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https://www.readbyqxmd.com/read/28320175/mechanical-embolectomy-for-acute-ischemic-stroke-beyond-six-hours-from-symptom-onset-using-mri-based-perfusion-imaging
#1
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/28320076/paediatric-vertebral-artery-aneurysms-a-literature-review
#2
REVIEW
Kevin Phan, Konrad Schultz, Victor M Lu, Ryan J Campbell, Nelson Wang, Prashanth J Rao
Vertebral artery (VA) aneurysms in the paediatric population are a rare but a serious condition. However, the epidemiology of paediatric VA aneurysms is poorly understood and there is little consensus on what constitutes the appropriate treatment. Although multiple treatment options are available, including surgery, endovascular approaches, coil embolization and parent artery occlusion, there is limited clinical evidence regarding which approach is most optimal. This review outlines the current literature and evidence outlining the epidemiology, presentation, pathogenesis and treatment of paediatric VA aneurysms...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#3
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/28319471/early-secondary-prevention-after-initially-ineffective-revascularization-treatments-for-acute-ischemic-stroke-due-to-tandem-occlusion
#4
Stefano Forlivesi, Elia Pancheri, Giuseppe Moretto, Paolo Bovi, Manuel Cappellari
The most effective treatment of patients with stroke due to tandem occlusion is still unclear. We report the case of a man with stroke due to tandem internal carotid artery/middle cerebral artery occlusion, who underwent initially ineffective intravenous thrombolysis (IVT) and endovascular treatment. Early anticoagulation with apixaban was started after 48 h of IVT, given a newly diagnosed nonvalvular atrial fibrillation. Spontaneous partial recanalization of the cervical internal carotid artery was noted, and carotid endarterectomy was performed 72 h after IVT and 8 h after the last dose of apixaban...
March 17, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28319000/endovascular-treatment-of-symptomatic-renal-artery-aneurysm-with-hostile-anatomy
#5
J Sousa, A Mansilha
No abstract text is available yet for this article.
March 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#6
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
March 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28318954/computed-tomography-perfusion-based-decision-making-for-acute-ischemic-stroke-missing-the-mismatch
#7
J A Molad, M Findler, E Auriel
The emerging use of mechanical thrombectomy for acute ischemic stroke treatment focuses on the importance of patient selection. Computed tomography perfusion (CTP) is one of widely used techniques. However, the accuracy and reliability of this modality is in debate among vascular neurologists. We present a case of an 80-year-old man admitted because of acute ischemic stroke. CT angiography demonstrated left proximal M2 occlusion. As CTP demonstrated signs of large ischemic core with no significant penumbra, mechanical thrombectomy was not performed following tPA administration...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28318830/long-term-outcome-of-the-gore-excluder-aaa-endoprosthesis-for-treatment-of-infrarenal-aortic-aneurysms
#8
Claire G Poublon, Suzanne Holewijn, Steven M M van Sterkenburg, Ignace F J Tielliu, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To evaluate long-term outcome of GORE EXCLUDER AAA Endoprosthesis (W.L. Gore & Associates, Inc, Flagstaff, Arizona) for elective treatment of infrarenal aortic aneurysms and to evaluate performance of different generations of the device. MATERIALS AND METHODS: A retrospective analysis was performed of 248 patients undergoing elective endovascular aneurysm repair with the GORE EXCLUDER between January 2000 and December 2015 in 2 hospitals. Primary endpoint was reintervention-free survival...
March 15, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28318632/endovascular-aneurysm-repair-evar-and-transcatheter-aortic-valve-replacement-tavr-associated-acute-kidney-injury
#9
REVIEW
Kenar D Jhaveri, Athanasios N Saratzis, Rimda J Wanchoo, Pantelis A Sarafidis
Acute kidney injury (AKI) after surgery or intervention is an important complication that may impact mortality, morbidity, and health care costs. Endovascular procedures are now performed routinely for a variety of pathologies that were traditionally treated with open surgery because randomized trials comparing endovascular and open surgery have shown at least equally good results and reduced complication and hospitalization rates with endovascular techniques. However, endovascular procedures have been associated with an increased risk for postoperative AKI, predominantly owing to contrast nephrotoxicity...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28317622/aortic-dissection-in-takayasu-arteritis
#10
Kun-Qi Yang, Yan-Kun Yang, Xu Meng, Ying Zhang, Hui-Min Zhang, Hai-Ying Wu, Ya-Xin Liu, Xiong-Jing Jiang, Jun Cai, Xian-Liang Zhou, Ru-Tai Hui, De-Yu Zheng, Li-Sheng Liu
BACKGROUND: Aortic dissection (AD) is a rare complication of Takayasu arteritis (TA). The clinical presentation and long-term management outcomes of AD in patients with TA have not been well described. MATERIALS AND METHODS: We conducted a retrospective study of patients with TA along with AD admitted to Fuwai Hospital between January 1985 and March 2016. Clinical data and follow-up data were collected and analyzed. RESULTS: Of the 1,154 patients with TA, we identified 10 patients (0...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28316870/dural-arteriovenous-fistula-manifested-as-rapid-progressive-dementia-successfully-treated-by-endovascular-embolization-only
#11
Heewon Hwang, Yun Kyung La, Min Seok Baek, Kyoungwon Baik, Sang Hyun Suh, Won-Joo Kim
A 43-year-old male presented with daytime sleepiness at work and indifferent behavior like never before. Two weeks prior to hospital admission, he had episodic memory loss with well preserved remote memory. Brain MRI showed a dural arteriovenous fistula (DAVF) in the right lateral transverse sinus with a bilateral thalamic venous infarction. Cerebral angiography confirmed a right transverse sigmoid dural arteriovenous fistula with a feeding artery of the right occipital artery and left posterior meningeal artery...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28314974/health-related-quality-of-life-prospectively-evaluated-by-the-8-item-short-form-after-endovascular-repair-versus-open-surgery-for-abdominal-aortic-aneurysms
#12
Takayoshi Kato, Mototsugu Tamaki, Tomohiro Tsunekawa, Yusuke Motoji, Akihiro Hirakawa, Yasuhide Okawa, Shinji Tomita
Open repair for infra-renal abdominal aortic and iliac artery aneurysms (AAAs) is a robust treatment. On the other hand, endovascular aneurysm repair (EVAR) has been widespread because of its less invasiveness. However, patients after EVAR frequently require postoperative radiographic examinations and may feel anxiety for their endoleaks. We prospectively evaluated Health-related Quality of Life of the patients with these two fashions using the 8-item Short Form (SF-8). From 2011 to 2013, 89 consecutive elective cases of AAAs were treated...
March 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#13
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304199/jailed-double-microcatheter-technique-following-horizontal-stenting-for-coil-embolization-of-intracranial-wide-necked-bifurcation-aneurysms-a-technical-report-of-two-cases
#14
Takahiro Kitahara, Taketo Hatano, Makoto Hayase, Etsuko Hattori, Akinori Miyakoshi, Takehiko Nakamura
The horizontal stenting technique facilitates endovascular treatment of wide-necked bifurcation intracranial aneurysms. Previous literature shows, however, that subsequent coil embolization at initial treatment results in incomplete obliteration in many cases. The authors present two consecutive cases of wide-necked large bifurcation aneurysms to describe an additional coil embolization technique following horizontal stenting. The patients were a 53-year-old female with an unruptured internal carotid artery terminus aneurysm and a 57-year-old female with a recurrent basilar artery tip aneurysm...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304197/endovascular-treatment-of-a-dural-arteriovenous-fistula-in-a-patient-with-loeys-dietz-syndrome-a-case-report
#15
Rie Aoki, Kittipong Srivatanakul, Takahiro Osada, Kazuko Hotta, Takatoshi Sorimachi, Mitsunori Matsumae, Hiroko Morisaki
Background Loeys-Dietz syndrome (LDS) is a recently recognized autosomal dominant connective tissue disease. The manifestations of LDS include vascular tortuosity, scoliosis, craniosynostosis, aneurysm and aortic dissections. Clinical presentation A 35-year-old woman treated with Stanford type B aortic dissection and breast cancer was referred to us for Borden type II dural arteriovenous fistula (dAVF) draining to the vein of Galen, involving the midline of tentorium cerebelli. The dAVF was treated successfully by combined transarterial and transvenous embolization...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304190/the-second-generation-eclips-endovascular-clip-system-initial-experience
#16
Albert H Chiu, Joost De Vries, Cian J O'Kelly, Howard Riina, Ian McDougall, Jonathan Tippett, Martina Wan, Airton Leonardo de Oliveira Manoel, Thomas R Marotta
OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIPs (Endovascular Clip System) device, a novel hybrid stent-like assist device with flow diverter properties that was first described in 2008. METHODS A registry was established covering 13 international centers at which patients were treated with the second-generation eCLIPs device...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28303209/mixed-aneurysm-a-new-proposed-nomenclature-for-a-rare-condition
#17
Cassiano U Crusius, Paulo Henrique P de Aguiar, Marcelo U Crusius
BACKGROUND: Mixed intracranial aneurysms are vascular lesions appearing in the ruptured saccular aneurysms whose blood is contained by perivascular tissues forming another cavity called pseudoaneurysm. All cases until now have been reported in the literature with subarachnoid hemorrhage. CASE DESCRIPTION: A 65-year-old woman presented with multiple brain aneurysms with no history of subarachnoid hemorrhage. Endovascular treatment was chosen for left-sided aneurysms [lateral carotid wall (LCW) and posterior communicating (PCom)]...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28303064/accessory-left-gastric-artery-aneurysms-in-granulomatosis-with-polyangiitis-a-case-report-and-literature-review
#18
Toshihide Tomosugi, Takuji Takahashi, Yoshihisa Kawase, Koichi Yoshida, Shogo Hayashi, Takefumi Sugiyama, Mitsuya Shimizu, Michita Shoka, Kohichi Sawaki, Eiji Onishi, Naomi Hayashi, Hidenobu Matsushita, Osamu Okochi
Aneurysm formation is a potential complication of granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis. It is a very rare complication, but immediate diagnosis and therapy should be performed because an aneurysm can be life-threatening if it ruptures. An accessory left gastric artery (ALGA) is also a rare variant gastric artery that may obtain its blood supply from the left hepatic artery and left gastric artery. We herein describe a 57-year-old Japanese man who was diagnosed with GPA complicated by aneurysm rupture in an ALGA...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28302611/site-and-rate-of-occlusive-disease-in-cervicocerebral-arteries-a-ct-angiography-study-of-2209-patients-with-acute-ischemic-stroke
#19
D C Rotzinger, P J Mosimann, R A Meuli, P Maeder, P Michel
BACKGROUND AND PURPOSE: CTA can rapidly and accurately detect and localize occlusive disease in patients with ischemic stroke. We have used CTA to assess arterial stenosis and occlusion in an ischemic stroke population arriving at a tertiary stroke center within 24 hours of symptom onset in order to obtain a comprehensive picture of occlusive disease pattern, and to determine the proportion of eligible candidates for endovascular treatment. MATERIALS AND METHODS: Data from consecutive patients with acute ischemic stroke admitted to a single center between 2003 and 2012, collected in the Acute Stroke Registry and Analysis of Lausanne data base, were retrospectively analyzed...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#20
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
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