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Stroke Perfusion

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https://www.readbyqxmd.com/read/28105641/innominate-artery-cannulation-for-arterial-perfusion-during-aortic-arch-surgery
#1
Gaku Uchino, Keiji Yunoki, Naoya Sakoda, Munehiro Saiki, Kunikazu Hisamochi, Hideo Yoshida
OBJECTIVE: Antegrade cerebral perfusion during aortic arch surgery plays an important role in improving postoperative neurological outcomes. We report our experience using innominate artery cannulation for arterial perfusion during aortic arch surgery. METHODS: From January 2008 to December 2015, 159 patients underwent aortic arch surgery using innominate artery perfusion and were included in the study analysis (mean age, 71.4 ± 9.1 years; male, 120). RESULTS: Total arch replacement was performed in 84...
January 20, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28104836/validating-a-predictive-model-of-acute-advanced-imaging-biomarkers-in-ischemic-stroke
#2
Andrew Bivard, Christopher Levi, Longting Lin, Xin Cheng, Richard Aviv, Neil J Spratt, Min Lou, Tim Kleinig, Billy O'Brien, Kenneth Butcher, Jingfen Zhang, Jim Jannes, Qiang Dong, Mark Parsons
BACKGROUND AND PURPOSE: Advanced imaging to identify tissue pathophysiology may provide more accurate prognostication than the clinical measures used currently in stroke. This study aimed to derive and validate a predictive model for functional outcome based on acute clinical and advanced imaging measures. METHODS: A database of prospectively collected sub-4.5 hour patients with ischemic stroke being assessed for thrombolysis from 5 centers who had computed tomographic perfusion and computed tomographic angiography before a treatment decision was assessed...
January 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28100765/acute-transient-vestibular-syndrome-prevalence-of-stroke-and-efficacy-of-bedside-evaluation
#3
Jae-Hwan Choi, Min-Gyu Park, Seo Young Choi, Kyung-Pil Park, Seung Kug Baik, Ji-Soo Kim, Kwang-Dong Choi
BACKGROUND AND PURPOSE: The aim of this study was to determine the prevalence of stroke and efficacy of bedside evaluation in diagnosing stroke in acute transient vestibular syndrome (ATVS). METHODS: We performed a prospective, single-center, observational study that had consecutively recruited 86 patients presenting with ATVS to the emergency department of Pusan National University Yangsan Hospital from January to December 2014. All patients received a constructed evaluation, including HINTS plus (head impulse, nystagmus patterns, test of skew, and finger rubbing) and brain magnetic resonance imagings...
January 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28095387/mri-of-cerebellar-infarction
#4
Laurens J L De Cocker, Karl-Olof Lövblad, Jeroen Hendrikse
BACKGROUND: MRI is the imaging modality of choice for diagnosing brain infarction. Because of few or atypical clinical symptoms and a relatively low sensitivity of CT scans, many cerebellar infarctions may be detected only with MRI. With adequate recognition of cerebellar infarction on MRI and prompt initiation or optimisation of preventive therapeutic measures, more dramatic strokes may be avoided in selected cases. SUMMARY: We first briefly review the clinical presentation of cerebellar infarctions, followed by a short refresher on cerebellar anatomy and pathophysiological mechanisms of cerebellar infarcts...
January 18, 2017: European Neurology
https://www.readbyqxmd.com/read/28094088/usefulness-of-multiparametric-computerized-tomography-findings-in-the-differential-diagnosis-of-stroke-mimics-of-epileptic-origin-a-preliminary-study
#5
R López Ruiz, S Quintas, P Largo, M de Toledo, M T Carreras, A Gago-Veiga, R Manzanares, J Vivancos
OBJECTIVE: Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events. MATERIAL AND METHODS: We conducted a retrospective observational study; data were gathered prospectively during one year. We studied multiparametric CT images of patients admitted following code stroke activation and finally diagnosed with epilepsy...
January 13, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28087112/the-impact-of-temperature-in-aortic-arch-surgery-patients-receiving-antegrade-cerebral-perfusion-for-30%C3%A2-minutes-how-relevant-is-it-really
#6
Ourania Preventza, Joseph S Coselli, Shahab Akvan, Sarang A Kashyap, Andrea Garcia, Katherine H Simpson, Matt D Price, Jessica Mayor, Kim I de la Cruz, Lorraine D Cornwell, Shuab Omer, Faisal G Bakaeen, Ricky J L Haywood-Watson, Athina Rammou
OBJECTIVE: We examined the early outcomes and the long-term survival associated with different degrees of hypothermia in patients who received antegrade cerebral perfusion (ACP) for >30 minutes. METHODS: During a 10-year period, 544 consecutive patients underwent proximal and total aortic arch surgery and received ACP for >30 minutes and 1 of 3 levels of hypothermia: deep (14.1°C-20°C; n = 116 [21.3%]), low-moderate (20.1°C-23.9°C; n = 262 [48.2%]), and high-moderate (24°C-28°C; n = 166 [30...
December 19, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28079797/case-report-rapid-improvement-of-crossed-cerebellar-diaschisis-after-intravascular-laser-irradiation-of-blood-in-a-case-of-stroke
#7
Wan-Hua Yang, Shiou-Ping Lin, Shin-Tsu Chang
RATIONALE: Crossed cerebellar diaschisis (CCD) is a poor prognostic factor after stroke because without immediate cerebral reperfusion no further improvements in the patient's condition can be achieved. We investigated the clinical effects of intravascular laser irradiation therapy (ILIB) on CCD and evaluated the therapeutic effect in the sub-acute post-stroke stage. PATIENT CONCERNS: The 77-year-old male with cerebral infarction in the territory of the right anterior cerebral artery only underwent conservative treatment including hydration and aspirin in the acute post-stroke stage...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068866/cognitive-abnormalities-and-cerebral-perfusion-defects-in-a-community-dwelling-cohort-of-elderly-men-with-mmse-within-the-normal-range
#8
Lena André-Petersson, Ola Thorsson, Arkadiusz Siennicki-Lantz
OBJECTIVES: Mini Mental State Examination's (MMSE's) sensitivity in its upper level is questioned, hence we investigated cognitive abnormalities and defects in regional cerebral blood flow (rCBF) in elderly with MMSE scores ≥24. METHODS: One hundred and four men at age 81 with MMSE scores ≥24 (mean 28.4 ± 1.7), no dementia or stroke, were examined with neuropsychological test battery, and their rCBF was estimated using (99mTc)-HMPAO SPECT. RESULTS: MMSE was very sparsely correlated with rCBF...
January 9, 2017: Neuropsychology, Development, and Cognition. Section B, Aging, Neuropsychology and Cognition
https://www.readbyqxmd.com/read/28068417/preserved-collateral-blood-flow-in-the-endovascular-m2cao-model-allows-for-clinically-relevant-profiling-of-injury-progression-in-acute-ischemic-stroke
#9
Philip Little, Ola Kvist, Rikard Grankvist, Stefan Jonsson, Peter Damberg, Michael Söderman, Fabian Arnberg, Staffan Holmin
Interventional treatment regimens have increased the demand for accurate understanding of the progression of injury in acute ischemic stroke. However, conventional animal models severely inhibit collateral blood flow and mimic the malignant infarction profile not suitable for treatment. The aim of this study was to provide a clinically relevant profile of the emergence and course of ischemic injury in cases suitable for acute intervention, and was achieved by employing a M2 occlusion model (M2CAO) that more accurately simulates middle cerebral artery (MCA) occlusion in humans...
2017: PloS One
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#10
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28063669/longer-term-impact-of-hemiparetic-stroke-on-skeletal-muscle-metabolism-a-pilot-study
#11
Jennifer Klaer, Anja Mähler, Nadja Scherbakov, Lars Klug, Stephan von Haehling, Michael Boschmann, Wolfram Doehner
BACKGROUND: Hemiparetic stroke leads to structural and metabolic alterations of skeletal muscle tissue, thereby contributing to functional impairment associated with stroke. In situ metabolic processes at tissue level in skeletal muscle have not been investigated. We hypothesize that muscular metabolic capacity is limited after hemiparetic stroke, and that changes affect rather the paretic than non-paretic limb. METHODS: Nine male hemiparetic stroke survivors (age, 62±8years; BMI, 28±4kg/m(2); median stroke latency, 23months ranging from 7 to 34months poststroke) underwent dynamic in situ measurements of carbohydrate and lipid metabolism at fasting condition and during oral glucose tolerance testing, using bilateral microdialysis...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28062548/modified-frozen-elephant-trunk-for-acute-type-a-aortic-dissection-a-comparative-study-with-standard-repair-technique
#12
Peter Matt, Prerana Banerjee, Martin Grapow, Florian Rueter, Ulrich Schurr, Martin Siegemund, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
OBJECTIVES: We hypothesized that antegrade open stent graft implantation in the descending aorta during acute type A aortic dissection surgery is safe and improves patient outcome compared with the standard repair technique. METHODS: Hundred and forty-one consecutive patients underwent surgery for acute type A aortic dissection at our institution from 2010 to 2016. Of those, 104 patients underwent ascending aorta and hemiarch repair under hypothermic circulatory arrest with antegrade cerebral perfusion (standard group)...
January 5, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#13
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28048545/we-de-207a-04-advances-in-radiological-neuro-endovascular-interventional-imaging
#14
S Rudin
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048454/we-de-207a-00-advances-in-image-guided-neurointerventions-clinical-pull-and-technology-push
#15
Jeffrey Siewerdsen, Rebecca Fahrig
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047800/we-de-207a-01-parallels-in-the-evolution-of-x-ray-angiographic-systems-and-devices-used-for-minimally-invasive-endovascular-therapy
#16
C Strother
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047144/we-de-207a-02-advances-in-cone-beam-ct-anatomical-and-functional-imaging-in-angio-suite-to-enable-one-stop-shop-stroke-imaging-workflow
#17
G Chen
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046482/we-de-207a-03-recent-advances-in-devices-used-in-neuro-interventions
#18
M Gounis
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#19
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#20
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
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