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cerebral revascularization

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https://www.readbyqxmd.com/read/28530158/analyzing-circle-of-willis-blood-flow-in-ischemic-stroke-patients-through-3d-stroke-arterial-flow-estimation
#1
Aichi Chien, Fernando Viñuela
Background The objective of ischemic stroke (IS) treatment is to achieve revascularization in cerebral arteries to restore blood flow. However, there is no available method to extract arterial flow data from clinical CTA images. We developed 3D Stroke Arterial Flow Estimation (SAFE), which provides blood flow data throughout the Circle of Willis based on 3D CTA and allows comparison of arterial flow distribution in the brain. Methods We implemented a newly developed 3D vascular reconstruction algorithm for clinical stroke CTA images...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28524121/-the-use-of-high-flow-extracranial-intracranial-artery-bypass-in-pathology-of-the-cerebral-and-brachiocephalic-arteries-technical-features-and-surgical-outcomes
#2
A V Dubovoy, K S Ovsyannikov, V E Guzhin, A V Cherepanov, D M Galaktionov, A M Perfil'ev, A O Sosnov
BACKGROUND: Poor outcomes of surgical treatment for complex cerebral aneurysms due to the development of cerebral ischemia were the cause to use cerebral revascularization surgery for this pathology. OBJECTIVE: the study objective was to master a high-flow extracranial-intracranial (EC-IC) artery bypass technique and evaluate its application in surgical treatment of complex and giant cerebral aneurysms as well as complex lesions of the brachiocephalic arteries. MATERIAL AND METHODS: Fifty two patients underwent high-flow IC-EC bypass surgery; of these, 34 patients had complex cerebral aneurysms, and 18 patients had complex stenotic occlusive lesions of the brachiocephalic arteries...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28521360/exposure-of-the-external-carotid-artery-through-the-posterior-triangle-of-the-neck-a-novel-approach-to-facilitate-bypass-procedures-to-the-posterior-cerebral-circulation
#3
Ali Tayebi Meybodi, Michael T Lawton, Pooneh Mokhtari, Olivia Kola, Ivan H El-Sayed, Arnau Benet
BACKGROUND: The external carotid artery (ECA) is the main high-flow donor for extracranial-intracranial revascularization procedures. However, anatomic restraints limit the availability of ECA in posterior exposures of the craniocervical junction aimed for bypass to distal vertebral artery segments. OBJECTIVE: To examine the feasibility and safety of exposure of the ECA through the posterior triangle of the neck. METHODS: A preliminary feasibility study on the posterior neck exposure of the ECA was performed in 1 cadaveric head (2 sides) followed by a morphometric study on 9 cadaveric heads (18 sides)...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521345/superficial-temporal-artery-distal-posterior-cerebral-artery-bypass-through-the-subtemporal-approach-technical-note-and-pilot-surgical-cases
#4
Akitsugu Kawashima, Hugo Andrade-Barazarte, Behnam Rezai Jahromi, Minna Oinas, Ahmed Elsharkawy, Juri Kivelev, Yuichi Kubota, Takakazu Kawamata, Juha A Hernesniemi
BACKGROUND: Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications. OBJECTIVE: To describe the technique of trapping a fusiform PCA aneurysm and revascularization of the distal PCA using a superficial temporal artery (STA) graft through the same microsurgical approach. METHODS: From September 2012 to October 2014, we retrospectively identified 3 patients harboring a fusiform PCA aneurysm (P2 segment aneurysm) who underwent trapping of the aneurysm and reconstruction of the distal PCA through the same subtemporal approach...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28504557/carotid-angioplasty-assisted-mechanical-thrombectomy-without-urgent-stenting-may-be-a-better-option-in-acute-tandem-occlusions
#5
Cetin K Akpinar, Erdem Gürkaş, Emrah Aytac
Background The aim of the study was to assess the efficacy of balloon angioplasty-assisted mechanical thrombectomy without urgent stenting in the carotid artery as another approach for endovascular treatment of tandem occlusions. Methods Fifteen consecutive cases of tandem occlusions treated with the endovascular approach between January 2014 and May 2016 were reviewed. The study cohort included patients with an etiology of large vessel atherosclerosis. Extracranial carotid stenting was performed in another session if post-thrombectomy mRS modified Rankin Score (mRS) was 0-2...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28499862/successful-revascularization-of-aortic-arch-in-a-39-year-old-blunt-trauma-patient-with-acute-diffuse-axonal-injury-without-the-use-of-systemic-anticoagulation
#6
Andrew M Abi-Chaker, Keith M Jones, Priscilla Sanchez, Jordan Sasson, Xiaoyi Li, Jorge Rey
BACKGROUND: Blunt traumatic aortic injury is the second leading cause of death in trauma patients age 4 to 34. Of the patients that are able to receive treatment, mortality rates as high as 40% have been reported. Endovascular repair options have allowed for more expeditious repairs with reduced iatrogenic trauma; however, when the injury involves the ascending aorta or arch, current endografts lack fenestrations needed for cerebral blood flow. Traditionally, on pump cardiopulmonary bypass with systemic anticoagulation has been used to repair these injuries...
May 9, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28497183/rapid-contralateral-progression-of-focal-cerebral-arteriopathy-distinguished-from-rnf213-related-moyamoya-disease-and-fibromuscular-dysplasia
#7
Yoshio Araki, Yasushi Takagi, Yohei Mineharu, Hatasu Kobayashi, Susumu Miyamoto, Toshihiko Wakabayashi
BACKGROUND: Focal cerebral arteriopathy includes unifocal or multifocal lesions that are unilateral or bilateral. Large- and/or medium-sized vessels are involved and can be visualized on angiography. CASE REPORT: We report a case of cerebral infarction in a 9-year-old Japanese female who presented with a transient ischemic attack. Steno-occlusion involving the distal part of the internal carotid artery, proximal middle cerebral artery, and anterior cerebral artery was observed...
May 11, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28490683/-concomitant-surgery-for-symptomatic-severe-carotid-artery-stenosis-and-aortic-valve-stenosis-with-contralateral-internal-carotid-artery-occlusion-a-case-report
#8
Tomonori Takeshita, Kohei Ishihara, Yuu Murakami, Hiroshi Munakata, Katsuhito Mabuni, Tadao Kugai, Tomoaki Nagamine
We report a case of concomitant carotid endarterectomy(CEA)and aortic valve replacement(AVR)for symptomatic severe carotid artery and aortic valve stenosis(AS). A 77-year-old man, presented to our hospital with AS complicated by right internal carotid artery(ICA)stenosis and left ICA occlusion, seeking treatment for AS. He suffered from left hemiparesis, and diffusion-weighted magnetic resonance imaging(MRI)showed multiple ischemic lesions in the right cerebral hemisphere. He was admitted to our neurosurgical department and received treatment for acute cerebral infarction caused by severe right ICA stenosis...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28490201/a-comparison-of-haemodynamics-between-subcranial-intracranial-bypass-and-the-traditional-extracranial-intracranial-bypass
#9
Zaitao Yu, Yang Yang, Xiang'en Shi, Hai Qian, Fangjun Liu
BACKGROUND: Ischemic cerebrovascular diseases are traditionally treated using an extracranial-intracranial (EC-IC) bypass. The use of the internal maxillary artery (IMA) in the subcranial-intracranial (SC-IC) bypass was recently described as an alternative treatment. However, the haemodynamics of this new approach have not been defined. METHODS: The haemodynamic parameters (flow volume [FV], internal diameter [ID], time-averaged mean velocity [TAM], pulsatility index [PI] and resistance index [RI]) of the IMA-radial artery graft (RAG)-middle cerebral artery (MCA) (n = 12) bypass and superficial temporal artery (STA)-MCA bypass (n = 18) were measured using intraoperative duplex ultrasonography and compared...
May 11, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28488662/cerebral-revascularization-the-standard-method-of-anastomosis-or-the-newly-recommended-technique
#10
Yeshwant A Patki
No abstract text is available yet for this article.
May 2017: Neurology India
https://www.readbyqxmd.com/read/28487332/neurocognitive-performance-after-cerebral-revascularization-in-adult-moyamoya-disease
#11
Penelope D Zeifert, Peter Karzmark, Teresa E Bell-Stephens, Gary K Steinberg, Leslie J Dorfman
BACKGROUND AND PURPOSE: Cerebral revascularization using EC-IC bypass is widely used to treat moyamoya disease, but the effects of surgery on cognition are unknown. We compared performance on formal neurocognitive testing in adults with moyamoya disease before and after undergoing direct EC-IC bypass. METHODS: We performed a structured battery of 13 neurocognitive tests on 84 adults with moyamoya disease before and 6 months after EC-IC bypass. The results were analyzed using reliable change indices for each test, to minimize test-retest variability and practice effects...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28487329/aspects-alberta-stroke-program-early-ct-score-measurement-using-hounsfield-unit-values-when-selecting-patients-for-stroke-thrombectomy
#12
Maxim Mokin, Christopher T Primiani, Adnan H Siddiqui, Aquilla S Turk
BACKGROUND AND PURPOSE: The ASPECTS (Alberta Stroke Program Early CT Score) is a quantitate score that measures the extent of early ischemic changes. Our aim was to investigate how measurement of ASPECTS using Hounsfield unit (HU) values on initial noncontrast head computerized tomography (CT) correlates with the extent of final infarct on follow-up imaging. METHODS: Cases of acute stroke from the middle cerebral artery M1 occlusion in which complete recanalization (TICI [Thrombolysis in Cerebral Infarction] 3) was achieved were included for analysis...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28486696/coronary-artery-bypass-surgery-within-48%C3%A2-hours-after-cardiac-arrest-due-to-acute-myocardial-infarction
#13
Christina Grothusen, Christine Friedrich, Tim Attmann, Jette Meinert, Eva Ohnewald, Ulysses Ulbricht, Katharina Huenges, Assad Haneya, Derk Frank, Jan-Thorsten Graesner, Jan Schoettler, Jochen Cremer
OBJECTIVES: Cardiac arrest (CA) in patients with acute myocardial infarction is associated with a poor prognosis. Due to the additional trauma, risk of stroke and lack of data, coronary artery bypass grafting (CABG) is a controversial revascularization strategy for patients who cannot be treated percutaneously. Against this background, we investigated the outcome of patients from our department with acute myocardial infarction undergoing CABG after CA. METHODS: Between January 2001 and January 2015, 129 patients with preoperative CA due to acute myocardial infarction underwent CABG at our institution within 48 h after the CA had occurred...
May 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28484550/distal-posterior-cerebral-artery-revascularization-for-a-fusiform-pca-aneurysm-a-lesson-learned
#14
Gavin W Britz, Ali Zomorodi, Ciaran J Powers
The need for revascularization with proximal posterior cerebral artery occlusion in the treatment of giant and fusiform aneurysms is unclear. While early series demonstrated only about a 10% chance of infarction following posterior cerebral artery occlusion, recently several authors have advocated a bypass prior to parent vessel sacrifice in all cases. We present the case of an adult man with a fusiform aneurysm of the right posterior cerebral artery at the P2-P3 junction. He clinically failed a balloon test occlusion preoperatively and therefore underwent an occipital artery to distal posterior cerebral artery bypass with subsequent endovascular occlusion of the parent vessel and aneurysm...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28479455/safety-of-carotid-revascularization-during-the-acute-period-of-neurological-symptom-onset-in-women
#15
Paola De Rango, Gioele Simonte, Virginia J Howard, Luca Farchioni, Enrico Cieri, Valeria Caso, Selena Pelliccia, Massimo Lenti
BACKGROUND: Benefit from carotid revascularization is supposed to be lower in women due to increased periprocedural risks. The aim of this study was to investigate the risk of stroke/death after carotid intervention in women treated within 15 days from last neurological event. METHODS: Data from 282 consecutive patients treated during 2009-2015 by carotid endarterectomy (CEA) or carotid stenting (CAS) within 15 days from neurological symptoms were analyzed by sex and stratified according to treatment delay towards symptoms onset...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28465270/assessment-of-the-temporopolar-artery-as-a-donor-artery-for-intracranial-to-intracranial-bypass-to-the-middle-cerebral-artery-anatomical-feasibility-study
#16
Ali Tayebi Meybodi, Michael T Lawton, Dylan Griswold, Pooneh Mokhtari, Andre Payman, Halima Tabani, Sonia Yousef, Olivia Kola, Arnau Benet
BACKGROUND: Intracranial-intracranial bypass is a valuable cerebral revascularization option. Despite several advantages, one of the main shortcomings of the intracranial-intracranial bypass is the possibility of ischemic complications of the donor artery. However, when sacrificed, the temporopolar artery is not associated with major neurological deficits. We sought to define the role of TPA as a donor for revascularization of the middle cerebral artery (MCA). METHODS: A Pterional craniotomy was performed on 14 specimens...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28450677/intra-arterial-contrasted-cone-beam-computed-tomography-assessment-of-vessels-distal-from-occluded-site-in-acute-ischemic-stroke-with-major-vessel-occlusion
#17
Tatsuo Amano, Masayuki Sato, Yuji Matsumaru, Hideyuki Sakuma, Syogo Yoda, Yusuke Hamada
Characterization of vessels distal from occluded site is important when considering endovascular revascularization therapy (EVT) for acute ischemic stroke. The goal of this study was to assess the clinical value of intra-arterial contrasted high-resolution cone-beam computed tomography from the ascending aorta (Ao-CBCT) for visualization of the vessels distal from occluded site. Acute ischemic stroke patients with large vessel occlusion who were to undergo EVT were evaluated. In EVT, digital subtraction angiography (DSA) and Ao-CBCT were performed with local anesthesia...
April 26, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28446622/cortical-venous-redness-represents-tissue-circulation-status-in-patients-with-moyamoya-disease
#18
Toshio Machida, Yoshinori Higuchi, Shigeki Nakano, Satoshi Ishige, Atsushi Fujikawa, Yuichi Akaogi, Junichiro Shimada, Yoichi Yoshida, Sigenori Maru, Junichi Ono
BACKGROUND AND PURPOSE: Venous oxygen saturation (SO2) is measured in medical fields to assess tissue circulation insufficiency. This study aimed to elucidate the use of a cortical venous redness measurement to evaluate hemodynamic changes during revascularization surgery for patients with moyamoya disease. METHODS: In this retrospective case-series analysis, we first quantitatively measured and correlated SO2 and R intensity of 24-bit color digital red-green-blue pictures of blood samples from 3 volunteers...
April 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28445265/comparison-of-clinical-outcomes-after-drug-eluting-stent-implantation-in-diabetic-versus-nondiabetic-patients-in-china-a-retrospective-study
#19
Yong-Jin Jiang, Wei-Xing Han, Chao Gao, Jun Feng, Zheng-Fei Chen, Jing Zhang, Chun-Miao Luo, Jian-Yuan Pan
Diabetes mellitus (DM) has been proved to be a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Drug-eluting stents (DESs) could reduce the adverse events in DM patients. In this study, we aimed to analyze the clinical outcome after DES implantation in diabetic versus nondiabetic patients in China. Totally, 200 Chinese DM patients and 400 Chinese non-DM patients were enrolled in this retrospective study. Compared with non-DM patients, DM patients were more likely to have a higher incidence of cardiac death (3...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441445/impact-of-aberrant-cerebral-perfusion-on-resting-state-functional-mri-a-preliminary-investigation-of-moyamoya-disease
#20
Yituo Wang, Lubin Wang, Penggang Qiao, Fugeng Sheng, Cong Han, Enmao Ye, Yu Lei, Feng Yan, Shanshan Chen, Yuyang Zhu, Guiyun Mi, Gongjie Li, Zheng Yang
The impact of chronic cerebral hypoperfusion on resting-state blood oxygen level-dependent signal fluctuations remains unknown. We aimed to determine whether chronic ischemia induces changes in amplitude of low-frequency fluctuations (ALFF) and to investigate the correlation between ALFF and perfusion-weighted magnetic resonance imaging (PWI) parameters in patients with moyamoya disease (MMD). Thirty patients with pre- and postoperative resting-state functional magnetic resonance imaging and PWI were included, and thirty normal controls underwent resting-state functional magnetic resonance imaging...
2017: PloS One
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