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Spinal cord ischemia

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https://www.readbyqxmd.com/read/29773299/diffusion-mri-in-acute-nervous-system-injury
#1
Matthew D Budde, Nathan P Skinner
Diffusion weighted magnetic resonance imaging (DWI) and related techniques such as diffusion tensor imaging (DTI) are uniquely sensitive to the microstructure of the brain and spinal cord. In the acute aftermath of nervous system injury, for example, DWI reveals changes caused by injury that remains invisible on other MRI contrasts such as T2 -weighted imaging. This ability has led to a demonstrated clinical utility in cerebral ischemia. However, despite strong promise in preclinical models and research settings, DWI has not been as readily adopted for other acute injuries such as traumatic spinal cord, brain, or peripheral nerve injury...
April 30, 2018: Journal of Magnetic Resonance
https://www.readbyqxmd.com/read/29770500/variable-anatomic-configuration-of-the-posterior-spinal-arteries-in-humans
#2
Santiago Rojas, Marisa Ortega, Alfonso Rodríguez-Baeza
INTRODUCTION: Posterior spinal arteries (PSAs) arise from the vertebral (VA) or posterior inferior cerebellar (PICA) artery. We identified variations in their origins and their anastomosis with the first posterior radiculomedullary branches in human spinal cords. MATERIALS AND METHODS: Spinal cords from male and female cadavers (n = 30) were injected with colored latex through the vertebral, ascending cervical, costocervical trunk and segmental arteries. Specimens were fixed in formalin and the spinal arteries were dissected under a surgical microscope...
May 17, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29749245/serum-endocan-level-and-the-severity-of-spinal-cord-injury
#3
K Ur, S Demiroz, A S Bengu, A Ulucan, O Oz Gergin, C Kizmazoglu, E Ozer
OBJECTIVE: To determine whether the endocan level may be related to the severity of spinal cord injury. BACKGROUND: Several biomarkers were evaluated for this purpose, but endocan has never been studied before. It is correlated to endothelial dysfunction and ischemia, which are the characteristics of spinal cord injury in most cases. MATERIAL AND METHODS: A total of 21 male Sprague-Dawley rats weighing 300-350 g were randomly divided into three groups...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29743351/survival-of-syngeneic-and-allogeneic-ipsc-derived-neural-precursors-after-spinal-grafting-in-minipigs
#4
Jan Strnadel, Cassiano Carromeu, Cedric Bardy, Michael Navarro, Oleksandr Platoshyn, Andreas N Glud, Silvia Marsala, Jozef Kafka, Atsushi Miyanohara, Tomohisa Kato, Takahiro Tadokoro, Michael P Hefferan, Kota Kamizato, Tetsuya Yoshizumi, Stefan Juhas, Jana Juhasova, Chak-Sum Ho, Taba Kheradmand, PeiXi Chen, Dasa Bohaciakova, Marian Hruska-Plochan, Andrew J Todd, Shawn P Driscoll, Thomas D Glenn, Samuel L Pfaff, Jiri Klima, Joseph Ciacci, Eric Curtis, Fred H Gage, Jack Bui, Kazuhiko Yamada, Alysson R Muotri, Martin Marsala
The use of autologous (or syngeneic) cells derived from induced pluripotent stem cells (iPSCs) holds great promise for future clinical use in a wide range of diseases and injuries. It is expected that cell replacement therapies using autologous cells would forego the need for immunosuppression, otherwise required in allogeneic transplantations. However, recent studies have shown the unexpected immune rejection of undifferentiated autologous mouse iPSCs after transplantation. Whether similar immunogenic properties are maintained in iPSC-derived lineage-committed cells (such as neural precursors) is relatively unknown...
May 9, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29725663/recovery-of-lost-motor-evoked-potentials-in-open-thoracoabdominal-aortic-aneurysm-repair-using-intercostal-artery-bypass
#5
Alexander Gombert, Jochen Grommes, Danny Hilkman, Drosos Kotelis, Werner H Mess, Michael J Jacobs
Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29715704/benefits-and-risks-of-prophylactic-cerebrospinal-fluid-catheter-and-evoked-potential-monitoring-in-symptomatic-spinal-cord-ischemia-low-risk-thoracic-endovascular-aortic-repair
#6
Sven Maier, Maria Shcherbakova, Friedhelm Beyersdorf, Christoph Benk, Fabian Alexander Kari, Matthias Siepe, Martin Czerny, Bartosz Rylski
BACKGROUND:  To assess risks and benefits of a standardized strategy to prevent symptomatic spinal cord ischemia (SSCI) after thoracic endovascular repair (TEVAR) using routine cerebrospinal fluid (CSF) catheter placement and evoked potential (EP) monitoring. METHODS:  One hundred and ninety-five patients underwent 223 SSCI low-risk TEVAR procedures between 1998 and 2014. CSF catheter was used to measure CSF pressure and drain CSF if necessary throughout the procedure and up to 24 hours thereafter...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29701420/lumbar-cerebrospinal-fluid-drainage-in-endovascular-aortic-repair-reference-centre-experience
#7
Ana Margarida Martins, Marisa Silva, Maria de Lurdes Castro, Ana Ferro
INTRODUCTION: Spinal cord ischemia (SCI) and the resulting paraplegia are one of the most feared postoperative complications after thoraco-abdominal aortic surgery, with an incidence 4,3-8,0% after thoracic endovascular aortic repair (TEVAR), increasing patients morbi-mortality. Lumbar cerebrospinal fluid (CSF) drainage catheter is recommended as preventive measure in high risk patients. OBJECTIVE: To evaluate the efficiency and safety of CSF drainage catheter as preventive or therapeutic measure in endovascular aortic repair (EAR)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701382/institutional-protocol-for-prevention-of-tevar-related-spinal-cord-ischemia-the-first-9-cases
#8
Marina Dias-Neto, Pedro Reis, Leonor Mendes, Margarida Rodrigues, Cristina Amaral, Graça Afonso, José Fernando Teixeira
INTRODUCTION: Spinal cord ischemia (SCI) is a feared complication after endovascular correction of thoracic aortic diseases (TEVAR). The guidelines of the European Society for Vascular Surgery recommend prophylactic lumbar drainage (LD) of cerebrospinal fluid in high-risk patients undergoing TEVAR. Our institutional protocol considers as high-risk patients as: coverage of the origin of the Adamkiewicz artery (T9-T12), aortic coverage >15 cm, involvement of collaterals (treated or untreated abdominal aortic aneurysm, left subclavian artery revascularization or bilateral occlusion of the internal iliac arteries) and symptomatic SCI...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29685248/management-of-visceral-aortic-patch-aneurysms-after-thoracoabdominal-repair-with-open-hybrid-or-endovascular-approach
#9
Luca Bertoglio, Daniele Mascia, Tommaso Cambiaghi, Andrea Kahlberg, Yamume Tshomba, Jose Chaves Gomez, Germano Melissano, Roberto Chiesa
OBJECTIVE: The objective of this study was to investigate the outcomes of patients with visceral aortic patch (VAP) aneurysms after open repair of thoracoabdominal aortic aneurysm (TAAA) treated with three different approaches: open, hybrid, and endovascular repair. METHODS: Between 1993 and 2016, there were 29 cases treated for VAP aneurysm after initial TAAA open repair (median time interval, 6.2 years; interquartile range, 4-8 years). Three different treatment modalities were employed: redo open repair (O group) in 14 cases (48...
May 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29682475/malperfusion-syndromes-in-type-a-aortic-dissection-what-we-have-learned-from-irad
#10
REVIEW
Paolo Berretta, Santi Trimarchi, Himanshu J Patel, Thomas G Gleason, Kim A Eagle, Marco Di Eusanio
Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29682471/hybrid-thoracoabdominal-aortic-aneurysm-repair-is-the-future-here
#11
REVIEW
Vicente Orozco-Sevilla, Scott A Weldon, Joseph S Coselli
Open surgical repair has been the gold standard for thoracoabdominal aortic aneurysm (TAAA) repair for more than 6 decades, but 2 additional options have emerged: total endovascular TAAA repair and a hybrid approach that combines open and endovascular repair. Despite the optimism for an endovascular approach, long-term results for these repairs are still lacking. Some of the issues with this emerging technology include the risk of paraplegia after extensive endovascular repair, the need for multiple reinterventions, continuous stent-graft surveillance, endograft branch stenosis, as well as the significant learning curve...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29682469/conservative-management-versus-endovascular-or-open-surgery-in-the-spectrum-of-type-b-aortic-dissection
#12
Xun Yuan, Andreas Mitsis, Mohammed Ghonem, Ilias Iakovakis, Christoph A Nienaber
Background: Type B aortic dissection is a life-threatening acute aortic condition often with acute ischemic signs or symptoms. With initial management focusing on alleviating malperfusion and pain, and avoiding propagation of dissection or rupture both systolic blood and pulse pressure should be reduced initially by an aggressive medical approach. In the setting of persistent signs of complications endovascular strategies have replaced open surgery and led to a fourfold increase in early survival and better long-term outcomes...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29676670/timing-severity-of-deficits-and-clinical-improvement-after-surgery-for-spinal-dural-arteriovenous-fistulas
#13
Michael M Safaee, Aaron J Clark, Jan-Karl Burkhardt, Ethan A Winkler, Michael T Lawton
OBJECTIVE Spinal dural arteriovenous fistulas (dAVFs) are rare vascular abnormalities caused by arteriovenous shunting. They often form at the dural root sleeve between a radicular feeding artery and draining medullary vein causing venous congestion and edema, decreased perfusion, and ischemia of the spinal cord. Treatment consists of either surgical ligation of the draining vein or selective embolization via an endovascular approach. There is a paucity of data on which modality provides more durable and effective outcomes...
April 20, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29664452/protective-role-of-astragalus-injection-in-spinal-cord-ischemia-reperfusion-injury-in-rats
#14
Liya Zhou, Zhenfei Song, Liwen Zhou, Yongchi Qiu, Nan Hu, Yong Hu, Xingming Hu
OBJECTIVE: To investigate the neuroprotective effect of Astragalus injection in a spinal cord ischemia-reperfusion (I/R) injury model. METHODS: A total of 27 Sprague Dawley rats were randomly divided into 3 groups: control group (n=3), I/R group (n=12), and Astragalus injection group (Ast group, n=12). Spinal cord ischemia was induced by occlusion of the abdominal aorta above the right renal artery for 32 min. Animals in the Ast group were administered Astragalus injection (6...
April 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29657948/early-results-of-the-petticoat-technique-for-the-management-of-acute-type-a-aortic-dissection
#15
Vamshi Krishna Kotha, Zlatko I Pozeg, Eric J Herget, Michael C Moon, Jehangir J Appoo
Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29650001/prediction-of-autonomic-dysreflexia-during-urodynamics-a-prospective-cohort-study
#16
Matthias Walter, Stephanie C Knüpfer, Jacquelyn J Cragg, Lorenz Leitner, Marc P Schneider, Ulrich Mehnert, Andrei V Krassioukov, Martin Schubert, Armin Curt, Thomas M Kessler
BACKGROUND: Autonomic dysreflexia is a severe and potentially life-threatening condition in patients with spinal cord injury, as it can lead to myocardial ischemia, brain hemorrhage, or even death. Urodynamic investigation is the gold standard to assess neurogenic lower urinary tract dysfunction due to spinal cord injury and reveal crucial pathological findings, such as neurogenic detrusor overactivity. However, neurogenic detrusor overactivity and urodynamic investigation are known to be leading triggers of autonomic dysreflexia...
April 13, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29623938/delayed-xenon-post-conditioning-mitigates-spinal-cord-ischemia-reperfusion-injury-in-rabbits-by-regulating-microglial-activation-and-inflammatory-factors
#17
Yan-Wei Yang, Yun-Lu Wang, Jia-Kai Lu, Lei Tian, Mu Jin, Wei-Ping Cheng
The neuroprotective effect against spinal cord ischemia/reperfusion injury in rats exerted by delayed xenon post-conditioning is stronger than that produced by immediate xenon post-conditioning. However, the mechanisms underlying this process remain unclear. Activated microglia are the main inflammatory cell type in the nervous system. The release of pro-inflammatory factors following microglial activation can lead to spinal cord damage, and inhibition of microglial activation can relieve spinal cord ischemia/reperfusion injury...
March 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29606568/satisfactory-short-term-outcomes-of-the-stabilise-technique-for-type-b-aortic-dissection
#18
Germano Melissano, Luca Bertoglio, Enrico Rinaldi, Daniele Mascia, Andrea Kahlberg, Diletta Loschi, Monica De Luca, Fabrizio Monaco, Roberto Chiesa
OBJECTIVE: The aim of this study was to evaluate the perioperative and short-term results in a cohort of patients treated during the last year at our institution with the stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique for acute complicated aortic dissection. METHODS: Between June 2016 and June 2017, 10 patients (all male; mean age, 62.6 ± 7.4 years) received treatment for acute complicated aortic dissection with the STABILISE technique...
March 29, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602471/early-and-midterm-outcome-of-multilayer-flow-modulator-stent-for-complex-aortic-aneurysm-treatment-in-germany
#19
Walid Ibrahim, Konstantinos Spanos, Andreas Gussmann, Christoph A Nienaber, Joerg Tessarek, Heinrich Walter, Jörg Thalwitzer, Sebastian E Debus, Nikolaos Tsilimparis, Tilo Kölbel
OBJECTIVE: The objective of this study was to assess the early and midterm outcomes of endovascular repair of complex aortic aneurysm cases using the Multilayer Flow Modulator (MFM; Cardiatis, Isnes, Belgium) endograft in Germany. METHODS: A retrospective study including patients presenting with abdominal aortic aneurysm (AAA), thoracic aortic aneurysm, or thoracoabdominal aortic aneurysm treated with the MFM was conducted in Germany. Mortality and morbidity (in terms of spinal cord ischemia, visceral ischemia, and stroke) at 30 days postoperatively were evaluated...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29596155/mir-221-alleviates-the-inflammatory-response-and-cell-apoptosis-of-neuronal-cell-through-targeting-tnfaip2-in-spinal-cord-ischemia-reperfusion
#20
Dong Zhao, Shu-Cai Deng, Yi Ma, Yong-Hong Hao, Zhan-Hua Jia
This study aimed to examine the role of miR-221 in inflammatory response and apoptosis of neuronal cells after spinal cord ischemia/reperfusion (I/R) injury. Blood samples were obtained from 20 I/R patients and that of 20 healthy individuals were used as a control. AGE1.HN and SY-SH-5Y neuronal cell lines subjected to oxygen-glucose deprivation (OGD) stress were used in cell experiments. Real-time PCR and western blot were used to evaluate the expression of miR-221, tumor necrosis factor-α, and TNFAIP2. TUNEL assay analyzed cell apoptosis...
March 28, 2018: Neuroreport
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