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Stroke Perfusion

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https://www.readbyqxmd.com/read/29689105/cerebral-desaturation-in-heart-failure-potential-prognostic-value-and-physiologic-basis
#1
Yu-Jen Chen, Jong-Shyan Wang, Chih-Chin Hsu, Pyng-Jing Lin, Feng-Chun Tsai, Ming-Shien Wen, Chi-Tai Kuo, Shu-Chun Huang
Cerebral tissue oxygen saturation (SctO2) reflects cerebral perfusion and tissue oxygen consumption, which decline in some patients with heart failure with reduced ejection fraction (HFrEF) or stroke, especially during exercise. Its physiologic basis and clinical significance remain unclear. We aimed to investigate the association of SctO2 with oxygen transport physiology and known prognostic factors during both rest and exercise in patients with HFrEF or stroke. Thirty-four HFrEF patients, 26 stroke patients, and 17 healthy controls performed an incremental cardiopulmonary exercise test using a bicycle ergometer...
2018: PloS One
https://www.readbyqxmd.com/read/29685718/distal-arch-aneurysm-repair-using-left-subclavian-artery-transposition-with-stented-elephant-trunk-in-the-hybrid-repair-era
#2
Rui-Dong Qi, Jun-Ming Zhu, Yong-Min Liu, Lei Chen, Cheng-Nan Li, Xiao-Yan Xing, Nan Zhang, Li-Zhong Sun
BACKGROUND: Hybrid aortic arch repair is an invasive approach to the surgical management of distal aortic arch aneurysm. The complications associated with hybrid aortic arch repair, such as stroke and endoleaks, are not uncommon and late reintervention is frequent. We retrospectively reviewed our experience of distal aortic arch aneurysm repair using the stented elephant trunk procedure with left subclavian artery (LSCA)-left common carotid artery (LCCA) transposition in the hybrid repair era...
March 27, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29678936/effect-of-stroke-thrombolysis-predicted-by-distal-vessel-occlusion-detection
#3
Wolfgang G Kunz, Matthias P Fabritius, Wieland H Sommer, Christopher Höhne, Pierre Scheffler, Lukas T Rotkopf, Wolfgang P Fendler, Bastian O Sabel, Felix G Meinel, Franziska Dorn, Birgit Ertl-Wagner, Maximilian F Reiser, Kolja M Thierfelder
OBJECTIVE: Among ischemic stroke patients with negative CT angiography (CTA), we aimed to determine the predictive value of enhanced distal vessel occlusion detection using CT perfusion postprocessing (waveletCTA) for the treatment effect of IV thrombolysis (IVT). METHODS: Patients were selected from 1,851 consecutive patients who had undergone CT perfusion. Inclusion criteria were (1) significant cerebral blood flow (CBF) deficit, (2) no occlusion on CTA, and (3) infarction confirmed on follow-up...
April 20, 2018: Neurology
https://www.readbyqxmd.com/read/29677249/in-perfusion-imaging-selected-acute-ischemic-stroke-thrombectomy-at-6-to-16-hours-improved-functional-outcomes
#4
Omar Damji, Eddy Lang
No abstract text is available yet for this article.
April 17, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29669868/improving-microcirculatory-reperfusion-reduces-parenchymal-oxygen-radical-formation-and-provides-neuroprotection
#5
Aslihan Taskiran-Sag, Muge Yemisci, Yasemin Gursoy-Ozdemir, Sefik Evren Erdener, Hulya Karatas, Deniz Yuce, Turgay Dalkara
BACKGROUND AND PURPOSE: Reperfusion is the most significant determinant of good outcome after ischemic stroke. However, complete reperfusion often cannot be achieved, despite satisfactory recanalization. We hypothesized that microvascular protection was essential for achieving effective reperfusion and, hence, neuroprotection. To test this hypothesis, we have developed an in vivo model to differentially monitor parenchymal and vascular reactive oxygen species (ROS) formation. By comparing the ROS-suppressing effect of N-tert-butyl-α-phenylnitrone (PBN) with its blood-brain barrier impermeable analog 2-sulfo-phenyl-N-tert-butylnitrone (S-PBN), we assessed the impact of vascular ROS suppression alone on reperfusion and stroke outcome after recanalization...
April 18, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29667266/application-of-the-dawn-clinical-imaging-mismatch-and-defuse-3-selection-criteria-benefit-seems-similar-but-restrictive-volume-cut-offs-might-omit-potential-responders
#6
Célina Ducroux, Naim Khoury, Augustin Lecler, Raphaël Blanc, Annaëlle Chetrit, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Simon Escalard, Jean-Philippe Desilles, Mikaël Mazighi, Malek Ben Maacha, Michel Piotin, Robert Fahed
BACKGROUND: We aimed to conduct an external validation of the selection criteria of the diffusion-weighted-imaging or computerized-tomography-perfusion assessment with clinical mismatch in the triage of wake-up and late-presenting strokes undergoing Neurointervention with Trevo (DAWN) and the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke (DEFUSE3) trials in a cohort of unknown onset stroke (UOS) patients treated with thrombectomy. METHODS: A validation cohort of UOS patients was selected from a prospectively collected thrombectomy database to match the inclusion criteria of DAWN and DEFUSE3...
April 18, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29660944/cardiovascular-response-to-mental-stress-in-mild-cognitive-impairment-and-its-association-with-cerebral-perfusion
#7
Brandon C Henley, Mahsa Shokouhi, Anushree Y Mahajan, Omer T Inan, Ihab Hajjar
Mental stress has been linked to various chronic diseases including Alzheimer's disease, but the mechanisms underlying cognitive decline with mental stress are unknown. Reduced cardiovascular response to stress is associated with cardiovascular disease, and the latter is associated with cognitive impairment. We measured electrodermal activity, blood pressure, and cardiac hemodynamics in cognitively normal and mild cognitive impairment (MCI) adults (n = 76, mean age = 58 years, 46% MCI) during rest, a math test, and face-name recall tasks to derive the following cardiovascular indicators: mean arterial pressure, heart rate, stroke volume and cardiac output...
April 11, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29652661/combined-brain-and-heart-magnetic-resonance-imaging-in-systemic-vasculitides-fiction-or-real-need
#8
REVIEW
Sophie I Mavrogeni, George Kitas, Hildo J Lamb, Klearchos Psychoyios, Theodoros Dimitroulas, Loukia Koutsogeorgopoulou, Kyriaki Boki, Vasiliki Vartela, Genovefa Kolovou, George Markousis-Mavrogenis, Cees G Kallenberg, Loic Guillevin, Dimitrios Vassilopoulos
Systemic vasculitides (SVs) is a group of diseases characterised by inflammation/necrosis of the blood vessel wall in various organs. Simultaneous brain and heart involvement is a cause of increased morbidity/mortality in SV. We aimed to present evidence of concurrent brain/heart involvement in SV and the role of a combined brain/heart magnetic resonance imaging (MRI) in their risk stratification. Cerebral vasculitis (CV) can be presented as focal deficits, seizures, headache, neuropsychiatric manifestations or cognitive dysfunction and cardiovascular disease (CVD) as myocardial/vascular inflammation, perfusion/function defects and fibrosis...
April 10, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29652229/a-useful-diagnostic-method-to-reduce-the-in-hospital-time-delay-for-mechanical-thrombectomy-volume-perfusion-computed-tomography-with-added-vessel-reconstruction
#9
Ho Jun Yi, Jae Hoon Sung, Dong Hoon Lee, Seung Ho Yang, Jae Taek Hong
OBJECTIVE Volume perfusion CT (VPCT) with added CT angiography (CTA)-like reconstruction from VPCT source data (VPCTA) can reveal multiple intracranial parameters. The authors examined the usefulness of VPCTA in terms of reducing the in-hospital time delay for mechanical thrombectomy. METHODS A total of 180 patients who underwent mechanical thrombectomy at the authors' institution between January 2014 and March 2017 were divided into 2 groups: a CTA-based thrombectomy decision group (group 1: CTA) and a VPCTA-based decision group (group 2: VPCTA)...
April 13, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29651557/higher-admission-fasting-plasma-glucose-levels-are-associated-with-a-poorer-short-term-neurologic-outcome-in-acute-ischemic-stroke-patients-with-good-collateral-circulation
#10
Feng Wang, Beisi Jiang, Lasheta Kanesan, Yuwu Zhao, Bernard Yan
AIMS: In this retrospective study, we sought to delineate the collateral circulation status of acute ischemic stroke patients by CT perfusion and evaluate 90-day modified Rankin Scale (mRS) scores of patients with good or poor collaterals and its correlation with admission fasting plasma glucose (FPG). METHODS: We enrolled acute ischemic stroke patients who presented to our hospital 4.5 h within an onset of the first episode between January 2009 and December 2015...
April 12, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29649783/radiation-dose-reduction-in-perfusion-ct-imaging-of-the-brain-using-a-256-slice-ct-80-mas-versus-160-mas
#11
Isabelle Riederer, Claus Zimmer, Daniela Pfeiffer, Silke Wunderlich, Holger Poppert, Ernst J Rummeny, Armin Huber
PURPOSE: To examine CTP of the brain in real patient data after reducing tube current down to 80 mAs to decrease radiation dose. METHODS: CTP was acquired in 60 suspected stroke patients with 80 (n: 30) or 160 (n: 30) mAs. Data were analyzed retrospectively by two independent readers. SNR, perfusion maps and image quality were compared in hypoperfused and non-affected areas. RESULTS: SNR was significantly higher in CTP with 160 mAs compared to 80 mAs (p < 0...
April 5, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29643681/mismatch-in-brain-perfusion-and-metabolism-detected-with-99m-tc-hexamethyl-propylene-amine-oxime-single-photon-emission-computed-tomography-and-18-f-fluorodeoxyglucose-positron-emission-tomography-in-moyamoya-disease
#12
Justo Serrano Vicente, Luis Fernández Prudencio, José Rafael Infante Torre, Juan Ignacio Rayo Madrid
We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with "puff of smoke" suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29628948/clinical-and-imaging-outcomes-of-endovascular-therapy-in-patients-with-acute-large-vessel-occlusion-stroke-and-mild-clinical-symptoms
#13
Meredith T Bowen, Leticia C Rebello, Mehdi Bouslama, Diogo C Haussen, Jonathan A Grossberg, Nicolas A Bianchi, Samir Belagaje, Aaron Anderson, Michael R Frankel, Raul G Nogueira
Background: The minimal stroke severity justifying endovascular intervention remains elusive. However, a significant proportion of patients presenting with large vessel occlusion stroke (LVOS) and mild symptoms go untreated and face poor outcomes. We aimed to evaluate the clinical outcomes of patients presenting with LVOS and low symptom scores (National Institutes of Health Stroke Scale [NIHSS] score ≤8) undergoing endovascular therapy (ET). Methods: We performed a retrospective analysis of a prospectively collected ET database between September 2010 and March 2016...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29626134/modified-thrombolysis-in-cerebral-infarction-2c-thrombolysis-in-cerebral-infarction-3-reperfusion-should-be-the-aim-of-mechanical-thrombectomy-insights-from-the-aster-trial-contact-aspiration-versus-stent-retriever-for-successful-revascularization
#14
Cyril Dargazanli, Robert Fahed, Raphael Blanc, Benjamin Gory, Julien Labreuche, Alain Duhamel, Gaultier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin, Bertrand Lapergue
BACKGROUND AND PURPOSE: Although successful reperfusion is usually defined as a modified Thrombolysis in Cerebral Infarction (mTICI) 2B or 3 at the end of the procedure, studies have shown that mTICI 2B patients had poorer functional outcomes than TICI 3 patients. An mTICI 2C category has been recently introduced for patients with near-complete perfusion except for slow flow in a few distal cortical vessels or presence of small distal cortical emboli after mechanical thrombectomy. The purpose of this study was to evaluate the difference in functional outcome between patients achieving successful reperfusion (ie, mTICI 2B, mTICI 2C, and TICI 3 scores)...
April 6, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29625501/a-contemporary-meta-analysis-of-antegrade-versus-retrograde-cerebral-perfusion-for-thoracic-aortic-surgery
#15
Hisato Takagi, Shohei Mitta, Tomo Ando
OBJECTIVE:  To determine which of antegrade and retrograde cerebral perfusion (ACP and RCP) surpasses for a reduction in postoperative incidence of neurological dysfunction and all-cause death in thoracic aortic surgery, we performed a meta-analysis of contemporary comparative studies. METHODS:  MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from January 2010 to June 2017. For each study, data regarding the endpoints in both the ACP and RCP groups were used to generate odds ratios (ORs) and 95% confidence intervals (CIs)...
April 6, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29625153/brain-ct-perfusion-improves-intracranial-vessel-occlusion-detection-on-ct-angiography
#16
Marinus J Becks, Rashindra Manniesing, Jeroen Vister, Sjoert A H Pegge, Stefan C A Steens, Ewoud J van Dijk, Mathias Prokop, Frederick J A Meijer
BACKGROUND AND PURPOSE: To evaluate whether brain CT perfusion (CTP) aids in the detection of intracranial vessel occlusion on CT angiography (CTA) in acute ischemic stroke. MATERIALS AND METHODS: Medical-ethical committee of our hospital was obtained and informed consent was waived. Patients suspected of acute ischemic stroke who underwent non-contrast CT(NCCT), CTA and whole-brain CTP in our center in the year 2015 were included. Three observers with different levels of experience evaluated the imaging data of 110 patients for the presence or absence of intracranial arterial vessel occlusion with two strategies...
April 3, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29622554/slow-collateral-flow-is-associated-with-thrombus-extension-in-patients-with-acute-large-artery-occlusion
#17
R Zhang, Y Zhou, S Yan, S Zhang, X Ding, M Lou
BACKGROUND AND PURPOSE: It is still poorly understood about the dynamic changes of the thrombus after intravenous thrombolysis and how the remaining thrombus affects clinical outcome in human stroke. Collateral flow was assumed to help to deliver endo/exogenous tissue-type plasminogen activator to the clot. We aimed to analyze the impact of collateral flow on the dynamic changes of the thrombus in patients with acute large-artery occlusion who received intravenous thrombolysis. MATERIALS AND METHODS: We reviewed consecutive patients with acute ischemic stroke with M1 segment or distal internal carotid artery occlusion who underwent multimodal MR imaging or CT perfusion before and 24 hours after intravenous thrombolysis without recanalization...
April 5, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29619889/mild-focal-hypothermia-regulates-the-dynamic-polarization-of-microglia-after-ischemic-stroke-in-mice
#18
Liqiang Liu, Xiangrong Liu, Rongliang Wang, Feng Yan, Yumin Luo, Ankush Chandra, Yuchuan Ding, Xunming Ji
Objectives The protective effects of hypothermia on acute stroke have been demonstrated in many studies. However, its underlying mechanisms have not been thoroughly elucidated. Following an ischemic stroke event, microglia undertakes an early 'healthy' M2 phenotype and gradually transform into a 'sick' M1 phenotype over time. This transformation of polarity of microglia has influence on the degree of damage following a stroke. This study investigated the effects of mild focal hypothermia on microglia polarization following ischemic stroke...
April 5, 2018: Neurological Research
https://www.readbyqxmd.com/read/29616230/anesthesia-associated-relative-hypovolemia-mechanisms-monitoring-and-treatment-considerations
#19
Jessica Noel-Morgan, William W Muir
Although the utility and benefits of anesthesia and analgesia are irrefutable, their practice is not void of risks. Almost all drugs that produce anesthesia endanger cardiovascular stability by producing dose-dependent impairment of cardiac function, vascular reactivity, and compensatory autoregulatory responses. Whereas anesthesia-related depression of cardiac performance and arterial vasodilation are well recognized adverse effects contributing to anesthetic risk, far less emphasis has been placed on effects impacting venous physiology and venous return...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29608660/branched-endografts-in-the-aortic-arch-following-open-repair-for-debakey-type-i-aortic-dissection
#20
Nikolaos Tsilimparis, Christian Detter, Franziska Heidemann, Konstantinos Spanos, Fiona Rohlffs, Yskert von Kodolitsch, Sebastian E Debus, Tilo Kölbel
OBJECTIVES: DeBakey Type I aortic dissections are frequently treated by an ascending aortic tube graft or hemiarch replacement with the residual dissection remaining untreated. We investigated the outcomes of branched thoracic endovascular repair for post-dissection aneurysms of the aortic arch. METHODS: We conducted a retrospective, single-centre evaluation of 20 consecutive patients with a false-lumen aneurysm after a DeBakey I aortic dissection treated with branched thoracic endovascular repair...
March 28, 2018: European Journal of Cardio-thoracic Surgery
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