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Large vessel occlusion

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https://www.readbyqxmd.com/read/27922810/impact-of-chronic-total-occlusion-revascularization-attempts-on-subsequent-clinical-outcomes
#1
Ahmad Jabbar, Georgios Christopoulos, Aris Karatasakis, Omar M Jeroudi, Georgios E Christakopoulos, Abdallah El Sabbagh, Barbara Danek, Judit Karacsonyi, Michele Roesle, Bavana V Rangan, Jerrold Grodin, Michael Luna, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We examined a contemporary, unselected cohort of patients with coronary chronic total occlusions (CTOs) to determine the impact of CTO revascularization on long-term outcomes. METHODS: We retrospectively assessed the impact of CTO revascularization on clinical outcomes of consecutive patients found to have a CTO during coronary angiography performed at our institution during 2011 and 2012. The primary endpoint was the incidence of a major adverse cardiac event (MACE, defined as a composite of death, myocardial infarction, stroke, and target-vessel revascularization [TVR])...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27922805/near-infrared-spectroscopy-analysis-of-coronary-chronic-total-occlusions
#2
Georgios E Christakopoulos, Judit Karacsonyi, Barbara Anna Danek, Aris Karatasakis, Aya Alame, Pratik Kalsaria, Atif Mohammed, Michele Roesle, Bavana V Rangan, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVE: To examine the presence and localization of lipid-core plaque (LCP) in coronary vessels with chronic total occlusions (CTOs) using near-infrared spectroscopy (NIRS). METHODS: NIRS imaging was performed after guidewire crossing of the occlusion in 15 patients with CTOs. LCP was defined as ≥2 adjacent 2 mm yellow blocks on the block chemogram. We also measured the maximum lipid-core burden index (LCBI) in a 4 mm length of artery (maxLCBI4mm). Large LCP was defined as maxLCBI4mm ≥500...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27922251/endovascular-prevention-and-treatment-of-stroke-related-to-extracranial-carotid-artery-disease
#3
Leonardo Rangel-Castilla, Gary B Rajah, Hakeem J Shakir, Jason M Davies, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy, L N 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...
December 6, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27917948/association-of-cortical-vein-filling-with-clot-location-and-clinical-outcomes-in-acute-ischaemic-stroke-patients
#4
Sonu Bhaskar, Andrew Bivard, Peter Stanwell, John R Attia, Mark Parsons, Michael Nilsson, Christopher Levi
Delay in cortical vein filling during the late-venous phase (delayed-LCVF) is characterized by opacification of cerebral veins despite contrast clearance from contralateral veins on dynamic computed tomography angiography (dCTA) in acute ischemic stroke (AIS) patients. The aim of the study was to investigate the associations of delayed-LCVF with clot location, reperfusion status at 24 hours, and 90-days functional outcome in AIS patients who received reperfusion therapy. A prospective cohort of AIS patients treated with intravenous thrombolysis was studied...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27913263/experience-with-adapt-for-thrombectomy-in-distal-cerebral-artery-occlusions-causing-acute-ischemic-stroke
#5
Jan Vargas, Alex M Spiotta, Kyle Fargen, Raymond D Turner, Imran Chaudry, Aquilla Turk
BACKGROUND: Thromboembolic occlusion of distal branches in anterior and posterior circulation may produce severe clinical deficits. The ADAPT technique is a simple, fast method for achieving good angiographic and clinical outcomes using large bore catheters in large vessel occlusions. OBJECTIVE: We present our results using the ADAPT technique with distal cerebral artery occlusions. METHODS: Thirty-five patients with acute ischemic stroke with thrombus in the distal MCA, ACA, or PCA were treated with the ADAPT technique...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913202/adiponectin-gene-polymorphism-and-ischemic-stroke-subtypes-in-a-chinese-population
#6
Shanshan Li, Ning Lu, Zhongnan Li, Bin Jiao, Hanping Wang, Jia Yang, Tao Yu
As an adipose tissue-specific protein, adiponectin has been suggested as a protective factor for stroke, acting through anti-inflammatory and antiatherogenic effects. Therefore, we aimed to investigate whether 3 polymorphisms (rs1501299, rs2241767, and rs3774261) in the adiponectin (ADIPOQ) gene and their haplotypes were associated with ischemic stroke (IS) and its subtypes in a Chinese population. ADIPOQ gene rs1501299, rs2241767, and rs3774261 polymorphisms were analyzed in 385 IS patients, including 182 patients with large-artery atherosclerosis (LAA), 203 patients with small-vessel occlusion (SVO), and 418 matched controls...
November 29, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27909202/prediction-of-blood-brain-barrier-disruption-and-intracerebral-hemorrhagic-infarction-using-arterial-spin-labeling-magnetic-resonance-imaging
#7
Takeya Niibo, Hajime Ohta, Shirou Miyata, Ichiro Ikushima, Kazuchika Yonenaga, Hideo Takeshima
BACKGROUND AND PURPOSE: Arterial spin-labeling magnetic resonance imaging is sensitive for detecting hyperemic lesions (HLs) in patients with acute ischemic stroke. We evaluated whether HLs could predict blood-brain barrier (BBB) disruption and hemorrhagic transformation (HT) in acute ischemic stroke patients. METHODS: In a retrospective study, arterial spin-labeling was performed within 6 hours of symptom onset before revascularization treatment in 25 patients with anterior circulation large vessel occlusion on baseline magnetic resonance angiography...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27908816/blunt-traumatic-occlusion-of-the-common-iliac-artery-repaired-with-segmental-excision-and-internal-iliac-artery-patch-angioplasty
#8
Abid C Mogannam, Robert F Cubas, Ivan M Gutierrez, Juan A Astudillo, Ahmed M Abou-Zamzam
Common iliac artery (CIA) occlusion as a result of blunt trauma is rare and seldom reported. This has been associated with pelvic fractures and other great vessel lesions. Management options include endovascular covered stent placement, open anatomic repair with autogenous conduit, or open extra-anatomic repair with prosthetic material. We report the case of a middle-aged male with a right CIA injury secondary to blunt trauma who underwent a successful repair using an internal iliac artery (IIA) patch for injury to a 2 cm segment of CIA with peritoneal contamination...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#9
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906117/carotid-artery-stenting-versus-no-stenting-assisting-thrombectomy-for-acute-ischaemic-stroke-protocol-for-a-systematic-review-of-randomised-clinical-trials-with-meta-analyses-and-trial-sequential-analyses
#10
Henrik Steglich-Arnholm, Markus Holtmannspötter, Christian Gluud, Derk Wolfgang Krieger
BACKGROUND: In patients with intracranial large vessel arterial occlusion, ipsilateral extracranial carotid artery occlusions or near-occlusions pose a significant hurdle in endovascular management of acute ischaemic stroke. Stenting of the carotid lesion may be beneficial in this situation to provide a stable access for introducing catheters through the carotid lesion into the intracranial vasculature and the target occlusion. Furthermore, carotid stenting may ensure ample blood flow for wash-out of clot material and reperfusion of the ischaemic penumbral tissue...
December 1, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27899751/air-pollution-is-associated-with-ischemic-stroke-via-cardiogenic-embolism
#11
Jong-Won Chung, Oh Young Bang, Kangmo Ahn, Sang-Soon Park, Tai Hwan Park, Jae Guk Kim, Youngchai Ko, SooJoo Lee, Kyung Bok Lee, Jun Lee, Kyusik Kang, Jong-Moo Park, Yong-Jin Cho, Keun-Sik Hong, Hyun-Wook Nah, Dae-Hyun Kim, Jae-Kwan Cha, Wi-Sun Ryu, Dong-Eog Kim, Joon-Tae Kim, Jay Chol Choi, Mi-Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Ji Sung Lee, Juneyoung Lee, Hong-Kyun Park, Beom Joon Kim, Moon-Ku Han, Hee-Joon Bae
BACKGROUND AND PURPOSE: The aim of the study was to assessed the impact of short-term exposure to air pollution on ischemic stroke subtype, while focusing on stroke caused via cardioembolism. METHODS: From a nationwide, multicenter, prospective, stroke registry database, 13 535 patients with acute ischemic stroke hospitalized to 12 participating centers were enrolled in this study. Data on the hourly concentrations of particulate matter <10 μm, nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) were collected from 181 nationwide air pollution surveillance stations...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27899742/acute-endovascular-treatment-delivery-to-ischemic-stroke-patients-transferred-within-a-telestroke-network-a-retrospective-observational-study
#12
Jessica Barlinn, Johannes Gerber, Kristian Barlinn, Lars-Peder Pallesen, Timo Siepmann, Charlotte Zerna, Claudia Wojciechowski, Volker Puetz, Rüdiger von Kummer, Heinz Reichmann, Jennifer Linn, Ulf Bodechtel
BACKGROUND: Five randomized controlled trials recently demonstrated efficacy of endovascular treatment in acute ischemic stroke. Telestroke networks can improve stroke care in rural areas but their role in patients undergoing endovascular treatment is unknown. AIM: We compared clinical outcomes of endovascular treatment between anterior circulation stroke patients transferred after teleconsultation and those directly admitted to a tertiary stroke center. METHODS: Data derived from consecutive patients with intracranial large vessel occlusion who underwent endovascular treatment from January 2010 to December 2014 at our tertiary stroke center...
November 29, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27899517/endovascular-management-of-cerebral-septic-embolism-three-recent-cases-and-review-of-the-literature
#13
Eugene L Scharf, Tia Chakraborty, Alejandro Rabinstein, Amrendra S Miranpuri
Endovascular management of acute ischemic stroke secondary to septic emboli from bacterial endocarditis is case-specific and outside established guidelines. We report three new cases of an acute ischemic stroke secondary to septic embolus from two different centers. All cases reported here were large vessel occlusions of the middle cerebral artery in anticoagulated patients. In one case the embolus was noted to be firm and aspiration thrombectomy was attempted in lieu of stent retrieval. Thrombolysis in Cerebral Ischemia (TICI) 3 recanalization was achieved and the patient experienced a good outcome with resolution of deficits...
November 29, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27891240/differences-in-the-clinical-manifestations-and-short-term-prognosis-of-acute-cerebral-infarction-after-exposure-to-agent-orange
#14
SangWoo Han, Inha Hwang, Seung Min Kim, Young Soon Yang, SangWon Ha, Jeong Ho Han, Tae Hwan Park
BACKGROUND: Agent Orange (AO) is the code name for one of the herbicides and defoliants used in the Vietnam War. Studies conducted thus far show a significant correlation between AO and the occurrence of cardiovascular diseases. But there is little data on the association between AO and stroke, and limited studies have targeted patient groups exposed to AO. METHOD: Bohun medical center Institutional Review Board (IRB) approved the study. (ID: 341) We studied patients with acute ischemic stroke within 7 days of onset in VHS medical center and 4 other general hospitals...
2016: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27888552/initial-clinical-experience-with-the-medtronic-micro-vascular-plug%C3%A2-in-transcatheter-occlusion-of-pdas-in-extremely-premature-infants
#15
Shyam Sathanandam, Henri Justino, B Rush Waller, Wolfgang Radtke, Athar M Qureshi
OBJECTIVES: To describe the early multicenter, clinical experience with the Medtronic Micro Vascular Plug™ (MVP) for the occlusion of patent ductus arteriosus (PDA) in premature infants. BACKGROUND: The MVP is a large diameter plug that can be delivered through a microcatheter for occlusion of abnormal blood vessels. METHODS: A Retrospective review of PDA embolization procedures performed in two centers using the MVP was performed. RESULTS: Fifteen premature infants underwent attempted PDA occlusion using the MVP...
November 26, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27876083/two-year-clinical-follow-up-of-the-multicenter-randomized-clinical-trial-of-endovascular-treatment-for-acute-ischemic-stroke-in-the-netherlands-mr-clean-design-and-statistical-analysis-plan-of-the-extended-follow-up-study
#16
Lucie A van den Berg, Marcel G W Dijkgraaf, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Hester Lingsma, Charles B M Majoie, Diederik W J Dippel, Aad J van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Yvo B W E M Roos
BACKGROUND: MR CLEAN was the first randomized trial to demonstrate the short-term clinical effectiveness of endovascular treatment in patients with acute ischemic stroke caused by large vessel occlusion in the anterior circulation. Several other trials confirmed that endovascular treatment improves clinical outcome at three months. However, limited data are available on long-term clinical outcome. We aimed to estimate the effect of endovascular treatment on functional outcome at two-year follow-up in patients with acute ischemic stroke...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27875796/development-of-extensive-inferior-vena-cava-thrombosis-due-to-the-ligation-of-a-large-mesenteric-caval-shunt-during-liver-transplantation-a-case-report
#17
Hideya Kamei, Yasuharu Onishi, Masatoshi Ishigami, Yoji Ishizu, Kojiro Suzuki, Yasuhiro Ogura
INSTRUCTION: Inferior vena cava (IVC) thrombosis can be a life-threatening complication after liver transplantation (LT). Although this complication is usually related to technical problems associated with vascular anastomosis, we report a case of IVC thrombosis which developed from a ligated large mesenteric-caval shunt. PRESENTATION OF CASE: A 35-year-old man underwent LT from a brain-dead donor for primary sclerosing cholangitis. Enhanced computed tomography (CT) before LT showed a huge collateral vessel of the inferior mesenteric vein (IMV) draining into the infra-renal IVC directly...
November 15, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27867673/central-retinal-artery-occlusion-in-takayasu-s-arteritis-as-the-first-presentation-of-the-disease
#18
Hande Guclu, Vuslat Pelitli Gurlu, Sadık Altan Ozal, Orkut Guclu
Takayasu's arteritis (TA) is a chronic inflammatory granulomatous vasculitis which affects large and medium arterial vessels. The disease involves especially subclavian arteries and aortic branches but it can consist of any arteries. The major pathology is granulomatous panarteritis with intima proliferation and defects of the elastic lamina of the vessels. We present a case of central retinal artery occlusion in TA as the first presentation of the disease. To the best of our knowledge, the present case is the first case that demonstrates central retinal artery occlusion as an initial manifestation in TA...
2016: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/27864582/-skin-diseases-due-to-systemic-vasculitides-and-vasculopathies
#19
REVIEW
S Volc, J C Maier, M Röcken
Vasculitis and vasculopathy are two distinct disease entities. Each entity comprises a large number of heterogeneous diseases, which can occur alone or associated with autoimmune, infectious or neoplastic diseases. The terms vasculitis and vasculopathy are often falsely used synonymously. A vasculitis initially causes inflammation of the vessel walls that may result in a secondary occlusion. In contrast, a vasculopathy is a primary occlusion of the vascular lumen, which is followed by inflammation after ischemia and ulceration...
December 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27863833/rapid-systematic-review-intra-arterial-thrombectomy-clot-retrieval-for-selected-patients-with-acute-ischemic-stroke
#20
William J Meurer, Bradley E Barth, Gary Gaddis, Gary M Vilke, Samuel H F Lam
BACKGROUND: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality. However, precisely defining the optimal treatment for individual patients early after AIS onset remains elusive. There has recently been a surge in published studies documenting the effectiveness of mechanical intra-arterial thrombectomy for treatment of a subset of patients with AIS. This therapy has been proposed and studied for the small (<1.2%) subgroup of patients with ischemic strokes who have "large vessel" strokes or strokes that fail to improve after the administration of tissue plasminogen activator (t-PA)...
November 15, 2016: Journal of Emergency Medicine
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