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REVIEW
Guozhen Zhang, Qiang Wang, Bing Jiang, Lihe Yao, Wenjuan Wu, Xiaoyan Zhang, Dongjun Wan, Youquan Gu
The death of cells can occur through various pathways, including apoptosis, necroptosis, mitophagy, pyroptosis, endoplasmic reticulum stress, oxidative stress, ferroptosis, cuproptosis, and disulfide-driven necrosis. Increasing evidence suggests that mitophagy and ferroptosis play crucial regulatory roles in the development of stroke. In recent years, the incidence of stroke has been gradually increasing, posing a significant threat to human health. Hemorrhagic stroke accounts for only 15% of all strokes, while ischemic stroke is the predominant type, representing 85% of all stroke cases...
2024: Frontiers in Pharmacology
#2
JOURNAL ARTICLE
Yan-Qin Geng, Li-Na Qiu, Yuan-Qiu Cheng, Juan-Juan Li, Yi-Lin Ma, Cheng-Cheng Zhao, Ying Cai, Xue-Bin Zhang, Jieli Chen, Yu-Chen Pan, Ke-Rang Wang, Xiu-Hua Yao, Dong-Sheng Guo, Jia-Ling Wu
Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is the primary treatment for ischemic stroke. However, rtPA treatment can substantially increase blood-brain barrier (BBB) permeability and susceptibility to hemorrhagic transformation. Herein, the mechanism underlying the side effects of rtPA treatment is investigated and demonstrated that ferroptosis plays an important role. The ferroptosis inhibitor, liproxstatin-1 (Lip) is proposed to alleviate the side effects. A well-designed macrocyclic carrier, glucose-modified azocalix[4]arene (GluAC4A), is prepared to deliver Lip to the ischemic site...
April 22, 2024: Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
#3
Patrick Silveira, Justin McCloskey, Mohammad Kassar
Both acute ischemic stroke (AIS) and pulmonary embolism (PE) are major causes of morbidity and mortality, with overlapping risk factors. Incidental or silent PE therefore may be discovered during an AIS work-up. Thrombolytic therapy is considered first-line therapy for eligible patients with AIS. We present the case of an 88-year-old man with an AIS, who was incidentally found to have a PE, and then received thrombolytic therapy leading to favorable outcomes in both conditions.
July 2024: Radiology Case Reports
#4
JOURNAL ARTICLE
Leyla Ramazanoglu, Kalyoncu Isil Aslan, Yilmaz Onal, Murat Velioglu, Osman Melih Topcuoglu
BACKGROUND: The safety and efficacy of mechanical thrombectomy (MT) for proximal large vessel occlusion after acute ischemic stroke (AIS) have been demonstrated. Clinical investigations of endovascular approaches for treating AIS due to M2 occlusions have been ongoing. PURPOSE: To assess the outcomes of M2 occlusions according to treatment modality and anatomical division. METHODS: A total of 113 consecutive M2 occlusions treated with endovascular treatment (EVT) at our tertiary stroke center between January 2019 and December 2022 were retrospectively analyzed...
April 22, 2024: Acta Radiologica
#5
JOURNAL ARTICLE
Hou Yifang, Duan Jun, Yan Jingting, Shan Ying, Zhang Ping, Deng Xiaomei
Venous thromboembolism (VTE) is a major contributor to hospital mortality and disability-adjusted life-year (DALY) loss. Multiple guidelines recommend using the Padua or IMPROVE scores to stratify VTE risk in hospitalized medical patients. However, the IMPROVE score is not recommended in Chinese guidelines, and there is very little evaluation of its clinical application and effectiveness in the Chinese population. The objective of this study is to compare the efficacy of the Padua and IMPROVE scoring models for assessing VTE risk in Chinese medical inpatients...
April 21, 2024: Journal of Thrombosis and Thrombolysis
#6
JOURNAL ARTICLE
R R M M Knapen, M Celen, F M E Pinckaers, B A J M Wagemans, W H van Zwam, R J van Oostenbrugge, C van der Leij
PURPOSE: Balloon guide catheters (BGCs) are used in endovascular treatment (EVT) for ischemic stroke. Previous literature did not distinguish between BGC use with and without inflated balloon. This study aims to compare outcomes between non-BCG and BGC use with and without inflated balloon during EVT. METHODS: Patients who underwent EVT for anterior circulation ischemic stroke between September 2020 and February 2023 were analyzed. Patients were divided into three groups: non-BGC, BGC with inflated balloon, or BGC without inflated balloon...
April 19, 2024: Cardiovascular and Interventional Radiology
#7
JOURNAL ARTICLE
Philip Sun, Ling Zheng, Michelle Lin, Steven Cen, Gmerice Hammond, Karen E Joynt Maddox, May Kim-Tenser, Nerses Sanossian, William Mack, Amytis Towfighi
BACKGROUND: Despite its approval for acute ischemic stroke >25 years ago, intravenous thrombolysis (IVT) remains underused, with inequities by age, sex, race, ethnicity, and geography. Little is known about IVT rates by insurance status. METHODS AND RESULTS: We assessed temporal trends from 2002 to 2015 in IVT for acute ischemic stroke in the Nationwide Inpatient Sample using adjusted, survey - weighted logistic regression. We calculated odds ratios for IVT for each category in 2002 to 2008 (period 1) and 2009 to 2015 (period 2)...
April 19, 2024: Journal of the American Heart Association
#8
JOURNAL ARTICLE
Cornelius Deuschl, Lukas Goertz, Christoph Kabbasch, Martin Köhrmann, Christoph Kleinschnitz, Ansgar Berlis, Christoph Johannes Maurer, Iris Mühlen, Bernd Kallmünzer, Matthias Gawlitza, Daniel P O Kaiser, Joachim Klisch, Donald Lobsien, Daniel Behme, Maximilian Thormann, Fabian Flottmann, Laurens Winkelmeier, Elke Ruth Gizewski, Lukas Mayer-Suess, Markus Holtmannspoetter, Christoph Moenninghoff, Martin Schlunz-Hendann, Dominik Grieb, Christophe T Arendt, Ferdinand O Bohmann, Jens Altenbernd, Yan Li, Ulrich Sure, Ruben Mühl-Benninghaus, Thomas Rodt, Kai Kallenberg, Alexandru Durutya, Mohamed Elsharkawy, Christian-Paul Stracke, Mathias Gerhard Schumann, Alexander Bock, Omid Nikoubashman, Martin Wiesmann, Hans Henkes, Sebastian Dolff, Aydin Demircioglu, Michael Forsting, Hanna Styczen
BACKGROUND: Data on impact of COVID-19 vaccination and outcomes of patients with COVID-19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience. METHODS AND RESULTS: This was a retrospective analysis of patients with COVID-19 and known vaccination status treated with mechanical thrombectomy for acute ischemic stroke at 20 tertiary care centers between January 2020 and January 2023. Baseline demographics, angiographic outcome, and clinical outcome evaluated by the modified Rankin Scale score at discharge were noted...
April 19, 2024: Journal of the American Heart Association
#9
REVIEW
Jessica M Noll, Arya A Sherafat, Gregory D Ford, Byron D Ford
Ischemic stroke is the leading cause of serious long-term disability and the 5th leading cause of death in the United States. Revascularization of the occluded cerebral artery, either by thrombolysis or endovascular thrombectomy, is the only effective, clinically-approved stroke therapy. Several potentially neuroprotective agents, including glutamate antagonists, anti-inflammatory compounds and free radical scavenging agents were shown to be effective neuroprotectants in preclinical animal models of brain ischemia...
2024: Frontiers in Cellular Neuroscience
#10
JOURNAL ARTICLE
Marina Guasch-Jiménez, Rajat Dhar, Atul Kumar, Julien Cifarelli, Garbiñe Ezcurra-Díaz, Álvaro Lambea-Gil, Anna Ramos-Pachón, Alejandro Martínez-Domeño, Luis Prats-Sánchez, Daniel Guisado-Alonso, Israel Fernández-Cadenas, Ana Aguilera-Simón, Rebeca Marín, José Pablo Martínez-González, Joaquin Ortega-Quintanilla, Isabel Fernández-Pérez, Carla Avellaneda-Gómez, Jorge Rodríguez-Pardo, Elena de Celis, Francisco Moniche, María Del Mar Freijo, Elisa Cortijo, Santiago Trillo, Pol Camps-Renom, Joan Martí-Fábregas
BACKGROUND: Cerebral edema (CED) is associated with poorer outcome in patients with acute ischemic stroke (AIS). The aim of the study was to investigate the factors contributing to greater early CED formation in patients with AIS who underwent endovascular therapy (EVT) and its association with functional outcome. METHODS: We conducted a multicenter cohort study of patients with an anterior circulation AIS undergoing EVT. The volume of cerebrospinal fluid (CSF) was extracted from baseline and 24-hour follow-up CT using an automated algorithm...
April 18, 2024: Journal of Neurointerventional Surgery
#11
JOURNAL ARTICLE
Ning Li, Ying-Lei Li, Jia-Min Shao, Chu-Han Wang, Si-Bo Li, Ye Jiang
BACKGROUND: Acute ischemic stroke (AIS) remains a leading cause of disability and mortality globally among adults. Despite Intravenous Thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) emerging as the standard treatment for AIS, approximately 6-40% of patients undergoing IVT experience Early Neurological Deterioration (END), significantly impacting treatment efficacy and patient prognosis. OBJECTIVE: This study aimed to develop and validate a predictive model for END in AIS patients post rt-PA administration using the Least Absolute Shrinkage and Selection Operator (LASSO) regression approach...
2024: Frontiers in Neuroscience
#12
REVIEW
Shiv Kumar Saini, Damanpreet Singh
Cerebral ischemic stroke is a major contributor to physical impairments and premature death worldwide. The available reperfusion therapies for stroke in the form of mechanical thrombectomy and intravenous thrombolysis increase the risk of cerebral ischemia-reperfusion (I-R) injury due to sudden restoration of blood supply to the ischemic region. The injury is manifested by hemorrhagic transformation, worsening of neurological impairments, cerebral edema, and progression to infarction in surviving patients. A complex network of multiple pathological processes has been known to be involved in the pathogenesis of I-R injury...
April 15, 2024: Mitochondrion
#13
RANDOMIZED CONTROLLED TRIAL
Andrew M Southerland, Stephan A Mayer, Nicole A Chiota-McCollum, Ashley C Bolte, Qi Pauls, L Creed Pettigrew, Thomas P Bleck, Mark Conaway, Karen C Johnston
BACKGROUND AND OBJECTIVES: Baseline hyperglycemia is associated with worse outcomes in acute ischemic stroke (AIS), including higher risk of symptomatic intracerebral hemorrhage (sICH) following treatment with thrombolysis. Prospective data are lacking to inform management of post-thrombolysis hyperglycemia. In a prespecified analysis from the Stroke Hyperglycemia Insulin Network Effort (SHINE) trial of hyperglycemic stroke management, we hypothesized that post-thrombolysis hyperglycemia is associated with a higher risk of sICH...
May 14, 2024: Neurology
#14
REVIEW
Ahmed E Ali, Richard C Becker
Arterial and venous thromboembolism is a major medical concern that requires therapeutic anticoagulation in various medical fields to prevent its drastic consequences. Despite significant advances in anticoagulant therapy, thrombosis remains a leading cause of morbidity and mortality worldwide. Traditional anticoagulants like heparin and vitamin K antagonists (VKAs) have shown efficacy in preventing and treating thrombosis but come with an inherent risk of bleeding due to their non-specific inhibition of multiple coagulation factors...
April 16, 2024: Journal of Thrombosis and Thrombolysis
#15
JOURNAL ARTICLE
Anis Choucha, Thomas Barraque, Mikael Meyer, Henry Dufour, Kaissar Farah, Stephane Fuentes
INTRODUCTION: Vertebral artery injury (VAI) following blunt trauma can lead to acute or delayed life-threatening posterior fossa ischemic stroke. Its management raises controversial issues and is still open to debate. MATERIAL & METHOD: We report the case of a 48-year-old male who presented a life-threatening posterior circulation ischemic stroke, secondary to a vertebral artery dissection caused by a cervical spine fracture. This case was successfully managed through intravenous thrombolysis and endovascular thrombectomy followed by antiplatelet therapy and an anterior cervical discectomy and fusion...
April 13, 2024: Neuro-Chirurgie
#16
JOURNAL ARTICLE
Salman Hashim, Nishita Patel, Ala Nozari, Wissam Mustafa
A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a large epiglottis. Two-handed, 2-provider mask ventilation with an oral airway proved difficult. The team successfully placed a supraglottic airway (SGA) through which an oral endotracheal tube (ETT) was advanced over a fiberoptic bronchoscope into the trachea...
April 1, 2024: A&A Practice
#17
JOURNAL ARTICLE
Paweł Wrona, Katarzyna Sawczyńska, Dominik Wróbel, Kaja Zdrojewska, Mateusz Giełczyński, Paweł Mizera, Paweł Brzegowy, Tadeusz Popiela, Agnieszka Słowik, Marcin Krzanowski
INTRODUCTION: Acute kidney injury (AKI) seems to worsen the prognosis of acute ischaemic stroke (AIS) patients treated with mechanical thrombectomy (MT). At the same time, the procedure of MT increases AKI risk by iodinated contrast use. Identification of factors predisposing to AKI after MT is important for recognizing vulnerable patients and successful prevention. AIM: To identify factors associated with the occurrence of AKI during hospitalization in MT-treated AIS patients...
March 2024: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
#18
JOURNAL ARTICLE
Ewa Włodarczyk, Paweł Wrona, Tomasz Homa, Maria Sobolewska, Dominik Wróbel, Dawid Rolkiewicz, Tadeusz Popiela, Agnieszka Słowik, Katarzyna Sawczyńska
INTRODUCTION: Patients with cancer (CP) need a different approach to acute ischaemic stroke (AIS) treatment as intravenous thrombolysis (IVT) may be contraindicated. Mechanical thrombectomy (MT) is a treatment of choice for otherwise eligible patients, although the literature on its long-term outcomes in CP is limited. AIM: Assessing outcomes of MT-treated AIS patients with concomitant malignancy in a year-long follow-up. MATERIAL AND METHODS: The study included 593 MT-treated AIS patients admitted in 2019-2021...
March 2024: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
#19
REVIEW
Anna M Schneider, Ain A Neuhaus, Gina Hadley, Joyce S Balami, George W Harston, Gabriele C DeLuca, Alastair M Buchan
This narrative review provides an overview of the posterior circulation and the clinical features of common posterior circulation stroke (PCS) syndromes in the posterior arterial territories and how to distinguish them from mimics. We outline the hyperacute management of patients with suspected PCS with emphasis on how to identify those who are likely to benefit from intervention based on imaging findings. Finally, we review advances in treatment options, including developments in endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT), and the principles of medical management and indications for neurosurgery...
May 2023: Clinical Medicine: Journal of the Royal College of Physicians of London
#20
REVIEW
Christina Zompola, Lina Palaiodimou, Konstantinos Voumvourakis, Leonidas Stefanis, Aristeidis H Katsanos, Else C Sandset, Estathios Boviatsis, Georgios Tsivgoulis
The management of blood pressure variability (BPV) in acute stroke presents a complex challenge with profound implications for patient outcomes. This narrative review examines the role of BPV across various stages of acute stroke care, highlighting its impact on treatment strategies and prognostic considerations. In the prehospital setting, while guidelines lack specific recommendations for BP management, emerging evidence suggests a potential link between BPV and outcomes. Among ischaemic stroke patients who are ineligible for reperfusion therapies, BPV independently influences functional outcomes, emphasising the need for individualised approaches to BP control...
March 29, 2024: Journal of Clinical Medicine
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