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cerebral revascularization

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https://www.readbyqxmd.com/read/28329291/coronary-artery-bypass-graft-surgery-versus-drug-eluting-stent-implantation-for-high-surgical-risk-patients-with-left-main-or-multivessel-coronary-artery-disease
#1
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: There are limited data comparing long-term outcomes of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with high surgical risk. We evaluated 5-year outcomes following CABG versus PCI with DES in 598 patients with left main or multivessel coronary artery disease (CAD) and a high surgical risk [EuroSCORE (European system for cardiac operative risk evaluation) ≥ 6]. METHODS: Databases were merged from the BEST, PRECOMBAT and SYNTAX trials...
December 20, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28327889/hemodynamic-changes-after-unilateral-revascularization-for-moyamoya-disease-serial-assessment-by-quantitative-magnetic-resonance-angiography
#2
Tackeun Kim, Jae Seung Bang, O-Ki Kwon, Gyojun Hwang, Jeong Eun Kim, Hyun-Seung Kang, Won-Sang Cho, Cheolkyu Jung, Chang Wan Oh
BACKGROUND: Ultrasonic flow meters and quantitative magnetic resonance angiography quantitatively assess flow during hemodynamic evaluation of cerebral ischemia. Although their reliability and reproducibility have been verified, their clinical impact in moyamoya disease has rarely been reported. OBJECTIVE: To investigate flow measurement outcomes in moyamoya disease patients pre- and postoperatively through a retrospective observational study. METHODS: We evaluated 41 patients undergoing their first revascularization surgery who were followed ≥6 mo...
January 2, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28323181/perioperative-changes-in-cerebral-perfusion-territories-assessed-by-arterial-spin-labeling-magnetic-resonance-imaging-are-associated-with-postoperative-increases-in-cerebral-blood-flow-in-patients-with-carotid-stenosis
#3
Daisuke Yamamoto, Kohkichi Hosoda, Yoshito Uchihashi, Atsushi Fujita, Takashi Sasayama, Masahiko Fujii, Kazuro Sugimura, Masaaki Kohta, Eiji Kohmura
OBJECTIVE: MRI technique known as Territorial ASL (TASL) allows for noninvasive visualization of their perfusion territories. The objective of this study was to use TASL to assess the relationship between perioperative changes in the perfusion territories of ICA and CBF after carotid revascularization. METHODS: In 32 patients, ICA perfusion volume (PV) and CBF were measured before and after CEA/CAS using TASL and SPECT, respectively. ICA flow was measured during CEA before and after reconstruction, using an electromagnetic flowmeter...
March 16, 2017: World Neurosurgery
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/28314403/management-of-cavernous-sinus-involvement-in-sinonasal-and-ventral-skull-base-malignancies
#5
REVIEW
Amol Raheja, William T Couldwell
Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. The article discusses the indications, techniques, nuances, advantages, limitations, and complications of minimally invasive CS biopsy, transcranial microscopic, and transfacial endoscopic approaches to the CS using illustrative diagrams and operative videos...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28292867/vessel-patency-at-24-hours-and-its-relationship-with-clinical-outcomes-and-infarct-volume-in-revascat-trial-randomized-trial-of-revascularization-with-solitaire-fr-device-versus-best-medical-therapy-in-the-treatment-of-acute-stroke-due-to-anterior-circulation
#6
Mònica Millán, Sebastià Remollo, Helena Quesada, Arturo Renú, Alejandro Tomasello, Priyanka Minhas, Natalia Pérez de la Ossa, Marta Rubiera, Laura Llull, Pedro Cardona, Fahad Al-Ajlan, María Hernández, Zarina Assis, Andrew M Demchuk, Tudor Jovin, Antoni Dávalos
BACKGROUND AND PURPOSE: Higher rates of target vessel patency at 24 hours were noted in the thrombectomy group compared with control group in recent randomized trials. As a prespecified secondary end point, we aimed to assess 24-hour revascularization rates by treatment groups and occlusion site as they related to clinical outcome and 24-hour infarct volume in REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset)...
March 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28284448/growth-of-giant-intracranial-aneurysms-an-aneurysmal-wall-disorder
#7
F-X Ferracci, V Gilard, H Cebula, N Magne, J-P Lejeune, O Langlois, F Proust
The enlargement of giant intracranial aneurysms (IA) can be observed in 30 % of cases resulting in a neurological deficit and epilepsy due to its mass effect. This growth process could be due to a morphological disorder of the IA wall. The authors report on 2 cases of giant IA growth responsible for intracranial hypertension. The treatment of these giant IA required a microsurgical excision combined with a series of cerebral revascularization procedures. The role of vasa vasorum on the inflammatory granuloma outside the vessel, which induced the enlargement, is discussed...
March 8, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28281190/ruptured-dissecting-aneurysms-of-the-a1-segment-of-the-anterior-cerebral-artery-three-case-reports-and-a-review-of-the-literature
#8
REVIEW
Takafumi Mitsuhara, Fusao Ikawa, Toshikazu Hidaka, Yasuharu Kurokawa, Ushio Yonezawa
Dissecting aneurysms in the anterior cerebral artery (ACA), although rare, can cause ischemic and/or hemorrhagic stroke. Hemorrhagic dissecting aneurysms in the A1 portion of the ACA are often associated with a poor prognosis. We retrospectively investigated three rare cases of hemorrhagic dissecting aneurysms in the A1 portion. Dissecting aneurysms were diagnosed by carotid angiography or computed tomography angiography to visualize morphological changes in the vessel. All patients presented with diffuse subarachnoid hemorrhage...
March 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28275590/protocol-for-evaluating-the-cardio-ankle-vascular-index-to-predict-cardiovascular-events-in-japan-a-prospective-multicenter-cohort-study
#9
REVIEW
Toru Miyoshi, Hiroshi Ito, Shigeo Horinaka, Kohji Shirai, Jitsuo Higaki, Hajime Orimio
INTRODUCTION: The cardio-ankle vascular index (CAVI) was developed in Japan and is a blood pressure-independent index of arterial stiffness from the origin of the aorta to the ankle. In recent years, it has been studied by many researchers worldwide, and it is strongly anticipated that it will play a role as a predictive factor for arteriosclerotic diseases. The objective of this study was to examine the benefits of using CAVI as a predictor of cardiovascular events in high-risk patients...
January 2017: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/28271641/impact-of-baseline-ischemia-on-outcome-in-older-patients-undergoing-endovascular-therapy-for-acute-ischemic-stroke
#10
Yang Ha Hwang, Yong Won Kim, Dong Hun Kang, Yong Sun Kim, David S Liebeskind
BACKGROUND AND PURPOSE: The outcome for older stroke patients who undergo endovascular revascularization remains unsatisfactory. We aimed to determine the effect of the extent of baseline ischemia on outcome according to age, testing the hypothesis that the restorative capacity for recovery is only marginal in older patients. METHODS: Two hundred and thirteen patients who underwent endovascular revascularization due to occlusion in the M1 segment of the middle cerebral artery (with or without internal carotid artery occlusions) were selected for analysis...
March 6, 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28258787/cerebrovascular-reactivity-and-intellectual-outcome-in-childhood-stroke-with-transient-cerebral-arteriopathy
#11
Nomazulu Dlamini, Ivanna Yau, Robyn Westmacott, Manohar Shroff, Derek Armstrong, William Logan, David Mikulis, Gabrielle deVeber, Andrea Kassner
BACKGROUND: Hypercapnic-challenge blood oxygen level-dependent magnetic resonance imaging cerebrovascular reactivity (CVR), measures the regional perfusion response to altered carbon dioxide. CVR correlates with the tissue-level microvascular dysfunction and ischemic risk. Among children with arterial ischemic stroke, transient cerebral arteriopathy (TCA) is a frequent, nonprogressive unilateral intracranial arteriopathy, which typically results in basal ganglia infarction and chronic cerebral artery stenosis...
January 7, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28258019/open-and-endovascular-management-of-severe-cerebral-ischemia-in-takayasu-s-arteritis
#12
Xiao Yun Luo, Qing Hua Wu, Fu Xian Zhang
BACKGROUND: Severe cerebral ischemia in patients with Takayasu's arteries was caused by occlusion of most supra-aortic arteries. Arterial revascularization is necessary to decrease the incidence of stroke and improve the quality of life, but may be complicated with multiple occlusive lesions and inflammation condition of this disease. This study was to assess options and long-term outcomes of surgical and endovascular treatment. METHODS: Twenty nine patients with severe cerebral ischemic symptoms underwent surgical or endovascular treatment from January 1991 to July 2015...
February 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28223049/outcomes-of-coronary-artery-bypass-and-stents-for-unprotected-left-main-coronary-stenosis
#13
Yin-Shu Chang, Jia-Xiang Wang, Da-Wei Chang
BACKGROUND: This study assessed the short-, medium-, and long-term outcomes of coronary artery bypass grafting vs stenting for patients with unprotected left main coronary artery disease through a meta-analysis of randomized controlled trials. METHODS: PubMed, Embase, Scopus, Web of Science, Cochrane Library, and major conference proceedings databases were systematically searched for randomized controlled trials of coronary artery bypass grafting compared with stents in unprotected left main coronary artery disease...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28209313/the-arborization-bypass-sequential-intracranial-intracranial-bypasses-for-an-unruptured-fusiform-mca-aneurysm
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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