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Stroke Perfusion

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https://www.readbyqxmd.com/read/29241844/efficacy-and-safety-of-routine-aspiration-thrombectomy-during-primary-pci-for-st-segment-elevation-myocardial-infarction-a-metanalysis-of-large-randomized-controlled-trials
#1
Konstantinos Marmagkiolis, Abdul Hakeem, Mehmet Cilingiroglu, Dmitriy N Feldman, Konstantinos Charitakis
BACKGROUND: Recent randomized controlled trials (RCTs) have questioned the clinical efficacy and even safety of routine aspiration thrombectomy (AT) during primary PCI. A systematic synthesis of these randomized data is hence very timely to address this clinical equipoise. METHODS: We performed a meta-analysis of the larger (>150 patients) Randomized Controlled Trials (RCT) which compared aspiration thrombectomy with primary PCI alone. Procedural end-points were Myocardial Blush Grade (MBG) of 0 or 1 and ST segment resolution (STR) of >50%...
December 11, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29234612/near-infrared-spectroscopy-versus-transcranial-doppler-based-monitoring-in-carotid-endarterectomy
#2
Jun Woo Cho, Jae Seok Jang
Background: Proper monitoring of cerebral perfusion during carotid artery surgery is crucial for determining if a shunt is needed. We compared the safety and reliability of near-infrared spectroscopy (NIRS) with transcranial Doppler (TCD) for cerebral monitoring. Methods: This single-center, retrospective review was conducted on patients who underwent carotid endarterectomy (CEA) using selective shunt-based TCD or NIRS at Daegu Catholic University Medical Center from November 2009 to June 2016...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29222289/what-is-the-role-of-screening-for-pulmonary-hypertension-in-adults-and-children-with-sickle-cell-disease
#3
REVIEW
Shaina M Willen, Mark T Gladwin
Patient case: An 18-year-old male patient with homozygous hemoglobin SS disease was evaluated for progressive dyspnea and elevated tricuspid regurgitant jet velocity (TRV) on echocardiography. The patient's case is described in detail in Lancet1 He had been treated with regular transfusions since childhood for stroke, had rare episodes of vaso-occlusive pain episodes, and did not take narcotic pain medications. He presented with progressive severe dyspnea on exertion and lower extremity edema. His laboratory tests were notable for a total hemoglobin level of 11...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222024/continuous-and-not-continuous-2-week-treadmill-training-enhances-the-performance-in-the-passive-avoidance-test-in-ischemic-gerbils
#4
Ana Paula Cassiano Silveira, Takae Tamy Kitabatake, Vivian Mozol Pantaleo, Hélio Zangrossi, Guilherme Bertolino, Elaine Caldeira de Oliveira Guirro, Hugo Celso Dutra de Souza, João Eduardo de Araujo
This study aims to investigate the frequency and total duration effects of the 2-week treadmill training after experimental ischemic stroke in the passive avoidance test. We performed bilateral occlusion of common external carotid arteries, for five minutes, in Mongolian gerbils. The training groups were: continuous training for twelve consecutive days or not continuous training for six non-consecutive days. The groups remained in the treadmill for 15min, with the speed set at 10m/min, and the training started 24h after the stroke...
December 6, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29218615/advanced-ct-for-diagnosis-of-seizure-related-stroke-mimics
#5
Friederike Austein, Monika Huhndorf, Johannes Meyne, Helmut Laufs, Olav Jansen, Thomas Lindner
BACKGROUND AND PURPOSE: It is assumed that up to 30 % of clinically diagnosed acute ischaemic strokes (AIS) are actually stroke mimics (SM). Our aim was to evaluate the usefulness of advanced CT including CT angiography (CTA) and CT perfusion (CTP) findings when distinguishing AIS from seizure-related SM. METHODS: Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29217747/mr-perfusion-to-determine-the-status-of-collaterals-in-patients-with-acute-ischemic-stroke-a-look-beyond-time-maps
#6
K Nael, A Doshi, R De Leacy, J Puig, M Castellanos, J Bederson, T P Naidich, J Mocco, M Wintermark
BACKGROUND AND PURPOSE: Patients with acute stroke with robust collateral flow have better clinical outcomes and may benefit from endovascular treatment throughout an extended time window. Using a multiparametric approach, we aimed to identify MR perfusion parameters that can represent the extent of collaterals, approximating DSA. MATERIALS AND METHODS: Patients with anterior circulation proximal arterial occlusion who had baseline MR perfusion and DSA were evaluated...
December 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29217363/positional-brain-single-photon-emission-computed-tomography-findings-in-a-case-of-limb-shaking-syndrome
#7
Caroline Bund, Céline Heimburger, Valérie Wolff, Izzie Jacques Namer
An 84-year-old man, who presented lower limbs limb-shaking syndrome at orthostatism lasting a few seconds, was referred in our stroke unit. Magnetic resonance imaging showed an acute infarction in the right thalamus and the insular cortex, left extracranial carotid stenosis at 80%, and low flow in the right middle cerebral artery but did not explain limb-shaking syndrome symptomatology. We performed comparative positional brain perfusion single-photon emission computed tomography (SPECT), in the upright and in the supine position, to explore and localize hypoperfusion-endangered brain structures that may be involved in the presenting symptoms...
December 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29212745/factors-associated-with-focal-computed-tomographic-perfusion-abnormalities-in-supratentorial-transient-ischemic-attacks
#8
Ivo A Meyer, Carlo W Cereda, Pamela N Correia, Jean-Baptiste Zerlauth, Francesco Puccinelli, David C Rotzinger, Michael Amiguet, Philippe Maeder, Reto A Meuli, Patrik Michel
BACKGROUND AND PURPOSE: Computed tomographic perfusion (CTP) is useful in diagnosis of patients with transient focal neurological symptoms. In acute imaging of patients with a suspected transient ischemic attack (TIA), it remains unclear which patients develop focal perfusion abnormalities (FPA), that is, hypoperfusion or hyperperfusion. We aimed at determining independent factors associated with FPA in patients with supratentorial TIAs. METHODS: We prospectively collected consecutive patients with supratentorial TIAs defined by the traditional time-based definition who underwent CTP within 24 hours of symptom onset...
December 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29210137/hyperoxia-does-not-affect-oxygen-delivery-in-healthy-volunteers-while-causing-a-decrease-in-sublingual-perfusion
#9
B Smit, Y M Smulders, E C Eringa, H P M M Gelissen, A R J Girbes, H J S de Grooth, H H M Schotman, P G Scheffer, H M Oudemans-van Straaten, A M E Spoelstra-de Man
To determine the human dose-response relationship between a stepwise increase in arterial oxygen tension and its associated changes in oxygen delivery and sublingual microcirculatory perfusion METHODS: Fifteen healthy volunteers breathed increasing oxygen fractions for 10 minutes to reach arterial oxygen tensions of baseline (breathing air), 20 kPa, 40 kPa, 60 kPa and max kPa (breathing oxygen). Systemic hemodynamics were measured continuously by the volume-clamp method. At the end of each period, the sublingual microcirculation was assessed by Sidestream Darkfield Imaging RESULTS: Systemic oxygen delivery was unchanged throughout the study (Pslope =0...
December 6, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29209923/plasma-microparticles-in-alzheimer-s-disease-the-role-of-vascular-dysfunction
#10
Soheila Hosseinzadeh, Maryam Noroozian, Esmaeil Mortaz, Kazem Mousavizadeh
Cerebrovascular lesions, a potent stimulus for endothelial cell activation, trigger cognitive and degenerative changes and contribute to pathology of Alzheimer's disease (AD). Circulating microparticles (MPs) are actively involved in the pathogenesis of AD and cerebrovascular diseases, which share common vascular risk factors. We examined the plasma changes of endothelial MPs (EMPs) and platelet MPs (PMPs) in AD patients with vascular risk factors. The plasma Annexin V+ CD 41a- CD144+ EMPs and Annexin V+ CD41a+ CD144- PMPs of 37 patients with AD, with or without vascular risk factors (hypertension, diabetes, dyslipidemia, stroke, coronary artery disease, and smoking), and 10 age-matched controls were quantified by flow cytometry...
December 5, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29206145/dual-wavelength-laser-speckle-contrast-imaging-dwlsci-improves-chronic-measurement-of-superficial-blood-flow-in-hands
#11
Lingke Zhang, Li Ding, Miao Li, Xiaoli Zhang, Diansan Su, Jie Jia, Peng Miao
Laser speckle contrast imaging (LSCI) has been widely used to determine blood flow and perfusion in biological tissues. The physical model of traditional LSCI ignores the effects of scattering property distribution in relation to speckle correlation time τc and blood flow v, which further results in biased estimation. In this study, we developed a dual-wavelength laser speckle contrast imaging (dwLSCI) method and a portable device for imaging the blood flow and tissue perfusion in human hands. Experimental data showed that dwLSCI could retrieve the vein vasculatures under the surface skin, and it further provided accurate measurements of vein blood flow signals, tissue perfusion signals, and fingertip perfusion signals, which assist with assessments of rehabilitation therapy for stroke patients...
December 5, 2017: Sensors
https://www.readbyqxmd.com/read/29205466/ischemic-core-thresholds-change-with-time-to-reperfusion-a-case-control-study
#12
Andrew Bivard, Tim Kleinig, Ferdinand Miteff, Kenneth Butcher, Longting Lin, Christopher Levi, Mark Parsons
INTRODUCTION: We aimed to identify if acute ischemic stroke patients with known complete reperfusion after thrombectomy had the same baseline CTP ischemic core threshold to predict infarction as thrombolysis patients with complete reperfusion. METHODS: Patients who underwent thrombectomy were matched by age, clinical severity, occlusion location, and baseline perfusion lesion volume to patients who were treated with intravenous alteplase alone from the International Stroke Perfusion Imaging Registry...
December 4, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#13
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201841/the-combined-use-of-cardiac-output-and-intracranial-pressure-monitoring-to-maintain-optimal-cerebral-perfusion-pressure-and-minimize-complications-for-severe-traumatic-brain-injury
#14
Jin Shup So, Jung-Ho Yun
Objective: To show the effect of dual monitoring including cardiac output (CO) and intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI) patiens. We hypothesized that meticulous treatment using dual monitoring is effective to sustain maintain minimal intensive care unit (ICU) complications and maintain optimal ICP and cerebral perfusion pressure (CPP) for severe TBI patiens. Methods: We included severe TBI, below Glasgow Coma Scale (GCS) 8 and head abbreviation injury scale (AIS) >4 and performed decompressive craniectomy at trauma ICU of our hospital...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29199136/cerebral-venous-collaterals-a-new-fort-for-fighting-ischemic-stroke
#15
REVIEW
Lu-Sha Tong, Zhen-Ni Guo, Yi-Bo Ou, Yan-Nan Yu, Xiao-Cheng Zhang, Jiping Tang, John H Zhang, Min Lou
Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae...
November 30, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/29197461/ineffective-and-prolonged-apical-contraction-is-associated-with-chest-pain-and-ischaemia-in-apical-hypertrophic-cardiomyopathy
#16
Edward Stephenson, Pierre Monney, Francesca Pugliese, James Malcolmson, Steffen E Petersen, Charles Knight, Peter Mills, Andrew Wragg, Constantinos O'Mahony, Neha Sekhri, Saidi A Mohiddin
OBJECTIVES: To investigate the hypothesis that persistence of apical contraction into diastole is linked to reduced myocardial perfusion and chest pain. BACKGROUND: Apical hypertrophic cardiomyopathy (HCM) is defined by left ventricular (LV) hypertrophy predominantly of the apex. Hyperdynamic contractility resulting in obliteration of the apical cavity is often present. Apical HCM can lead to drug-refractory chest pain. METHODS: We retrospectively studied 126 subjects; 76 with apical HCM and 50 controls (31 with asymmetrical septal hypertrophy (ASH) and 19 with non-cardiac chest pain and culprit free angiograms and structurally normal hearts)...
January 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29196995/epigenetics-and-preeclampsia-programming-of-future-outcomes
#17
Alberto Borges Peixoto, Liliam Cristine Rolo, Luciano Marcondes Machado Nardozza, Edward Araujo Júnior
Pregnancy is known to induce rapid, progressive, and substantial changes to the cardiovascular system, ultimately facilitating successful pregnancy outcomes. Women who develop hypertensive disorders during pregnancy are considered to have "failed" the cardiovascular stress test of pregnancy and likely represent a subpopulation with inadequate cardiovascular accommodation. Preeclampsia is a serious complication with a myriad of manifestations in both mother and offspring. This pregnancy syndrome is a polygenic disease and has now been linked to a greater incidence of cardiovascular disease...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29190776/large-scale-identification-of-human-cerebrovascular-proteins-inter-tissue-and-intracerebral-vascular-protein-diversity
#18
Soo Jung Lee, Soonhyung Kwon, John R Gatti, Ejona Korcari, Ty E Gresser, Princess C Felix, Simon G Keep, Kevin C Pasquale, Tongxu Bai, Sabrina A Blanchett-Anderson, Nancy W Wu, Charissa Obeng-Nyarko, Kossi M Senagbe, Kathy C Young, Snehaa Maripudi, Bharath C Yalavarthi, Dajana Korcari, Andre Y Liu, Benjamin C Schaffler, Richard F Keep, Michael M Wang
The human cerebrovascular system is responsible for regulating demand-dependent perfusion and maintaining the blood-brain barrier (BBB). In addition, defects in the human cerebrovasculature lead to stroke, intracerebral hemorrhage, vascular malformations, and vascular cognitive impairment. The objective of this study was to discover new proteins of the human cerebrovascular system using expression data from the Human Protein Atlas, a large-scale project which allows public access to immunohistochemical analysis of human tissues...
2017: PloS One
https://www.readbyqxmd.com/read/29190675/in-patients-with-suspected-acute-stroke-ct-perfusion-based-cerebral-blood-flow-maps-cannot-substitute-for-dwi-in-measuring-the-ischemic-core
#19
William A Copen, Albert J Yoo, Natalia S Rost, Lívia T Morais, Pamela W Schaefer, R Gilberto González, Ona Wu
BACKGROUND: Neuroimaging may guide acute stroke treatment by measuring the volume of brain tissue in the irreversibly injured "ischemic core." The most widely accepted core volume measurement technique is diffusion-weighted MRI (DWI). However, some claim that measuring regional cerebral blood flow (CBF) with CT perfusion imaging (CTP), and labeling tissue below some threshold as the core, provides equivalent estimates. We tested whether any threshold allows reliable substitution of CBF for DWI...
2017: PloS One
https://www.readbyqxmd.com/read/29182658/high-permeability-region-size-on-perfusion-ct-predicts-hemorrhagic-transformation-after-intravenous-thrombolysis-in-stroke
#20
Josep Puig, Gerard Blasco, Pepus Daunis-I-Estadella, Cecile van Eendendburg, María Carrillo-García, Carlos Aboud, María Hernández-Pérez, Joaquín Serena, Carles Biarnés, Kambiz Nael, David S Liebeskind, Götz Thomalla, Bijoy K Menon, Andrew Demchuk, Max Wintermark, Salvador Pedraza, Mar Castellanos
OBJECTIVE: Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. METHODS: We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4...
2017: PloS One
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