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Large vessel occlusion

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https://www.readbyqxmd.com/read/29148253/quantification-of-vascular-damage-in-acute-kidney-injury-with-fluorine-magnetic-resonance-imaging-and-spectroscopy
#1
Jeremy K Moore, Junjie Chen, Hua Pan, Joseph P Gaut, Sanjay Jain, Samuel A Wickline
PURPOSE: To design a fluorine MRI/MR spectroscopy approach to quantify renal vascular damage after ischemia-reperfusion injury, and the therapeutic response to antithrombin nanoparticles (NPs) to protect kidney function. METHODS: A total of 53 rats underwent 45 min of bilateral renal artery occlusion and were treated at reperfusion with either plain perfluorocarbon NPs or NPs functionalized with a direct thrombin inhibitor (PPACK:phenyalanine-proline-arginine-chloromethylketone)...
November 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29146873/mobile-interventional-stroke-teams-lead-to-faster-treatment-times-for-thrombectomy-in-large-vessel-occlusion
#2
Daniel Wei, Thomas J Oxley, Dominic A Nistal, Justin R Mascitelli, Natalie Wilson, Laura Stein, John Liang, Lena M Turkheimer, Jacob R Morey, Claire Schwegel, Ahmed J Awad, Hazem Shoirah, Christopher P Kellner, Reade A De Leacy, Stephan A Mayer, Stanley Tuhrim, Srinivasan Paramasivam, J Mocco, Johanna T Fifi
BACKGROUND AND PURPOSE: Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model...
November 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29145742/improving-mechanical-thrombectomy-time-metrics-in-the-angiography-suite-stroke-cart-parallel-workflows-and-conscious-sedation
#3
Fabio Settecase, David B McCoy, Robert Darflinger, Matthew D Alexander, Daniel L Cooke, Christopher F Dowd, Steven W Hetts, Randall T Higashida, Van V Halbach, Matthew R Amans
Purpose Earlier reperfusion of large-vessel occlusion (LVO) stroke improves functional outcomes. We hypothesize that use of a stroke cart in the angiography suite, containing all commonly used procedural equipment in a mechanical thrombectomy, combined with parallel staff workflows, and use of conscious sedation when possible, improve mechanical thrombectomy time metrics. Methods We identified 47 consecutive LVO patients who underwent mechanical thrombectomy at our center, retrospectively and prospectively from implementation of these three workflow changes (19 pre- and 28 post-)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29135625/impact-of-sex-on-long-term-clinical-outcomes-after-percutaneous-coronary-intervention
#4
Seyed-Mohammad Ghoreyshi-Hefzabad, Seyed-Ebrahim Kassaian, Shahrbanoo Kheirkhah-Sabetghadam, Arash Jalali, Hamidreza Poorhosseini, Mohammad Reza Movahed, Ebrahim Nematipour, Mojtaba Salarifar, Mohammad Alidoosti, Seyedeharezoo Ghoreyshi-Hefzabad, Farshid Alaeddini, Saeed Sadeghian, Masoumeh Lotfi-Tokaldany
AIMS: To evaluate the impact of sex on long-term clinical outcomes after percutaneous coronary intervention (PCI). METHODS: In a large prospective cohort, 5664 patients (1716 women and 3948 men) who underwent PCI in a tertiary cardiac center between March 2007 and March 2010 were enrolled. Patients were followed up for median of 74.3 months. We compared the occurrence of long-term mortality, myocardial infarction (MI), and repeated revascularization between 2 sexes...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29134723/the-ct-defined-hyperdense-arterial-sign-as-a-marker-for-acute-intracerebral-large-vessel-occlusion
#5
Jaims Lim, Jordan A Magarik, Michael T Froehler
BACKGROUND AND PURPOSE: To determine the sensitivity and specificity of the hyperdense artery sign (HAS) on thin-slice non-contrast computed tomography (NCCT), combined with brief clinical history, as an indicator for large vessel occlusion (LVO) in the setting of acute ischemic stroke. METHODS: Ninety-nine LVO and 102 non-LVO acute ischemic stroke patients were retrospectively identified from a prospective database at a single institution. After reviewing each patient's neurologic presentation based on his or her initial National Institute of Health Stroke Scale (NIHSS) and neurologic evaluation, all thin (1 mm) and thick (5 mm) NCCT scans were reviewed for the HAS...
November 14, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29130951/prehospital-computed-tomography-angiography-in-acute-stroke-management
#6
Michael Kettner, Stefan Alexander Helwig, Andreas Ragoschke-Schumm, Lenka Schwindling, Safwan Roumia, Isabel Keller, Daniel Martens, Johann Kulikovski, Matthias Manitz, Martin Lesmeister, Silke Walter, Iris Quasar Grunwald, Thomas Schlechtriemen, Wolfgang Reith, Klaus Fassbender
BACKGROUND: An ambulance equipped with a computed tomography (CT) scanner, a point-of-care laboratory, and telemedicine capabilities (mobile stroke unit [MSU]) has been shown to enable the delivery of thrombolysis to stroke patients directly at the emergency site, thereby significantly decreasing time to treatment. However, work-up in an MSU that includes CT angiography (CTA) may also potentially facilitate triage of patients directly to the appropriate target hospital and specialized treatment, according to their individual vascular pathology...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29127196/mechanical-thrombectomy-for-acute-ischemic-stroke-with-occlusion-of-the-m2-segment-of-the-middle-cerebral-artery-a-meta-analysis
#7
Hamidreza Saber, Sandra Narayanan, Mohan Palla, Jeffrey L Saver, Raul G Nogueira, Albert J Yoo, Sunil A Sheth
BACKGROUND: Endovascular thrombectomy has demonstrated benefit for patients with acute ischemic stroke from proximal large vessel occlusion. However, limited evidence is available from recent randomized trials on the role of thrombectomy for M2 segment occlusions of the middle cerebral artery (MCA). METHODS: We conducted a systematic review and meta-analysis to investigate clinical and radiographic outcomes, rates of hemorrhagic complications, and mortality after M2 occlusion thrombectomy using modern devices, and compared these outcomes against patients with M1 occlusions...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29120976/case-report-masquerading-large-vessel-giant-cell-arteritis
#8
Paul Jacquier, Raphael Wuarin, Carlo Chizzolini, Gabriele Thumann, Heimo Steffen, Argyrios Chronopoulos
SIGNIFICANCE: Large-vessel giant cell arteritis (GCA) can be a diagnostic dilemma for the eye care provider because it may not involve the typical cranial arteries. When any of its potential ocular complications are diagnosed, it is important to consider this unusual form of GCA. PURPOSE: To report an unusual ophthalmic presentation of large-vessel GCA with sequential bilateral anterior ischemic optic neuropathy and branch retinal artery occlusion. METHODS: A 65-year-old previously healthy woman experienced sequential bilateral anterior ischemic optic neuropathy with branch retinal artery occlusion in the absence of other signs and symptoms suggestive of cranial GCA...
November 9, 2017: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/29119925/post-treatment-with-a-hydrogen-sulfide-donor-limits-neuronal-injury-and-modulates-potassium-voltage-gated-channel-subfamily-d-member-2-kv4-2-and-potassium-channel-interacting-protein-3-kchip3-during-transient-global-cerebral-ischemia
#9
Cheng-Ping Bai, ChenLiang Zhao, Lijuan Shen
BACKGROUND: Although the neuroprotective effect of sodium hydrosulfide (NaHS, a hydrogen sulfide donor) pretreatment has been revealed, the effect of NaHS post-conditioning remains largely unknown. OBJECTIVE: We aimed to investigate the neuroprotective effect of NaHS post-conditioning against transient global cerebral ischemia (tGCI)-induced hippocampal CA1 injury and its underlying molecular mechanism. METHODS: A tGCI rat model was established using the four-vessel occlusion method for 15 min of ischemia...
November 7, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/29119033/the-utility-of-mri-in-the-diagnosis-of-takayasu-arteritis
#10
Marian Gaballah, Rachelle Goldfisher, John B Amodio
Takayasu Arteritis (TA) is an inflammatory disorder involving the thoracoabdominal aorta and its branches and the pulmonary arteries, with eventual vascular stenosis, occlusion, or aneurysm formation. Conventional angiography has been the reference imaging standard for diagnosis of TA. The purpose of this case report is to demonstrate the utility of MR imaging and MR angiography in the diagnosis of Takayasu Arteritis in a pediatric patient. The patient is a 15-year-old female patient presenting with anemia, hypertension, and acute kidney injury...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29118798/internal-carotid-artery-and-the-proximal-m1-segment-are-optimal-targets-for-mechanical-thrombectomy
#11
Niko Sillanpää, Sara Protto, Jukka T Saarinen, Juha-Pekka Pienimäki, Janne Seppänen, Heikki Numminen, Harri Rusanen
Background and Purpose: Mechanical thrombectomy (MT) is an established treatment of acute anterior circulation stroke caused by large vessel occlusion (LVO). We compared the clinical outcome (3-month modified Rankin Scale, mRS) in hyperacute (<3h from the onset of symptoms) ischemic stroke between an MT and an intravenous thrombolysis (IVT) cohort in proximal (ICA and the proximal M1 segment of the middle cerebral artery) and distal (the distal M1 and the M2 segment) LVOs. Methods: We prospectively reviewed 67 patients who underwent MT with newer-generation stent retrievers...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118796/a-comparison-of-mechanical-thrombectomy-in-the-m1-and-m2-segments-of-the-middle-cerebral-artery-a-review-of-585-consecutive-patients
#12
Pervinder Bhogal, Philipp Bücke, Muhammad AlMatter, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar Pérez
Background: Mechanical thrombectomy for anterior-circulation large-vessel occlusion has shown benefit; however, the question of whether this technique is safe and effective in the distal vasculature remains unanswered. We sought to compare the outcome data from mechanical thrombectomy of the M2 branches of the middle cerebral artery (MCA) with those of the M1 segment. Methods: We performed a retrospective analysis of prospectively collected data of patients with acute ischaemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA between August 2008 and August 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118791/utilizing-ct-with-maximum-intensity-projection-reconstruction-bypassing-cta-improves-time-to-groin-puncture-in-large-vessel-occlusion-stroke-thrombectomy
#13
Kunakorn Atchaneeyasakul, Anita Tipirneni, Priyank Khandelwal, Vasu Saini, Richard Ronca, Steven Lord, Samir Sur, Luis Guada, Kevin Ramdas, Eric Peterson, Dileep Yavagal
Background and Purpose: Prior to thrombectomy for proximal anterior circulation large vessel occlusion (LVO) stroke, recent trials have utilized CT angiography (CTA) for vascular imaging immediately following noncontrast CT (NCCT) for decision-making, but thin-section NCCT with automated maximum intensity projection (MIP) reconstruction also has high accuracy in demonstrating the site of an occluding thrombus. We hypothesized that performing thin-section NCCT with MIP alone prior to thrombectomy improves the time to groin puncture (GP) compared to performing CTA after NCCT...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29115584/apolipoprotein-c-iii-in-the-high-density-lipoprotein-proteome-of-cerebral-lacunar-infarction-patients-impairs-its-anti-inflammatory-function
#14
Pu Lv, Mingming Zhao, Yuanyuan Liu, Haiqiang Jin, Wei Cui, Chenghe Fan, Yuming Teng, Lemin Zheng, Yining Huang
High-density lipoprotein (HDL) proteomic study has identified substantial changes associated with various disease states. In the current study, the HDL proteomes in patients with cerebral lacunar infarction (LACI) and control subjects were investigated. A total of 12 LACI patients without evident large vessel occlusions and 12 controls were enrolled in the study. The HDL fraction from each sample was isolated from the plasma by ultracentrifugation. The protemics of the HDL were investigated using nano liquid chromatography coupled to tandem mass spectrometry...
October 27, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29114095/direct-mechanical-intervention-versus-bridging-therapy-in-stroke-patients-eligible-for-intravenous-thrombolysis-a-pooled-analysis-of-2-registries
#15
Sebastian Bellwald, Ralph Weber, Tomas Dobrocky, Hannes Nordmeyer, Simon Jung, Jeffrie Hadisurya, Pasquale Mordasini, Marie-Luise Mono, Christian P Stracke, Hakan Sarikaya, Corrado Bernasconi, Klaus Berger, Marcel Arnold, René Chapot, Jan Gralla, Urs Fischer
BACKGROUND AND PURPOSE: Randomized controlled trials have shown that mechanical thrombectomy (MT) plus best medical treatment improves outcome in stroke patients with large-vessel occlusion in the anterior circulation. Whether direct MT is equally effective as bridging thrombolysis (intravenous thrombolysis plus MT) in intravenous thrombolysis eligible patients remains unclear. METHODS: We compared clinical and radiological outcomes at 3 months in 249 bridging patients with 111 patients receiving direct MT for large-vessel occlusion anterior circulation stroke from 2 prospective registries (study period Essen: June 2012 to August 2013, Bern February 2009 to August 2014)...
November 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29113900/dwell-time-of-stentriever-influences-complete-revascularisation-and-first-pass-tici3-revascularisation-in-acute-large-vessel-occlusive-stroke
#16
Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sylaja Padmavathy N, Sankara Sarma P, Sajith Sukumaran, Sapna Erat Sreedharan, Tirur Raman Kapilamoorthy
BACKGROUND AND OBJECTIVE: In acute ischemic stroke with large vessel occlusion, the interaction between the clot retriever and the stent is critical for achieving successful recanalization. The ideal time of stent deployment (dwell time, DT) to improve revascularization is currently unknown., We systematically analysed the effect of different DT on final angiographic and clinical outcome of of patients who underwent mechanical thrombectomy. METHODS: The DT was progressively increased from 3 minutes to 5 minutes and later, 8 minutes during the study period...
November 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29112740/evaluation-of-damage-in-giant-cell-arteritis
#17
Tanaz A Kermani, Antoine G Sreih, David Cuthbertson, Simon Carette, Gary S Hoffman, Nader A Khalidi, Curry L Koening, Carol A Langford, Carol A McAlear, Paul A Monach, Larry Moreland, Christian Pagnoux, Philip Seo, Kenneth J Warrington, Steven R Ytterberg, Peter A Merkel
Objectives: To evaluate damage and variables associated with damage in GCA. Methods: Patients with GCA enrolled in a prospective, multicentre, longitudinal study were included. Per-protocol assessments were made with the Vasculitis Damage Index and the Large-Vessel Vasculitis Index of Damage. Results: The study included 204 patients: 156 women (76%), mean age at diagnosis 71.3 years (s.d. 8.3), mean follow-up of 3.5 years (s.d. 1.9). One or more damage item was present in 54% at baseline and 79% at the last follow-up on the Vasculitis Damage Index, and 60% at baseline and 82% at the last follow-up on the Large-Vessel Vasculitis Index of Damage...
November 3, 2017: Rheumatology
https://www.readbyqxmd.com/read/29107162/artificial-stroke-clots-how-wide-is-the-gap-to-the-real-world
#18
Maria Berndt, Sascha Prothmann, Christian Maegerlein, Paul Oberdieck, Claus Zimmer, Barbara Hegge, Jaroslav Pelisek, Lucas Schirmer, Holger Poppert, Tobias Boeckh-Behrens
OBJECTIVE: Especially since the establishment of mechanical thrombectomy as part of the standard stroke therapy, artificial thrombi have become important in the training of interventionalists as well as for the development and testing of devices. So far, these in vitro clots lack direct comparisons with ex vivo thrombi. We therefore compared the histological appearance of dynamically produced clots with that of stroke thrombi acquired during mechanical recanalization. METHODS: Thrombi of 145 consecutive stroke patients with large-vessel occlusions were histologically compared with 10 artificial clots, dynamically created from human blood and pig's blood using a Chandler loop system...
October 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29106687/aspects-large-vessel-occlusion-and-time-of-symptom-onset-estimation-of-eligibility-for-endovascular-therapy
#19
Maxim Mokin, Aparna Pendurthi, Vladimir Ljubimov, William S Burgin, Adnan H Siddiqui, Elad I Levy, Christopher T Primiani
BACKGROUND: Understanding how many patients are eligible for endovascular therapy can help develop more effective stroke systems of care. OBJECTIVE: To determine the proportion of patients eligible for endovascular therapy. METHODS: In this single center retrospective cohort study, we identified patients with acute ischemic stroke from large vessel occlusion (LVO) from January 2014 to December 2015. Selection criteria including LVO location, Alberta stroke program early computed tomography score (ASPECTS) range, hospital arrival time, and the use of intravenous thrombolysis were applied to calculate proportions of patients eligible for endovascular therapy...
July 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29105494/causes-of-death-in-different-subtypes-of-ischemic-and-hemorrhagic-stroke
#20
Chi-Hung Liu, Jr-Rung Lin, Chia-Wei Liou, Jiann-Der Lee, Tsung-I Peng, Meng Lee, Tsong-Hai Lee
Causes of death in both ischemic stroke (IS) and hemorrhagic stroke (HS) subtypes are not comprehensively studied. Between 2008 and 2011, we enrolled 11 215 first-ever stroke patients from the Stroke Registry of Chang-Gung Healthcare System and linked these data to the national death registry. The main causes of death in each stroke subtype were assessed. Patients with HS had higher overall mortality than IS (32.0% vs 18.1%, P < .001). In IS subtypes, large-artery atherosclerosis plus cardioembolism had the worst mortality (40...
January 1, 2017: Angiology
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