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cerebral revascularization

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https://www.readbyqxmd.com/read/27899519/initial-clinical-experience-using-the-two-stage-aspiration-technique-tsat-with-proximal-flow-arrest-by-a-balloon-guiding-catheter-for-acute-ischemic-stroke-of-the-anterior-circulation
#1
Hiroyuki Matsumoto, Hirokazu Nishiyama, Yoshiaki Tetsuo, Hideki Takemoto, Naoyuki Nakao
BACKGROUND: Our initial experience using the two-stage aspiration technique (TSAT) with proximal flow arrest by a balloon guiding catheter is presented. In TSAT, aspiration is applied with the 5MAX ACE and also with the 3MAX catheter with a Penumbra aspiration pump, while arresting proximal flow by balloon inflation. METHODS: In patients treated with TSAT, clinical data including National Institutes of Health Stroke Scale (NIHSS) score at admission and the modified Rankin Scale (mRS) score at discharge, as well as procedural data including the Thrombolysis in Cerebral Infarction (TICI) score, procedural time, and complications were analyzed...
November 29, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27888077/subcortical-low-intensity-lesions-on-fluid-attenuated-inversion-recovery-images-after-revascularization-surgery-for-moyamoya-disease
#2
Toshio Machida, Shigeki Nakano, Satoshi Ishige, Junichi Ono, Atsushi Fujikawa
OBJECTIVE: Although uncommon, subcortical low-intensity (SCLI) changes on fluid-attenuated inversion recovery (FLAIR) images are observed in various pathologies, including cerebral ischemia. Here we aimed to clarify the incidence and clinical implications of SCLI changes after revascularization surgery for moyamoya disease (MMD), focusing on the correlation with postoperative transient neurological events (TNEs). METHODS: In this retrospective case series analysis, we included 10 hemispheres from 9 adults with MMD who underwent revascularization surgery...
November 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27857034/superficial-temporal-artery-to-middle-cerebral-artery-bypass-with-interposed-saphenous-vein-graft-in-patients-with-atherosclerotic-internal-carotid-artery-occlusive-disease-and-impaired-cerebral-hemodynamics
#3
Petr Galkin, Artem Gushcha, Andrey Chechetkin, Irina Krotenkova
BACKGROUND: The aim of this study was to evaluate the efficacy of interposed saphenous vein graft (SVG) usage during extracranial-intracranial (EC-IC) bypass surgery in patients with cerebral ischemia and appropriate donor artery absence. METHODS: Since October 2010 till January 2014, 62 EC-IC bypass surgeries were applied in 60 patients. In nineteen patients SVG was used to create low-flow bypasses between superficial temporal artery trunk and cortical segment of middle cerebral artery...
February 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27847768/the-efficacy-of-single-barrel-superficial-temporal-artery-middle-cerebral-artery-bypass-in-treatment-of-adult-patients-with-ischemic-type-moyamoya-disease
#4
Mahnjeong Ha, Chang Hwa Choi, Jae Il Lee, Seung Heon Cha, Sang Weon Lee, Jun Kyeung Ko
OBJECTIVE: So far, there is no study answering the question of which type of surgical technique is practically the most useful in the treatment of adult patients with ischemic type moyamoya disease (MMD). We evaluated the efficacy of single barrel superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in the treatment of adult patients with ischemic type MMD by retrospectively collecting clinical and radiological data. MATERIALS AND METHODS: A retrospective review identified 31 adult patients who underwent 43 single barrel STA-MCA bypass procedures performed for treatment of ischemic-type MMD between 2006 and 2014...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27846618/risk-factors-for-incident-carotid-artery-revascularization-among-older-adults-the-cardiovascular-health-study
#5
Parveen K Garg, Willam J H Koh, Joseph A Delaney, Ethan A Halm, Calvin H Hirsch, William T Longstreth, Kenneth J Mukamal, Anna Kucharska-Newton, Joseph F Polak, Lesley Curtis
BACKGROUND: Population-based risk factors for carotid artery revascularization are not known. We investigated the association between demographic and clinical characteristics and incident carotid artery revascularization in a cohort of older adults. METHODS: Among Cardiovascular Health Study participants, a population-based cohort of 5,888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993), 5,107 participants without a prior history of carotid endarterectomy (CEA) or cerebrovascular disease had a carotid ultrasound at baseline and were included in these analyses...
November 16, 2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27834592/the-anterior-temporal-artery-an-underutilized-but-robust-donor-for-revascularization-of-the-distal-middle-cerebral-artery
#6
Ali Tayebi Meybodi, Michael T Lawton, Dylan Griswold, Pooneh Mokhtari, Andre Payman, Arnau Benet
OBJECTIVE The anterior temporal artery (ATA) supplies an area of the brain that, if sacrificed, does not cause a noticeable loss of function. Therefore, the ATA may be used as a donor in intracranial-intracranial (IC-IC) bypass procedures. The capacities of the ATA as a donor have not been studied previously. In this study, the authors assessed the feasibility of using the ATA as a donor for revascularization of different segments of the distal middle cerebral artery (MCA). METHODS The ATA was studied in 15 cadaveric specimens (8 heads, excluding 1 side)...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27829722/cerebral-hyperperfusion-syndrome-after-intracranial-stenting-of-the-middle-cerebral-artery
#7
Boby Varkey Maramattom
Cerebral hyperperfusion syndrome (CHS) is a rare complication following cerebral revascularization. It presents with ipsilateral headache, seizures, and intracerebral hemorrhage. It has mostly been described following extracranial carotid endarterectomy and stenting and it is very unusual after intracranial stenting. A 71-year-old man with a stuttering stroke was taken up for a cerebral angiogram (digital subtraction angiography), which showed a dissection of the distal left middle cerebral artery. This was recanalized with a solitaire AB stent...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27829638/comparison-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-graft-in-aged-patients-with-unprotected-left-main-artery-lesions
#8
Zhonghai Wei, Jun Xie, Kun Wang, Lina Kang, Qing Dai, Jian Bai, Biao Xu
There is still much debate about revascularization strategies in aged patients with unprotected left main coronary artery (UPLM) lesions. This study compared the outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in this population.A total of 126 patients older than 60 years of age with LM lesions who underwent revascularization in our hospital from January 2012 to December 2013 were followed up for an average of 15.2 months. The cumulative incidence of major adverse cardiac and cerebral events (MACCE) was estimated by Kaplan-Meier plots...
November 9, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27820930/is-there-benefit-from-stenting-on-cognitive-function-in-intracranial-atherosclerosis
#9
Tanya N Turan, Alison Smock, George Cotsonis, David Bachman, Sami Al Kasab, Michael J Lynn, Azhar Nizham, Collin P Derdeyn, David Fiorella, Scott Janis, Bethany Lane, Jean Montgomery, Marc I Chimowitz
BACKGROUND: Revascularization of stenotic cerebral arteries is hypothesized to improve cognition by increasing cerebral perfusion. AIMS: We compared cognition impairment among patients treated with percutaneous angioplasty and stenting (PTAS) and aggressive medical management (AMM) versus AMM alone in the Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) Trial. METHODS: In SAMMPRIS, 451 patients with recent transient ischemic attack or stroke attributed to 70-99% intracranial stenosis were randomized to PTAS plus AMM or AMM alone...
November 5, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27816279/efficacy-of-early-superficial-temporal-artery-middle-cerebral-artery-double-anastomoses-for-atherosclerotic-occlusion-in-patients-with-progressing-stroke
#10
Akihiro Inoue, Kanehisa Kohno, Shinji Iwata, Shiro Ohue, Saya Ozaki, Satoko Ninomiya, Hitomi Tomita, Kenji Kamogawa, Kensho Okamoto, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Yawara Nakamura, Bungo Okuda
BACKGROUND: We investigated the efficacy of early superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses for patients with progressing stroke due to atherosclerotic occlusion. MATERIALS AND METHODS: Nine consecutive patients who underwent early STA-MCA double anastomoses were enrolled. All patients presented with progressing stroke despite maximal medical treatment. Cerebral blood flow in 7 patients was analyzed by single-photon emission tomography...
November 2, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27813463/bypass-surgery-for-complex-middle-cerebral-artery-aneurysms-an-algorithmic-approach-to-revascularization
#11
Ali Tayebi Meybodi, Wendy Huang, Arnau Benet, Olivia Kola, Michael T Lawton
OBJECT Management of complex aneurysms of the middle cerebral artery (MCA) can be challenging. Lesions not amenable to endovascular techniques or direct clipping might require a bypass procedure with aneurysm obliteration. Various bypass techniques are available, but an algorithmic approach to classifying these lesions and determining the optimal bypass strategy has not been developed. The objective of this study was to propose a comprehensive and flexible algorithm based on MCA aneurysm location for selecting the best of multiple bypass options...
November 4, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27801765/should-we-treat-a-patient-s-symptoms-or-angiography-image-in-tia-two-case-reports
#12
Hana Karpatová, Jana Jankových, Robert Mikulík
OBJECTIVES: Data on vascular status in the first hours after onset of transient ischemic attack (TIA) and its clinical significance are missing. Also, it is not known whether arterial occlusion, if present in TIA, should be the target for revascularization. We present 2 patients to demonstrate that TIA can be due to acute major intracranial arterial occlusion and to show how such arterial occlusion may affect the outcome. CASE REPORTS: Two patients (54 and 63 years old) were diagnosed with TIA and at the same time had occlusion of the middle cerebral artery...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801401/-perfusion-criteria-of-the-eicma-efficacy-in-patients-with-symptomatic-occlusion-of-the-internal-carotid-artery
#13
V A Lukshin, D Yu Usachev, I N Pronin, A D Akhmedov, E I Shul'ts
AIM: To investigate changes in cerebral perfusion in patients with unilateral internal carotid artery occlusion before and after surgical revascularization of the brain, depending on the clinical efficacy of surgical treatment. MATERIAL AND METHODS: The study included 60 patients with unilateral ICA occlusions who underwent placement of an extra-intracranial microvascular anastomosis (EICMA). All patients underwent a CT perfusion study before and after cerebral revascularization...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27801396/-results-of-deconstructive-endovascular-surgery-in-treatment-of-large-and-giant-intracranial-aneurysms
#14
S R Arustamyan, S B Yakovlev, A R Shakhnovich, I V Krasnoperov, O B Sazonova, A V Bocharov, E Yu Bukharin, O B Belousova, A N Kaftanov
AIM: To clarify the indications for deconstructive endovascular surgery in patients with large and giant intracranial aneurysms and to evaluate short-term and long-term postoperative outcomes. MATERIAL AND METHODS: The study was based on a retrospective analysis of the treatment results in 50 patients with large (15-25 mm) and giant (more than 25 mm) intracranial aneurysms, aged from 18 to 75 years, who were treated at the Burdenko Neurosurgical Institute in 2002-2014...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27798270/magnetic-resonance-imaging-of-local-and-remote-vascular-remodelling-after-experimental-stroke
#15
Pavel Yanev, Peter R Seevinck, Umesh S Rudrapatna, Mark Jrj Bouts, Annette van der Toorn, Karen Gertz, Golo Kronenberg, Matthias Endres, Geralda A van Tilborg, Rick M Dijkhuizen
The pattern of vascular remodelling in relation to recovery after stroke remains largely unclear. We used steady-state contrast-enhanced magnetic resonance imaging to assess the development of cerebral blood volume and microvascular density in perilesional and exofocal areas from (sub)acutely to chronically after transient stroke in rats. Microvascular density was verified histologically after infusion with Evans Blue dye. At day 1, microvascular cerebral blood volume and microvascular density were reduced in and around the ischemic lesion (intralesional borderzone: microvascular cerebral blood volume = 72 ± 8%; microvascular density = 76 ± 8%) (P < 0...
October 19, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27789787/initial-experience-with-sofia-as-an-intermediate-catheter-in-mechanical-thrombectomy-for-acute-ischemic-stroke
#16
Johnny H Y Wong, Huy M Do, Nicholas A Telischak, Adrienne M Moraff, Robert L Dodd, Michael P Marks, Shreya M Ingle, Jeremy J Heit
BACKGROUND: The benefits of mechanical thrombectomy for emergent large vessel occlusion (ELVO) have been established. Combined mechanical/aspiration (Solumbra) and a direct aspiration as a first pass technique (ADAPT) are valid procedures requiring an intermediate catheter for clot suction. Recently, SOFIA (Soft torqueable catheter Optimized For Intracranial Access) was developed as a single lumen flexible catheter with coil and braid reinforcement, but its suitability for mechanical thrombectomy had not been evaluated...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27789153/de-novo-development-of-moyamoya-disease-in-an-adult-female-with-a-genetic-variant-of-the-rnf-213-gene-case-report
#17
Ryosuke Tashiro, Miki Fujimura, Kuniyasu Niizuma, Hidenori Endo, Hiroyuki Sakata, Mika Sato-Maeda, Teiji Tominaga
BACKGROUND: The de novo development of moyamoya disease (MMD) in adults is extremely rare, with only 2 cases being previously reported. Furthermore, the mechanisms underlying the progression of adult MMD have not been elucidated yet. CASE REPORT: A transient ischemic attack occurred in a 46-year-old woman, owing to progressive MMD. Magnetic resonance (MR) angiography performed 7 years before the diagnosis of MMD did not detect any steno-occlusive changes in the major intracranial vessels, including the internal carotid artery (ICA) and the middle cerebral artery (MCA)...
October 24, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27781039/recanalization-and-angiographic-reperfusion-are-both-associated-with-a-favorable-clinical-outcome-in-the-ims-iii-trial
#18
Marie L Schmitz, Sharon D Yeatts, Thomas A Tomsick, David S Liebeskind, Achala Vagal, Joseph P Broderick, Pooja Khatri
BACKGROUND: Prompt revascularization is the main goal of acute ischemic stroke treatment. We examined which revascularization scale - reperfusion (modified Treatment in Cerebral Infarctions, mTICI) or recanalization (Arterial Occlusive Lesion, AOL) - better predicted the clinical outcome in ischemic stroke participants treated with endovascular therapy (EVT). Additionally, we determined the optimal thresholds for the predictive accuracy of each scale. METHODS: We included participants from the Interventional Management of Stroke (IMS) III trial with complete occlusion in the internal carotid artery terminus or proximal middle cerebral artery (M1 or M2) who completed EVT within 7 h of symptom onset...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27765556/impact-of-the-new-american-heart-association-american-stroke-association-definition-of-stroke-on-the-results-of-the-stenting-and-aggressive-medical-management-for-preventing-recurrent-stroke-in-intracranial-stenosis-trial
#19
Sami Al Kasab, Michael J Lynn, Tanya N Turan, Colin P Derdeyn, David Fiorella, Bethany F Lane, L Scott Janis, Marc I Chimowitz
BACKGROUND: An American Heart Association/American Stroke Association (AHA/ASA) writing committee has recently recommended that tissue evidence of cerebral infarction associated with temporary symptoms (CITS) lasting <24 hours should be considered a stroke. We analyzed the impact of considering CITS as equivalent to stroke on the results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. METHODS: We compared outcomes in the medical (n = 227) and stenting (n = 224) groups in SAMMPRIS using the following primary end point (new components in bold): any stroke, CITS, or death within 30 days after enrollment or within 30 days after a revascularization procedure for the qualifying lesion during follow-up; or ischemic stroke or CITS in the territory of the qualifying artery beyond 30 days...
October 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27751921/endovascular-treatment-of-tandem-common-carotid-artery-origin-and-distal-intracranial-occlusion-in-acute-ischemic-stroke
#20
Gregory M Weiner, Rafey Feroze, David M Panczykowski, Amin Aghaebrahim, William Ares, Nitin Agarwal, John Enis, Xiao Zhu, Andrew F Ducruet
INTRODUCTION: Tandem occlusion resulting in acute ischemic stroke (AIS) is associated with high morbidity and mortality and a poor response to thrombolytic therapy. The use of endovascular strategies for tandem stroke cases results in an improved outcome for this subgroup of patients. We present two cases with a pattern of tandem occlusion consisting of proximal obstruction at the origin of the common carotid artery (CCA) with concomitant intracranial occlusion treated by endovascular techniques...
October 14, 2016: World Neurosurgery
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