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cerebral revascularization

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https://www.readbyqxmd.com/read/28209313/the-arborization-bypass-sequential-intracranial-intracranial-bypasses-for-an-unruptured-fusiform-mca-aneurysm
#1
Jonathan J Russin
Revascularization techniques are being featured more prominently as endovascular treatments continue to select out complex cerebrovascular pathologies for open surgical management. The current healthcare environment requires decreased hospital stays and improved clinical outcomes despite the growing complexity of open surgical cases. Recent efforts to reduce operative room time and decrease risk for bypass surgery have focused on avoiding graft harvest and maintaining the entire bypass intracranial. The presented technique features an arborization bypass to serially anastomose the middle cerebral artery vessels allowing for proximal trapping of a complex aneurysm without graft harvest...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28191601/the-maxillary-artery-and-its-variants-an-anatomical-study-with-neurosurgical-applications
#2
Jorge E Alvernia, Joaquin Hidalgo, Marc P Sindou, Chad Washington, Gustavo Luzardo, Eddie Perkins, Remi Nader, Patrick Mertens
BACKGROUND: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures. OBJECTIVES: To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner. METHODS: Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques...
February 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28168990/clinical-assessment-of-cerebral-hemodynamics-in-moyamoya-disease-via-multiple-inversion-time-arterial-spin-labeling-and-dynamic-susceptibility-contrast-magnetic-resonance-imaging-a-comparative-study
#3
Peng-Gang Qiao, Cong Han, Zhi-Wei Zuo, Yi-Tuo Wang, Josef Pfeuffer, Lian Duan, Tianyi Qian, Gong-Jie Li
BACKGROUND AND PURPOSE: For Moyamoya disease (MMD) patients, accurate hemodynamic assessment is critical for treatment selection and efficacy assessment. This study aims to investigate the clinical value of mTI-ASL in assessing the cerebral hemodynamics of MMD patients before and after revascularization, relative to DSC-MRI. MATERIALS AND METHODS: Forty-one MMD patients underwent mTI-ASL and DSC-MRI during blood perfusion. Quantitative parameters for the bilateral supply vessels of middle and anterior cerebral arteries, including DSC-TTP, DSC-CBF, ASL-BAT, and ASL-CBF were measured...
February 3, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28168068/treatment-challenges-of-a-primary-vertebral-artery-aneurysm-causing-recurrent-ischemic-strokes
#4
Davide Strambo, Luca Peruzzotti-Jametti, Aurora Semerano, Giovanna Fanelli, Franco Simionato, Roberto Chiesa, Enrico Rinaldi, Vittorio Martinelli, Giancarlo Comi, Marco Bacigaluppi, Maria Sessa
Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1) came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28159458/relationship-between-the-change-of-language-symptoms-and-the-change-of-regional-cerebral-blood-flow-in-the-recovery-process-of-two-children-with-acquired-aphasia
#5
Junko Kozuka, Akira Uno, Hiroshi Matsuda, Yoshiya Toyoshima, Shin-Ichiro Hamano
OBJECTIVE: This study aimed to investigate the relationship between the change of language symptoms and the change of regional cerebral blood flow (rCBF) in the recovery process of two children with acquired aphasia caused by infarctions from Moyamoya disease with an onset age of 8years. METHODS: We compared the results for the Standard Language Test of Aphasia (SLTA) with rCBF changes in 7 language regions in the left hemisphere and their homologous regions in the right hemisphere at 4 time points from 3weeks for up to 5years after the onset of aphasia, while controlling for the effect of age...
January 31, 2017: Brain & Development
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#6
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28153617/the-susceptibility-pathogenesis-of-the-moyamoya-disease
#7
Juntao Hu, Jie Luo, Qianxue Chen
Moyamoya disease (MMD) is a cerebrovascular disease characterized by progressive stenosis of the intracranial internal carotid arteries and their proximal branches. Epidemiologically, MMD is more prevalent in east Asia than any region worldwide, which have been estimated at 0.94 per 100 000 in Japanese and 0.43 per 100,000 in Chinese.However, the etiology of this rare disease remains unknown. Regarding biomarkers of moyamoya disease, moyamoya disease is characterized by an increased expression of angiogenic factors and pro-inflammatory molecules such as vascular endothelial growth factors and matrix metalloproteinase-9, which may partly explain its clinical manifestations of the pathologic angiogenesis, spontaneous hemorrhage, and higher incidence of cerebral hyperperfusion after revascularization surgery...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28152266/bold-fmri-with-median-nerve-electrical-stimulation-predict-hemodynamic-improvement-after-revascularization-in-patients-with-moyamoya-disease
#8
Peng-Gang Qiao, Cong Han, Tianyi Qian, Gong-Jie Li, Hong Yin
PURPOSE: To assess the severity of cerebral hemodynamic impairment and hemodynamic improvements, after revascularization in moyamoya disease (MMD) by means of blood-oxygen-level dependent functional magnetic resonance imaging (BOLD-fMRI). MATERIALS AND METHODS: BOLD-fMRI with median nerve electrical stimulation based on echo planar imaging was performed in 73 volunteers with MMD and 15 healthy volunteers using a 3.0 Tesla MRI scanner. Twenty-four MMD patients were reexamined after encephaloduroarteriosynangiosis...
February 2, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28145873/incidence-of-bradycardia-and-outcomes-of-patients-who-underwent-orbital-atherectomy-without-a-temporary-pacemaker
#9
Michael S Lee, Heajung Nguyen, Richard Shlofmitz
OBJECTIVE: We analyzed the incidence of bradycardia and the safety of patients with severely calcified coronary lesions who underwent orbital atherectomy without the insertion of a temporary pacemaker. BACKGROUND: The presence of severely calcified coronary lesions can increase the complexity of percutaneous coronary intervention due to the difficulty in advancing and optimally expanding the stent. High-pressure inflations to predilate calcified lesions may cause angiographic complications like perforation and dissection...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28132922/clinical-features-surgical-treatment-and-long-term-outcome-in-elderly-patients-with-moyamoya-disease
#10
Peicong Ge, Qian Zhang, Xun Ye, Xingju Liu, Xiaofeng Deng, Rong Wang, Yan Zhang, Dong Zhang, Jizong Zhao
OBJECTIVE: To elucidate the clinical features, surgical treatment, and long-term outcome in elderly patients with moyamoya disease (MMD). METHODS: We retrospectively reviewed 87 elderly patients with MMD at Beijing Tiantan Hospital. Clinical features, radiologic findings, and outcomes were analyzed. RESULTS: The mean age at diagnosis was 54.0±3.7 years, Familial occurrence was 2.3%. Underlying vascular risk factors was 74.7%. Infarction was most common symptom in elderly MMD (40...
January 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28109863/disruption-of-cortical-arterial-network-is-associated-with-the-severity-of-transient-neurological-events-after-direct-bypass-surgery-in-adult-moyamoya-disease
#11
Yusuke Egashira, Keita Yamauchi, Yukiko Enomoto, Noriyuki Nakayama, Shinichi Yoshimura, Toru Iwama
OBJECTIVE: Transient neurological events (TNEs) frequently occur after revascularization in adult moyamoya disease (MMD). In the present study, we hypothesized that cortical arterial network disruption may be associated with TNE severity following bypass surgery. METHODS: This retrospective study included 76 hemispheres in 45 consecutive adult MMD patients who underwent direct revascularization surgery at our institution. We classified cortical arterial network disruption grade (NDG) into the following four categories based on angiography: NDG 0, > 90% of suprasylvian cortical branches of the middle cerebral artery demonstrated anterograde filling; NDG 1, 50% to 90%; NDG 2, < 50%; NDG 3, none...
January 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28109102/-long-term-outcomes-of-off-pump-coronary-artery-bypass-grafting-in-patients-aged-over-75-years
#12
Yi Guo, Chong-Lei Ren, Chang-Qing Gao, Cang-Song Xiao, Hua-Jun Zhang
OBJECTIVE: To investigate the long-term outcomes of off-pump coronary artery bypass grafting (OPCAB) in patients aged over 75 years and analyze the risk factors affecting the outcomes of the procedure. METHODS: Clinical data were reviewed for 97 consecutive patients aged 75 years or above receiving OPCAB at our center between November, 2000 and November, 2013. The perioperative data including length of ICU stay, duration of mechanical ventilation, incidence of postoperative complications and mortality rate of the patients were analyzed...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28104642/evaluation-of-encephaloduroarteriosynangiosis-efficacy-using-probabilistic-independent-component-analysis-applied-to-dynamic-susceptibility-contrast-perfusion-mri
#13
A N Laiwalla, F Kurth, K Leu, R Liou, J Pamplona, Y C Ooi, N Salamon, B M Ellingson, N R Gonzalez
BACKGROUND AND PURPOSE: Indirect cerebral revascularization has been successfully used for treatment in Moyamoya disease and symptomatic intracranial atherosclerosis. While angiographic neovascularization has been demonstrated after surgery, measurements of local tissue perfusion are scarce and may not reflect the reported successful clinical outcomes. We investigated probabilistic independent component analysis and conventional perfusion parameters from DSC-MR imaging to measure postsurgical changes in tissue perfusion...
January 19, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#14
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
January 12, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#15
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28050720/indocyanine-green-visualization-of-middle-meningeal-artery-before-craniotomy-during-surgical-revascularization-for-moyamoya-disease
#16
Nozomu Tanabe, Shusuke Yamamoto, Daina Kashiwazaki, Naoki Akioka, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda
BACKGROUND: The middle meningeal artery (MMA) is well known to function as an important collateral channel to the territory of the anterior cerebral artery in moyamoya disease. This study was aimed to evaluate whether indocyanine green (ICG) videoangiography could visualize the anterior branch of the MMA before craniotomy during surgical revascularization for moyamoya disease. METHODS: This study included 19 patients who developed TIA, ischemic stroke or hemorrhagic stroke due to moyamoya disease...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#17
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28033272/intraoperative-dexmedetomidine-and-postoperative-cerebral-hyperperfusion-syndrome-in-patients-who-underwent-superficial-temporal-artery-middle-cerebral-artery-anastomosis-for-moyamoya-disease-a-retrospective-observational-study
#18
Hyungseok Seo, Ho-Geol Ryu, Je Do Son, Jeong-Soo Kim, Eun Jin Ha, Jeong-Eun Kim, Hee-Pyoung Park
Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease.The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029271/hemodynamic-mechanisms-underlying-elevated-oxygen-extraction-fraction-oef-in-moyamoya-and-sickle-cell-anemia-patients
#19
Jennifer M Watchmaker, Meher R Juttukonda, Larry T Davis, Allison O Scott, Carlos C Faraco, Melissa C Gindville, Lori C Jordan, Petrice M Cogswell, Angela L Jefferson, Howard S Kirshner, Manus J Donahue
Moyamoya is a bilateral, complex cerebrovascular condition characterized by progressive non-atherosclerotic intracranial stenosis and collateral vessel formation. Moyamoya treatment focuses on restoring cerebral blood flow (CBF) through surgical revascularization, however stratifying patients for revascularization requires abilities to quantify how well parenchyma is compensating for arterial steno-occlusion. Globally elevated oxygen extraction fraction (OEF) secondary to CBF reduction may serve as a biomarker for tissue health in moyamoya patients, as suggested in patients with sickle cell anemia (SCA) and reduced oxygen carrying capacity...
January 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28025467/mechanical-thrombectomy-using-the-trevo-provue-in-50-consecutive-patients-with-anterior-circulation-stroke-a-single-center-experience-after-approval-of-the-stent-retriever-in-japan
#20
Taichiro Imahori, Kazuhiro Tanaka, Junji Koyama, Atsushi Arai, Ryoji Shiomi, Hirofumi Iwahashi, Akiyoshi Yokote, Kazushi Matsushima, Daisaku Matsui, Makoto Kobayashi, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
Mechanical thrombectomy using the stent retriever has been proven to be effective for select patients with acute ischemic stroke. We evaluated our early experience using the device after its approval in 2014 in Japan, with a special emphasis on the occlusion site. Fifty consecutive endovascular revascularization procedures for treating anterior acute large vessel occlusion were performed using the Trevo ProVue as the first-line device at our institute between April 2015 and March 2016. Focusing on the involvement of the M1-M2 bifurcation with deployment or retrieval of the stent retriever, we regarded the middle cerebral artery M1 mid-portion as the boundary and divided the cases into proximal (n = 26) and distal (n = 24) groups...
December 27, 2016: Neurologia Medico-chirurgica
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