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cerebral revascularization

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https://www.readbyqxmd.com/read/29351682/radial-artery-fascial-flow-through-free-flap-for-combined-revascularization-in-moyamoya-disease
#1
Jonathan Russin, Joseph Carey
BACKGROUND: Free flaps are commonly used by other surgical subspecialties for soft tissue reconstruction and revascularization. Cranial applications of these flaps have been limited to only a single case report. OBJECTIVE: To present a new technique for combined revascularization in moyamoya disease using a flow-through free flap. METHODS: Data were obtained from an Institutional Review Board-approved, prospectively maintained database with informed consent from the patient...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29339370/nature-s-wastebasket-the-role-of-the-external-carotid-artery-in-acute-stroke
#2
Jesse Jones, Conrad William Liang, Nima Ramezan-Arab, Gary Duckwiler, Satoshi Tateshima
We describe a novel technical approach to acute stroke illustrated by the case of a 41 year old male who presented with tandem right common carotid artery (CCA) and M1 occlusions. His NIHSS was 17 and Alberta stroke programe early CT score (ASPECTs) was 8. Thrombectomy initially proved challenging due to large volume CCA thrombus that repeatedly occluded the aspiration catheters. However, by inflating a balloon distally and pulling clot into the adjacent ECA, we were able to quickly restore distal contrast flow to the intracranial circulation and achieve Thrombolysis In Cerebral Infarction/Arterial Occlusive Lesion (TICI2C/AOL3) revascularization...
January 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29339321/internal-thoracic-artery-to-middle-cerebral-artery-bypass-surgery-cadaveric-feasibility-study
#3
Stephen Monteith, Oded Goren, Ragu Sampath, Eric Lehr, Akshal Patel, Paul J Choi, Joe Iwanaga, Marios Loukas, R Shane Tubbs
BACKGROUND: A few options of extracranial donor vessels exist for utilization in intracranial vascular bypass procedures. To our knowledge, the use of an internal thoracic artery for cerebral revascularization has not been studied previously. Hence, this cadaveric feasibility study was performed. METHODS: The internal thoracic artery was dissected in five adult cadaveric specimens. The proximal diameter, distal diameter, and the length of the vessel were measured and recorded...
January 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29310957/revascularization-for-aplastic-or-twiglike-middle-cerebral-artery-a-case-report
#4
Yuki Matsunaga, Tsuyoshi Izumo, Yoichi Morofuji, Nobutaka Horie, Kentaro Hayashi, Takayuki Matsuo
An aplastic or twiglike middle cerebral artery (Ap/T-MCA) is a congenital anomaly related to interference of normal embryonic development of the middle cerebral artery (MCA). This condition may cause ischemic and hemorrhagic strokes as a result of hypoperfusion, vulnerable collateral circulation, and associated aneurysms. We reported a case of Ap/T-MCA with transient ischemic attack, which was successfully treated with revascularization. A 19-year-old woman with a history of transient left upper limb hemiparesis, dysesthesia, and headache visited our hospital...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29301583/which-factor-is-the-most-effective-one-in-metabolic-sydrome-on-the-outcomes-after-coronary-artery-bypass-graft-surgery-a-cohort-study-of-5%C3%A2-years
#5
Lijuan Wang, Xiangyang Qian, Mingya Wang, Xinran Tang, Hushan Ao
BACKGROUND: Metabolic Syndrome and diabetes mellitus are risk factors for cardiovascular disease. However, the effects of Metabolic Syndrome with or without diabetes on perioperative and long-term morbidity and mortality after Coronary Artery Bypass Graft remain unclear. METHODS: An retrospective study was performed on 1166 patients who received isolated primary Coronary Artery Bypass Graft in Fuwai hospital. They were divided into three groups: control, Metabolic Syndrome of three factors together with diabetes and Metabolic Syndrome of three factors without diabetes (n = 868, 76 and 222 respectively)...
January 4, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29288845/surgical-revascularization-for-the-treatment-of-complex-anterior-cerebral-artery-aneurysms-experience-and-illustrative-review
#6
Sung Ho Lee, Yeongu Jung, Ji Wook Ryu, Seok Keun Choi, Byung Duk Kwun
BACKGROUND: A variety of methods for tackling complex anterior cerebral artery (ACA) aneurysms are available; however, there is substantial variation among methods because of various aneurysm locations, the relationship of the aneurysm to arterial branches, aneurysm size and other morphological characteristics, and/or the diameters of the parent or branching arteries. METHODS: We review complex ACA aneurysm cases based on both our own experience as well as the available literature...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29285484/undesired-outcomes-of-the-catania-stent-compared-to-the-xience-stent-in-patients-undergoing-angioplasty-a-double-blind-randomized-controlled-trial
#7
Masoud Pourmoghaddas, Hamid Reza Rohani, Hamid Sanei, Afshin Amirpour
Background: The present study tries to compare the unintended outcomes of the Catania stent versus Xience stent in patients undergoing angioplasty. Materials and Methods: In a three month, follow-up, double-blinded, randomized controlled trial, 83 patients undergoing angioplasty, who met the inclusion criteria were entered into the study. After randomization 43 patients were treated with the Xience stent and 40 patients with the Catania stent. Stent-related outcomes such as Cardiac and Non-Cardiovascular Death, Myocardial Infarction (MI), Target Lesion Revascularization (TLR), Stent Thrombosis (ST), Coronary Artery Bypass Grafting (CABG), Peripheral vasculopathy, and Cerebral Vascular Accident (CVA) were compared between the groups...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29284735/contact-aspiration-versus-stent-retriever-in-patients-with-acute-ischemic-stroke-with-m2-occlusion-in-the-aster-randomized-trial-contact-aspiration-versus-stent-retriever-for-successful-revascularization
#8
Benjamin Gory, Bertrand Lapergue, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
BACKGROUND AND PURPOSE: Middle cerebral artery M2-segment occlusions represent an important subgroup of patients with acute stroke with large-vessel occlusion. The safety of mechanical thrombectomy, especially contact aspiration (CA), in such distal intracranial occlusions is still under debate. We compared reperfusion, adverse events, neurological recovery, and functional outcome of patients with isolated M2 occlusions according to the first-line strategy mechanical thrombectomy devices (CA versus stent retriever [SR])...
December 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29282326/neurocognitive-functioning-and-cerebrovascular-reactivity-after-carotid-endarterectomy
#9
Simona Lattanzi, Luciano Carbonari, Gabriele Pagliariccio, Marco Bartolini, Claudia Cagnetti, Giovanna Viticchi, Laura Buratti, Leandro Provinciali, Mauro Silvestrini
OBJECTIVE: To evaluate in patients with TIA and ipsilateral high-grade internal carotid artery (ICA) stenosis whether changes in cognitive performance and cerebral hemodynamics occurred after carotid endarterectomy (CEA) and to explore their relationship. METHODS: Participants were patients who underwent CEA, had TIA within the last 6 months, and had an ipsilateral severe ICA stenosis. Coloured Progressive Matrices (CPM) plus Complex Figure Copy Test (CFCT) and phonemic (ph) plus categorical (ca) Verbal Fluency (VF) tests were performed to assess right and left hemisphere cognitive functions, respectively...
December 27, 2017: Neurology
https://www.readbyqxmd.com/read/29275602/-long-term-outcomes-of-implanting-drug-eluting-stents-for-unprotected-left-main-coronary-artery-disease-patients-with-left-ventricular-systolic-dysfunction
#10
Y Pan, Q Qiu, W H Ren, X P Yu, Q Li, X J Ren
Objective: To analyze the clinical characteristics and prognosis of implanting drug-eluting stents (DES) for unprotected left main (ULM) coronary artery disease patients with left ventricular systolic dysfunction (LVSD). Methods: A total of 511 ULM coronary artery disease patients who underwent DES implantation from January 2005 to January 2012 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. Based on left ventricular ejection fraction (LVEF), the patients were divided into three groups: LVEF≤40% (n=104), 41%≤LVEF≤49% (n=137), and LVEF≥50% (n=270)...
December 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29274451/treatment-of-progressive-herpes-zoster-induced-vasculopathy-with-surgical-revascularization-effects-on-cerebral-hemodynamics
#11
Sarah K Lants, Jennifer M Watchmaker, Meher R Juttukonda, Larry T Davis, Manus J Donahue, Matthew R Fusco
BACKGROUND: Herpes zoster ophthalmicus (HZO) is caused by the reactivation of the herpes simplex virus in the trigeminal nerve. HZO-initiated cerebral vasculopathy is well-characterized, however there are no documented cases that report the efficacy of surgical revascularization for improving cerebral hemodynamics following progressive HZO-induced vasculopathy. We present a case where quantitative anatomical and hemodynamic imaging were performed longitudinally before and after surgical revascularization in a patient with HZO and vasculopathic changes...
December 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29240062/-carotid-revascularization-in-type-2-diabetes-mellitus-significance-of-chronic-hyperglycaemia
#12
M M Tanashian, S I Skrylev, K V Antonova, R B Medvedev
Patients with type 2 diabetes mellitus (type 2 DM) are typically prone to the development of cerebral atherosclerosis. Presented herein are the results of examination of patients suffering from ischaemic cerebrovascular diseases on the background of type 2 DM subjected to open surgical or endovascular interventions. In patients with cerebrovascular pathology and type 2 DM, atherosclerosis progresses on the background of chronic hyperglycaemia combined with dyslipidaemia, leading to increased incidence of the development of cerebral circulatory impairments and detection of the indications for carrying out angioreconstructive operations on the internal carotid arteries...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29239899/stroke-severity-quantification-by-critical-care-physicians-in-a-mobile-stroke-unit
#13
Maren R Hov, Jo Røislien, Thomas Lindner, Erik Zakariassen, Kristi C G Bache, Volker M Solyga, David Russell, Christian G Lund
BACKGROUND: Cerebral revascularization in acute stroke requires robust diagnostic tools close to symptom onset. The quantitative National Institute of Health Stroke Scale (NIHSS) is widely used in-hospital, whereas shorter and less specific stroke scales are used in the prehospital field. This study explored the accuracy and potential clinical benefit of using NIHSS prehospitally. PATIENTS AND METHODS: Thirteen anesthesiologists trained in prehospital critical care enrolled patients with suspected acute stroke in a mobile stroke unit...
December 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29220356/color-doppler-ultrasonography-as-an-alternative-tool-for-postoperative-evaluation-of-collaterals-after-indirect-revascularization-surgery-in-moyamoya-disease
#14
Shin-Joe Yeh, Sung-Chun Tang, Li-Kai Tsai, Chung-Wei Lee, Ya-Fang Chen, Hon-Man Liu, Shih-Hung Yang, Meng-Fai Kuo, Jiann-Shing Jeng
The cerebral hypoperfusion caused by chronic progressive stenosis or occlusion of intracranial arteries in moyamoya disease can be treated by direct bypass or indirect revascularization procedures. The extent of collaterals from the external carotid artery (ECA) after indirect revascularization surgery is the key point of angiographic follow-up, and the invasiveness of angiography impelled us to investigate the role of ultrasonography in the evaluation of collaterals. We hypothesized that the collaterals shown on angiography might produce corresponding hemodynamic changes in color Doppler ultrasonography...
2017: PloS One
https://www.readbyqxmd.com/read/29205668/cerebrovascular-blood-pressure-autoregulation-monitoring-and-postoperative-transient-ischemic-attack-in-pediatric-moyamoya-vasculopathy
#15
Jennifer K Lee, Monica Williams, Michael Reyes, Edward S Ahn
BACKGROUND: Children with moyamoya vasculopathy are at high risk of perioperative cerebral ischemia or hyperperfusion. Maintaining blood pressure within the range of functional cerebrovascular blood pressure autoregulation might reduce the risk of perioperative neurologic injury. AIMS: We tested whether blood pressure autoregulation is associated with postoperative transient ischemic attack in a study of patients with pediatric moyamoya vasculopathy. METHODS: We conducted an observational study of 15 pediatric patients undergoing surgical revascularization with pial synangiosis...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29191051/preoperative-evaluation-of-moyamoya-spontaneous-anastomosis-of-combined-revascularization-donor-vessels-in-adults-by-duplex-ultrasonography
#16
Li Chen, Bin Xu, Yong Wang, Yujun Liao, Huiwen Pan, Yi Wang
OBJECTIVE: To evaluate the preoperative diagnostic value of duplex ultrasonography in moyamoya spontaneous anastomosis of combined revascularization donor vessels in adults. METHODS: A total of 99 preoperative adult patients who underwent superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis were retrospectively analyzed. Each side of the cerebral hemisphere was examined as a separate procedure. A total of 198 cerebral hemispheres were divided into three groups: a collateral, non-collateral, and control group based on digital subtraction angiography (DSA)...
November 30, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29180090/neurological-deterioration-in-patients-with-moyamoya-disease-during-pregnancy-delivery-and-puerperium
#17
Wonhyoung Park, Jae Sung Ahn, Jaewoo Chung, Yeongu Chung, Seungjoo Lee, Jung Cheol Park, Byung Duk Kwun
BACKGROUND: We reviewed our clinical experience of patients with moyamoya disease (MMD) who gave birth and assessed characteristics of those experiencing neurological deterioration. METHODS: The patients were classified into patients diagnosed with MMD during pregnancy and puerperium (Group 1) and those diagnosed before pregnancy (Group 2). We retrospectively reviewed patient characteristics, MMD treatment, neurological symptoms before and during pregnancy and/after puerperium, obstetrical history, and delivery type in Groups 1 and 2...
November 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29174234/in-situ-side-to-side-anastomosis-surgical-technique-and-complication-avoidance
#18
Jiwook Ryu, Yeongu Chung, Sung Ho Lee, Won-Sang Cho, Seok Keun Choi
In situ side-to-side (STS) anastomosis is a unique technique used for intracranial artery-intracranial artery revascularization. During a seven-year period, seven STS anastomoses were performed for anterior cerebral artery aneurysms in six patients and postero-inferior cerebellar artery aneurysm in one patient. We describe a step-by-step guide for suturing techniques from arteriotomy to vessel wall sutures based on clinical experiences, with detailed illustrations. Technical considerations in each stage are also discussed...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29158056/factors-associated-with-moyamoya-syndrome-in-a-kentucky-regional-population
#19
Catherine Y Wang, Stephen L Grupke, Jill Roberts, Jessica Lee, Justin F Fraser
OBJECTIVES: Our study aimed to report both new and previously identified conditions associated with moyamoya syndrome in a Western population and to present our outcomes after surgical treatment with indirect bypass. METHODS: We performed a retrospective chart review of patients evaluated at our institution from June 2011 to June 2015 who were diagnosed with moyamoya. Data collected include patient demographics, presenting manifestations, vessels involved, comorbid conditions, abnormal laboratory values, treatments administered, and clinical outcomes...
November 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#20
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
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