62.11%) had concurrent relative stenosis of MCA M1 segment. The neurologic deficit severity at admission was assessed by NIHSS and the infarct size by infarct lesion thickness and maximum diameter...
September 8, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28864597/parvovirus-b19-infection-in-children-with-arterial-ischemic-stroke
#18
MULTICENTER STUDY
Heather J Fullerton, Jorge M Luna, Max Wintermark, Nancy K Hills, Rafal Tokarz, Ying Li, Carol Glaser, Gabrielle A DeVeber, W Ian Lipkin, Mitchell S V Elkind
BACKGROUND AND PURPOSE: Case-control studies suggest that acute infection transiently increases the risk of childhood arterial ischemic stroke. We hypothesized that an unbiased pathogen discovery approach utilizing MassTag-polymerase chain reaction would identify pathogens in the blood of childhood arterial ischemic stroke cases. METHODS: The multicenter international VIPS study (Vascular Effects of Infection in Pediatric Stroke) enrolled arterial ischemic stroke cases, and stroke-free controls, aged 29 days through 18 years...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28856989/from-vulnerable-plaque-to-blood-healthy-therapy
#19
Sun Yuhua, Wang Baoping
Cardiovascular atherosclerotic disease is the leading cause of death in China and in Western nations. People with plaque or stenosis in the coronary artery or the carotid artery are the most susceptible population to suffer from acute events. Current investigations showed that plaque with the characteristics of intra-plaque hemorrhage or a thin cap with a large lipid core was causally associated with vulnerable plaque and plaque rupture. Of the many plaque ruptures occurring in patients with atherosclerotic disease, very few will trigger symptomatic events, rendering it exceedingly difficult to predict adverse outcomes...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28845749/patterns-of-acute-ischemic-strokes-after-carotid-endarterectomy-and-therapeutic-implications
#20
Fabien Lareyre, Juliette Raffort, Caroline Weill, Claire Marsé, Laurent Suissa, Julien Chikande, Réda Hassen-Khodja, Elixène Jean-Baptiste
AIM: Acute ischemic strokes following surgical treatment of carotid stenosis lead to substantial disability and mortality, and vascular mechanisms underlying their development are not fully elucidated. The goal of this study was to analyze the topographic patterns of acute ischemic stroke following carotid endarterectomy (CEA) on diffusion-weighted and perfusion-weighted magnetic resonance imaging (MRI). MATERIAL AND METHODS: Data were retrospectively collected from consecutive patients who underwent CEA and developed postoperative acute ischemic stroke...
October 2017: Vascular and Endovascular Surgery
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