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https://www.readbyqxmd.com/read/28346475/treatment-of-blunt-thoracic-aortic-injury-in-germany-assessment-of-the-traumaregister-dgu%C3%A2
#1
Alexander Gombert, Mohammad E Barbati, Martin Storck, Drosos Kotelis, Paula Keschenau, Hans-Christoph Pape, Hagen Andruszkow, Rolf Lefering, Frank Hildebrand, Andreas Greiner, Michael J Jacobs, Jochen Grommes
PURPOSE: Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS: Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries. RESULTS: 821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35...
2017: PloS One
https://www.readbyqxmd.com/read/28344762/protracted-refractory-pain-post-tevar-post-implantation-syndrome
#2
Peter Waweru, Hardeep Gill, Chris Abeid
Aortic dissection is a life-threatening condition and has one of the highest mortality rates of cardiovascular diseases. It remains a devastating disease; with multiple unanswered questions concerning treatment modalities. The role of thoracic endovascular aortic repair (TEVAR) in these patients; especially those with uncomplicated acute aortic Type B dissections (AAD-B) is especially controversial although it has been shown to have better long-term outcomes compared to medical therapy alone. For those who have TEVAR, up to 60% may develop an acute, transient systemic inflammatory response syndrome that remains vaguely defined...
October 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28344654/endovascular-thrombectomy-with-or-without-systemic-thrombolysis
#3
Georgios Tsivgoulis, Aristeidis H Katsanos, Dimitris Mavridis, Anne W Alexandrov, Georgios Magoufis, Adam Arthur, Valeria Caso, Peter D Schellinger, Andrei V Alexandrov
OBJECTIVES: Current recommendations advocate that pretreatment with intravenous thrombolysis (IVT) should first be offered to all eligible patients with emergent large vessel occlusion (ELVO) before an endovascular thrombectomy (ET) procedure. However, there are observational data that question the safety and efficacy of IVT pretreatment in patients with ELVO. METHODS: We performed a meta-analysis of the included subgroups from ET randomized controlled trials (RCTs) to evaluate the comparative efficacy between direct ET without IVT pretreatment and bridging therapy (IVT and ET) in patients with ELVO...
March 2017: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#4
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28342656/nurses-are-as-specific-and-are-earlier-in-calling-in-hospital-stroke-alerts-compared-to-physicians
#5
Pravin George, Dolora R Wisco, James Gebel, Ken Uchino, Christopher R Newey
INTRODUCTION: In-hospital stroke alerts are typically activated by nurses or physicians when a patient's neurological status acutely changes from baseline. It is unclear if knowledge of stroke symptoms translates to accurate activation of the acute stroke team. We hypothesized that nurses who activate the stroke alert system would correctly identify as great a proportion of acute strokes as physicians. We also investigated the time to activation of these in-hospital stroke alerts. METHODS: We retrospectively reviewed consecutive inpatient stroke team calls over a 12-month period at a single, tertiary care center...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28341523/intracranial-stents-in-the-endovascular-treatment-of-acute-ischemic-stroke
#6
F Delgado Acosta, E Jiménez Gómez, I Bravo Rey, F A Bravo Rodríguez, J J Ochoa Sepúlveda, R Oteros Fernández
OBJECTIVE: To evaluate the efficacy and safety of intracranial stenting as a rescue therapy after failed mechanical thrombectomy in patients with acute ischemic stroke. MATERIAL AND METHODS: We retrospectively studied 42 patients treated with intracranial stenting after failed mechanical thrombectomy between December 2008 and January 2016. We compared outcomes before and after the incorporation of stentrievers. We assessed the degree of recanalization in the carotid and basilar territories (modified TIMI score), prognostic factors, and outcome (modified Rankin Score at 3 months)...
March 21, 2017: Radiología
https://www.readbyqxmd.com/read/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#7
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341507/endovascular-aortic-repair-for-progressive-chronic-thoracoabdominal-aortic-dissections
#8
Vito Mantese, Shameem Kunhammed
BACKGROUND: Ascending and thoracic aortic dissections progress into thoracoabdominal aneurysms 20-40% of the time, due to the initial aortic injury with associated weakness of the aortic wall. The increased firmness of the intimal flap usually results in a collapsed true lumen that does not spontaneously re-expand even with progressive dilatation of the aorta. In an effort to identify a safe and effective treatment path for this complex disease process, we present 4 cases illustrating successful sequential thoracic endovascular aortic repair (TEVAR) and fenestrated endovascular aortic repair (FEVAR)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341503/endovascular-repair-of-a-large-abdominal-aortic-aneurysm-in-a-patient-presenting-with-lower-extremity-edema-as-a-result-of-inferior-vena-cava-thrombosis
#9
Nan Li, Ming Xue, Deng-Ke Hong, Xing-Sheng Chen
PURPOSE: Abdominal aortic aneurysm (AAA) can present with symptoms because of aneurysmal compression of adjacent organ systems. This condition has always been treated by open surgical repair. Here, we report a case of an AAA complicated by inferior vena cava (IVC) thrombosis and deep venous thrombosis (DVT) due to IVC compression by aneurysm successfully treated by endovascular aneurysm repair (EVAR). CASE REPORT: A 50-year-old man presented with three-day right lower extremity edema...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341499/renal-arteriovenous-malformations-a-rare-vascular-cause-of-back-pain
#10
Tazo Inui, David Frankel
OBJECTIVE: Renal arteriovenous malformation (AVM) is a very rare phenomenon (fewer than 200 cases in the literature), most commonly (75%) presenting with hematuria in young women. Renal AVMs may be cirsoid (multi-branched) or cavernous, with cirsoid morphology predominating 3:1. The historical treatment is partial nephrectomy. Best endovascular therapy is divided among many options. We present 2 cases of large renal AVMs treated with single Amplatzer plugs. METHODS: During a 2-year period (2014-15), 2 patients presented for vascular evaluation of renal AVMs found incidentally on workup for non-specific abdominal and back pain...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28340999/emergent-vs-elective-stenting-of-carotid-stenosis-with-intraluminal-carotid-thrombus
#11
Martin Hlavica, Jatta Berberat, Benjamin Victor Ineichen, Javier Añon, Michael Diepers, Krassen Nedeltchev, Timo Kahles, Luca Remonda
BACKGROUND AND PURPOSE: Carotid stenosis (CS) with intraluminal carotid artery thrombus (ICAT) is rare but ominous finding. The optimal treatment modality is unclear. The aim of this study was to analyze the feasibility and outcome of acute endovascular intervention and delayed elective endovascular therapy after initial anticoagulation in these delicate cases. Moreover, both treatment points were compared and several parameters discussed to facilitate the determination of the optimal time modality in future cases...
March 21, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#12
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28332957/three-dimensional-computed-tomography-reconstruction-in-transplant-renal-artery-stenosis
#13
Xufeng Zhang, Hongwei Wang, Shuangde Liu, Jieke Yan, Xiaoli Liu, Dongsheng Xu, Chuan Tian
OBJECTIVES: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. MATERIALS AND METHODS: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomography reconstruction and were treated with endovascular approaches or medically managed...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28332440/use-of-a-stent-graft-in-tumor-erosion-of-the-common-femoral-artery-with-life-threatening-bleeding
#14
Hong H Keo, Nicolas Diehm, Daniel Staub, Frederic Baumann
We report a case of a 56-year-old male patient with a life-threatening left common femoral artery bleeding due to tumor erosion. The patient had a history of advanced high-grade pleomorphic leiomyosarcoma of the left groin with pulmonary metastasis. Clinical examination revealed a massive tumor bulking at the left groin with necrosis and phleb- and lymphedema. Given the circumstances, open surgery was not possible. Thus, it was decided to treat the patient with an endovascular procedure. The postprocedural course was uneventful, the patient received blood product and was hemodynamically stable...
March 23, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28328002/endovascular-treatment-of-middle-cerebral-artery-m2-occlusion-strokes-clinical-and-procedural-predictors-of-outcomes
#15
Maxim Mokin, Christopher T Primiani, Zeguang Ren, Peter Kan, Edward Duckworth, Raymond D Turner, Aquilla S Turk, Kyle M Fargen, Guilherme Dabus, Italo Linfante, Travis M Dumont, Leonardo B C Brasiliense, Hussain Shallwani, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Patients with strokes from M2 segment middle cerebral artery (MCA) occlusion have been underrepresented in recent randomized trials of endovascular therapy. OBJECTIVE: To better understand the clinical, imaging, and procedural predictors of successful recanalization and clinical outcomes in this population of patients. METHODS: We performed a multicenter retrospective analysis of consecutive patients with acute MCA M2 segment occlusion who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique approach)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327983/changing-paradigms-in-the-endovascular-management-of-ruptured-anterior-communicating-artery-aneurysms
#16
Karam Moon, Min S Park, Felipe C Albuquerque, Michael R Levitt, Celene B Mulholland, Cameron G McDougall
BACKGROUND: Approximately 17% of ruptured anterior communicating artery (ACoA) aneurysms were deemed unsuitable for coil embolization during the Barrow Ruptured Aneurysm Trial (BRAT), most commonly due to unfavorable dome-to-neck ratio or small size. OBJECTIVE: To compare patients treated by coil embolization for ruptured ACoA aneurysms during the trial to those treated after the trial to determine whether advances in endovascular techniques have allowed for effective treatment of these lesions...
January 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28322039/recent-developments-in-the-management-of-in-stent-restenosis
#17
Jos C van den Berg
Both the use of drug-eluting stents and drug-coated balloons have mitigated the prevalence of in-stent restenosis, but in-stent remains a problem that continues to affect the long-term outcomes of femoro-popliteal endovascular therapy. This paper will provide an overview on the latest data with regard to the treatment of femoro-popliteal in-stent restenosis.
March 20, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28320175/mechanical-embolectomy-for-acute-ischemic-stroke-beyond-six-hours-from-symptom-onset-using-mri-based-perfusion-imaging
#18
Ryan A McTaggart, Shadi Yaghi, Daniel C Sacchetti, Richard A Haas, Morgan Hemendinger, Daniel Arcuri, Jeffrey M Rogg, Karen L Furie, Mahesh V Jayaraman
INTRODUCTION: There is very limited data on the use of MRI based perfusion imaging to select patients with acute ischemic stroke and large vessel occlusion (LVO) for intraarterial therapy beyond 6h from onset. Our aim is to report the outcome of patients with acute ischemic stroke and large artery occlusion who presented beyond 6h from onset, had favorable MRI imaging profile, and underwent mechanical embolectomy. METHODS: This is a single institution (Rhode Island Hospital) retrospective study between December 1st, 2015, and July 30th, 2016 that included patients with acute ischemic stroke and proximal LVO with CT ASPECTS of 6 or more and 6-24h from symptom onset who were assessed for mechanical embolectomy using MRI based perfusion imaging...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#19
Bhaskar Roy, Louise D McCullough, Rajat Dhar, James Grady, Yu-Bo Wang, Robert J Brown
BACKGROUND: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. METHODS: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319240/two-paradigms-for-endovascular-thrombectomy-after-intravenous-thrombolysis-for-acute-ischemic-stroke
#20
Gaspard Gerschenfeld, Ioan-Paul Muresan, Raphael Blanc, Michael Obadia, Marie Abrivard, Michel Piotin, Sonia Alamowitch
Importance: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) is recommended to treat acute ischemic stroke (AIS) with a large vessel occlusion (LVO). Most hospitals do not have on-site MT facilities, and most patients need to be transferred secondarily after IVT (drip and ship), which may have an effect on the neurologic outcome. Objective: To compare the functional independence at 3 months between patients treated under the drip-and-ship paradigm and those treated on site (mothership)...
March 20, 2017: JAMA Neurology
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