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https://www.readbyqxmd.com/read/28187920/holter-electrocardiogram-monitoring-in-patients-with-acute-ischaemic-stroke-find-afrandomised-an-open-label-randomised-controlled-trial
#1
Rolf Wachter, Klaus Gröschel, Götz Gelbrich, Gerhard F Hamann, Pawel Kermer, Jan Liman, Joachim Seegers, Katrin Wasser, Anna Schulte, Falko Jürries, Anna Messerschmid, Nico Behnke, Sonja Gröschel, Timo Uphaus, Anne Grings, Tugba Ibis, Sven Klimpe, Michaela Wagner-Heck, Magdalena Arnold, Evgeny Protsenko, Peter U Heuschmann, David Conen, Mark Weber-Krüger
BACKGROUND: Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. METHODS: Find-AFRANDOMISED is an open-label randomised study done at four centres in Germany...
February 8, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28178140/utility-of-duranta-a-wireless-patch-type-electrocardiographic-monitoring-system-developed-in-japan-in-detecting-covert-atrial-fibrillation-in-patients-with-cryptogenic-stroke-a-case-report
#2
Hisanao Akiyama, Saki Nukui, Takashi Araga, Masashi Hoshino, Keita Tanaka, Satoru Kashima, Rie Sasaki, Kenji Uchino, Yasuhiro Hasegawa
RATIONALE: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28174194/safety-and-efficacy-of-remote-ischemic-preconditioning-in-patients-with-severe-carotid-artery-stenosis-prior-to-carotid-artery-stenting-a-proof-of-concept-randomized-controlled-trial
#3
Wenbo Zhao, Ran Meng, Chun Ma, Baojun Hou, Liqun Jiao, Fengshui Zhu, Weijuan Wu, Jingfei Shi, Yunxia Duan, Renling Zhang, Jing Zhang, Yongxin Sun, Hongqi Zhang, Feng Ling, Yuping Wang, Wuwei Feng, Yuchuan Ding, Bruce Ovbiagele, Xunming Ji
BACKGROUND: -Remote ischemic preconditioning (RIPC) can inhibit recurrent ischemic events effectively in patients with acute or chronic cerebral ischemia. However, it is still unclear that whether RIPC can impede ischemic injury after carotid artery stenting (CAS) in patients with severe carotid artery stenosis. METHODS: -Subjects with severe carotid artery stenosis were recruited in this randomized controlled study, and assigned to RIPC, sham and no intervention (control) groups...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/28162027/retriever-wire-supported-carotid-artery-revascularization-rewised-care-in-acute-ischemic-stroke-with-underlying-tandem-occlusion-caused-by-an-internal-carotid-artery-dissection-technical-note
#4
Daniel Behme, Michael Knauth, Marios-Nikos Psychogios
We hereby report a novel technical approach for the treatment of acute stroke with underlying tandem occlusion. The so-called retriever wire supported carotid artery revascularization (ReWiSed CARe) technique, utilizing the wire of a stent-retriever as a guiding wire for carotid artery stenting, is technically feasible in tandem occlusions caused by an internal carotid artery (ICA) dissection or high grade ICA stenosis. This technique eliminates the need to use a long microwire in order to maintain the position inside the true lumen of a dissection...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28156253/severe-carotid-stenosis-and-delay-of-reperfusion-in-endovascular-stroke-treatment-an-interventional-management-of-stroke-iii-study
#5
Steven L Gogela, Yair M Gozal, Bin Zhang, Thomas A Tomsick, Andrew J Ringer, Joseph P Broderick, Pooja Khatri, Todd A Abruzzo
OBJECTIVE The impact of extracranial carotid stenosis on interventional revascularization of acute anterior circulation stroke is unknown. The authors examined the effects of high-grade carotid stenosis on the results of endovascular treatment of patients in the Interventional Management of Stroke (IMS)-III trial. METHODS The 278 patients in the endovascular arm of the IMS-III trial were categorized according to the degree of carotid stenosis as determined by angiography. In comparing patients with severe stenosis or occlusion (≥ 70%) to those without severe stenosis (< 70%), the authors evaluated the time to endovascular reperfusion, modified Thrombolysis in Cerebrovascular Infarction (mTICI) scores, 24-hour mean infarct volumes, symptomatic intracerebral hemorrhage rates, and modified Rankin Scale (mRS) scores at 90 days...
February 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28151862/a-lower-baseline-glomerular-filtration-rate-predicts-high-mortality-and-newly-cerebrovascular-accidents-in-acute-ischemic-stroke-patients
#6
Kai Dong, Xiaoqin Huang, Qian Zhang, Zhipeng Yu, Jianping Ding, Haiqing Song
Chronic kidney disease (CKD) is gradually recognized as an independent risk factor for cardiovascular and cardio-/cerebrovascular disease. This study aimed to examine the association of the estimated glomerular filtration rate (eGFR) and clinical outcomes at 3 months after the onset of ischemic stroke in a hospitalized Chinese population.Totally, 972 patients with acute ischemic stroke were enrolled into this study. Modified of Diet in Renal Disease (MDRD) equations were used to calculate eGFR and define CKD...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28127524/severe-carotid-artery-stenosis-evaluated-by-ultrasound-is-associated-with-post-stroke-vascular-cognitive-impairment
#7
Xuefeng Li, Xiangling Ma, Jing Lin, Xiangqin He, Feng Tian, Dongmei Kong
BACKGROUND: Acute ischemic stroke has been recognized as one key cause of vascular cognitive impairment (VCI). The purpose of this study was to evaluate the correlation between carotid artery stenosis and post VCI in acute ischemic stroke patients. METHODS: In this study, B-mode ultrasound was applied to measure the degree of carotid artery stenosis. After 1 year, the stroke patients' cognitive function was assessed by the mini-mental state examination (MMSE) score...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28116653/classical-and-additional-antiphospholipid-antibodies-in-blood-samples-of-ischemic-stroke-patients-and-healthy-controls
#8
Narin-Nard Carmel-Neiderman, David Tanne, Idan Goren, Pnina Rotman-Pikielny, Yair Levy
Classical antiphospholipid antibodies (aPLa) are found in 6-25% of blood samples from stroke patients. The frequency of novel aPLa antibodies in blood samples of CVA patients is not known. Enzyme-linked immunosorbent assays (ELISA) were performed on blood samples from 209 CVA patients (170 samples were obtained during the acute phase and 39 samples were from patients with complete carotid stenosis) and compared to 54 healthy controls. Subjects were tested for the presence of the classical aPL antibodies anticardiolipin (aCL) and anti-beta2-glycoprotein (aβ2gI), in addition to antiphosphatidylethanolamine (aPE), anti-phosphatidylserine (aPS), and Annexin V...
January 23, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28108499/relay-balloon-technique-for-recanalization-of-acute-symptomatic-proximal-internal-carotid-artery-occlusion-with-short-balloon-tipped-guiding-catheter-landing-zone
#9
Sang Hun Lee, Dong Geun Lee, Sun U Kwon, Deok Hee Lee
BACKGROUND: Endovascular recanalization of a completely occluded proximal internal carotid artery (ICA) with underlying stenosis may be challenging owing to a possible thrombotic component. This is especially true when the landing zone for a balloon-tipped guiding catheter (BGC) at the bulb portion is insufficient. Sequential application of the balloons of a BGC and an angioplasty catheter may prevent thromboembolism during revascularization. This study analyzed the safety and effectiveness of this relay-balloon technique...
January 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28105135/takayasu-s-arteritis-presenting-with-common-carotid-artery-dissection-a-rare-case-report
#10
Ruonan Hao, Jie Zhang, Zhicheng Ma, Ming Xiao, Lei Zhou, Nan Kang, Xiaoyu Liang, Fuxin Li
Takayasu's arteritis (TA) is a rare, idiopathic, chronic inflammatory disease associated with cell-mediated inflammation and involving predominantly the aorta and its primary branches. TA results in stenosis, occlusion or aneurysmal degeneration of large arteries pathologically. However, the incidence of dissection in arteries is low. As one of the primary causes of aortic dissection-associated ischemic stroke in young adults, only a limited number of TA cases presenting with aortic dissection have been published to date...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#11
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
January 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#12
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27995806/aetiologies-of-internal-carotid-artery-pseudo-occlusions-in-acute-stroke-patients-what-neurointerventionalists-can-expect
#13
REVIEW
Süha Akpınar, Pınar Gelener, Güliz Yilmaz
In cases of acute stroke, differentiation between an occluded and a patent internal carotid artery (ICA) is crucial for diagnosis and management. Although CT angiography (CTA) can be highly accurate in defining high-grade stenosis and ICA occlusions, misleading ICA occlusion patterns are not rare in patients with acute stroke. We investigated the underlying causes of ICA pseudo-occlusions with CTA with respect to digital subtraction angiography. 11 out of 72 patients had pseudo-occlusion on CTA. Of these, there were three cases of tandem occlusions accompanying high-grade ICA stenosis, five cases of Distal ICA bifurcation occlusion as a result of atrial fibrillation, two cases of cervical ICA dissection and one acute thrombosis of the stent...
February 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/27984560/relationship-between-carotid-stenosis-and-infarct-volume-in-ischemic-stroke-patients
#14
Aybala Neslihan Alagoz, Bilgehan Atılgan Acar, Türkan Acar, Alper Karacan, Bekir Enes Demiryürek
BACKGROUND Stroke is a serious health problem all over the world. Ischemia causes 85% of strokes and 75% of these ischemic strokes occur within the area supplied by the internal carotid artery (ICA). MATERIAL AND METHODS This study included 47 acute stroke patients who were in the large-artery atherosclerosis group according to Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification and who had an infarct in the area supplied by the internal carotid artery. We sought to determine whether there was a significant correlation between the infarct volume of the patients as measured by diffusion-weighted magnetic resonance imaging (DW MRI), their National Institutes of Health Stroke Scale (NIHSS), and degree of carotid stenosis as identified by carotid computed tomography angiography (CTA)...
December 16, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27941401/new-standards-of-care-in-ischemic-stroke
#15
Bree K Chancellor, Koto Ishida
BACKGROUND: Ischemic arterial strokes of the ophthalmic artery and its branches and posterior cerebral artery are common causes of visual disability. Etiologies of stroke affecting the retina, optic nerve, optic radiation, and visual cortex overlap with other types of ischemic strokes. Stenosis of the internal carotid is the most common cause of central retinal artery occlusion (CRAO). One-fourth of patients with CRAO have cerebral strokes. We report recent developments in the acute treatment and secondary prevention of ischemic stroke of relevance to clinicians who encounter patients with acute vision loss...
December 8, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27922251/endovascular-prevention-and-treatment-of-stroke-related-to-extracranial-carotid-artery-disease
#16
REVIEW
Leonardo Rangel-Castilla, Gary B Rajah, Hakeem J Shakir, Jason M Davies, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy, L Nelson Hopkins
Acute ischemic stroke (AIS) is the leading cause of premature mortality and morbidity worldwide for both men and women. Extracranial carotid artery stenosis/occlusion is responsible for approximately 11.5% of ischemic strokes, whereas extracranial large vessel disease comprises roughly 16.6% of ischemic strokes. Carotid artery disease has been the source of significant debate among neurovascular and cardiovascular specialists, as well as vascular surgeons, as to the best method of revascularization, surgical reconstruction versus endovascular recanalization...
February 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27919794/diagnostic-utility-of-contrast-enhanced-3d-t1-weighted-imaging-in-acute-cerebral-infarction-associated-with-graves-disease
#17
Yasufumi Gon, Manabu Sakaguchi, Naoki Oyama, Hideki Mochizuki
Graves disease is rarely complicated with cerebrovascular steno-occlusive diseases. Previous studies have suggested several hypotheses for this occurrence, including excess thyroid hormone, which stimulates the sympathetic nervous system, which in turn causes an abnormal hemodynamic response with consequent atherosclerotic changes, and antithyroid antibodies cause local vascular inflammation in patients with Graves disease. However, radiological findings of vasculitis in patients with Graves disease and cerebral infarction remain less known...
December 2, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27914836/perioperative-retinal-artery-occlusion-risk-factors-in-cardiac-surgery-from-the-united-states-national-inpatient-sample-1998-2013
#18
Tyler Calway, Daniel S Rubin, Heather E Moss, Charlotte E Joslin, Katharina Beckmann, Steven Roth
PURPOSE: To study the incidence and risk factors for retinal artery occlusion (RAO) in cardiac surgery. DESIGN: Retrospective study using the National Inpatient Sample (NIS). METHODS: The NIS was searched for cardiac surgery. Retinal artery occlusion was identified by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Postulated risk factors based on literature review were included in multivariate logistic models...
February 2017: Ophthalmology
https://www.readbyqxmd.com/read/27908279/co-existing-intracranial-and-extracranial-carotid-artery-atherosclerotic-plaques-and-recurrent-stroke-risk-a-three-dimensional-multicontrast-cardiovascular-magnetic-resonance-study
#19
Yilan Xu, Chun Yuan, Zechen Zhou, Le He, Donghua Mi, Rui Li, Yuanyuan Cui, Yilong Wang, Yongjun Wang, Gaifen Liu, Zhuozhao Zheng, Xihai Zhao
BACKGROUND: As a systemic disease, atherosclerosis commonly affects intracranial and extracranial carotid arteries simultaneously which is defined as co-existing plaques. Previous studies demonstrated that co-existing atherosclerotic diseases are significantly associated with ischemic cerebrovascular events. The aim of this study was to investigate the characteristics of co-existing intracranial and extracranial carotid atherosclerotic plaques and their relationships with recurrent stroke by using 3D multi-contrast magnetic resonance (MR) vessel wall imaging...
December 2, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27811331/carotid-stenting-versus-endarterectomy-in-the-same-patient-a-direct-comparison
#20
Marco M Ciccone, Pietro Scicchitano, Francesca Cortese, Michele Gesualdo, Annapaola Zito, Rosa Carbonara, Ilaria Dentamaro, Raffaele Pulli, Christian Salerno, Giovanni Impedovo, Davide Marinazzo, Domenico Angiletta, Davide Guido, Guido Regina
The aim of this study was to evaluate outcomes and feasibility of carotid artery stenting versus carotid endarterectomy, both procedures performed in the same patient. Forty-five subjects (33 males, 70 ± 7 years) underwent carotid endarterectomy or carotid artery stenting, the counter procedure on the contralateral carotid performed after a variable period. We evaluated the post-procedural percentage of carotid stenosis at 30, 180 days and one-year follow-up, and the occurrence of acute myocardial infarction, New York Heart Association class progression, stroke, death, cardiovascular death, angina, transient ischemic attack and renal failure...
November 3, 2016: Vascular
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