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https://www.readbyqxmd.com/read/29158056/factors-associated-with-moyamoya-syndrome-in-a-kentucky-regional-population
#1
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
#2
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
https://www.readbyqxmd.com/read/29146553/impact-of-marital-status-on-outcomes-following-st-segment-elevation-myocardial-infarction
#3
Moo Hyun Kim, Kwang Min Lee, Soo Jin Kim, So Yeon Kim, Jong Seong Park, Young Rak Cho, Kyungil Park, Tae Ho Park, Young Dae Kim, Victor Serebruany
BACKGROUND: Mood disorders, depression, and loneliness are established risk factors for thrombotic occlusions. Social relationships in general, and marital status in particular may play a role in predicting cardiovascular outcomes and survival after ST-segment elevation myocardial infarction (STEMI), but the evidence is inconclusive especially in Asians. METHODS: The Korean patients presented with STEMI (n=980) constituted married (n=780); or widowed, divorced, or single (WDS, n=200) groups...
July 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29146434/cerebral-hyperperfusion-syndrome-after-endovascular-reperfusion-therapy-in-a-patient-with-acute-internal-carotid-artery-and-middle-cerebral-artery-occlusions
#4
Tetsuya Hashimoto, Shoji Matsumoto, Mitsushige Ando, Hideo Chihara, Atsushi Tsujimoto, Taketo Hatano
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) is known to be a rare but devastating complication of carotid artery revascularization. Because patients with acute ischemic stroke due to acute major cerebral and/or cervical artery occlusion treated with endovascular reperfusion therapy may have impaired autoregulation in the cerebral vasculature, these patients may also develop CHS. Despite the growing number of endovascular reperfusion procedures for acute ischemic stroke, this complication has only rarely been reported...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29143147/-esc-guidelines-2017-on-peripheral-arterial-diseases-summary-of-the-most-important-recommendations-and-innovations
#5
C Espinola-Klein
The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis...
November 15, 2017: Herz
https://www.readbyqxmd.com/read/29137017/prognostic-value-of-glucose-metabolism-for-non-st-segment-elevation-infarction-patients-with-diabetes-mellitus-and-single-concomitant-chronic-total-occlusion-following-primary-percutaneous-coronary-intervention
#6
Zhi Xing, Lei Zhang, Zhiqiang Liu, Pengyi He, Yuchun Yang, Muhuyati Wulasihan
Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutaneous transluminal coronary intervention (pPCI)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29111474/the-middle-temporal-artery-surgical-anatomy-and-exposure-for-cerebral-revascularization
#7
Roberto Rodriguez Rubio, Michael T Lawton, Olivia Kola, Halima Tabani, Sonia Yousef, Ali Tayebi Meybodi, Jan-Karl Burkhardt, Ivan El-Sayed, Arnau Benet
BACKGROUND: The middle temporal artery (MTA) is the proximal medial branch of the superficial temporal artery (STA), supplying the temporalis muscle along with deep temporal arteries. Its use in vascularized flaps for reconstructive and otologic procedures has been described, yet its potential use in neurosurgery is not studied. We report a novel technique for exposing the MTA and evaluated its characteristics for extracranial-intracranial (EC-IC) cerebrovascular bypass. METHODS: After a curvilinear frontotemporal incision in 10 cadaveric specimens, the STA was dissected from distal to proximal...
October 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29110993/anterior-temporal-artery-to-posterior-cerebral-artery-bypass-for-revascularization-of-the-posterior-circulation-an-anatomical-study
#8
Kaan Yağmurlu, M Yashar S Kalani, Feres Chaddad-Neto, Orhun Mete Cevik, Baran Bozkurt, Evgenii Belykh, Hugo Leonardo Doria-Netto, Andrew W Grande, Mark C Preul, Robert F Spetzler
We describe a novel intracranial-to-intracranial bypass technique between the anterior temporal artery and the posterior cerebral artery for revascularization of the posterior circulation. Four formalin-fixed human heads were examined to demonstrate the detailed anatomy of the middle cerebral artery and the posterior cerebral artery, and to illustrate the step-by-step bypass procedure. The anterior temporal artery, a branch of the middle cerebral artery, can be anastomosed to the P2 segment of the posterior cerebral artery as an alternative to extracranial bypass donor segments for treatment of complex aneurysms requiring revascularization...
October 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#9
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29102749/surgical-revascularization-for-children-with-moyamoya-disease-a-new-modification-to-the-pial-synangiosis
#10
Chuan Chen, Hui Wang, Bo Hou, Lun Luo, Ying Guo
OBJECTIVE: To summarize the therapeutic efficacy of modified pial synangiosis in children with moyamoya disease and our experience with this method. METHOD: A retrospective study was conducted to analyze the clinical efficacy of modified pial synangiosis in children with moyamoya disease who were treated between October 2002 and August 2015 in our center. The clinical characteristics of these rare cases were summarized, and the surgical efficacy was assessed based on long-term follow-up results...
November 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29097075/endovascular-thrombectomy-for-acute-ischemic-stroke-a-single-center-experience-in-taiwan
#11
Hai-Jui Chu, Sung-Chun Tang, Chung-Wei Lee, Jiann-Shing Jeng, Hon-Man Liu
BACKGROUND/PURPOSE: Endovascular thrombectomy has been strongly recommended for treatment of acute ischemic stroke (AIS) with large vessel occlusion. This study aimed to evaluate its efficacy and safety in an Asian population from a single center in Taiwan. METHODS: Patients who experienced AIS and received endovascular thrombectomy during the period of September 2014 to September 2016 at National Taiwan University Hospital were included. Factors related to favorable outcome, defined as modified Rankin scale 0-2 at 90 days after stroke, were analyzed...
October 30, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29096901/-ischemic-stroke-related-to-spontaneous
#12
H Benamer, M A Bouzid, A Dufay, M Akodad, S Russel, X Halna du Fretay, F Haziza
Cardiovascular disease in women is a particularly complex pathology especially in the youngest population. The clinical presentation of acute coronary syndromes is sometimes misleading and does not necessarily point to the potential presence of cardiac disease given the frequent absence of cardiovascular risks. Such complexity results in delayed diagnosis, which worsens the outcome of myocardial infarction and generates complications related to the absence of coronary revascularization. We report the case of a patient who suffered an (undiagnosed) apical myocardial infarction that went undetected and was complicated by a voluminous intraventricular thrombus with embolus migration in the cerebral circulation resulting in an ischemic accident...
October 30, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29079663/favorable-revascularization-therapy-in-patients-with-aspects-%C3%A2-5-on-dwi-in-anterior-circulation-stroke
#13
Isabelle Mourand, Eitan Abergel, Daniel Mantilla, Xavier Ayrignac, Tzvika Sacagiu, Omer Faruk Eker, Gregory Gascou, Cyril Dargazanli, Carlos Riquelme, Marinette Moynier, Alain Bonafé, Caroline Arquizan, Vincent Costalat
BACKGROUND: A low baseline Alberta Stroke Programme Early CT Score (ASPECTS) is strongly associated with low rates of favorable outcome in patients with acute stroke. OBJECTIVE: To evaluate the efficacy and safety of revascularization therapy in patient with ASPECTS ≤5 in anterior circulation infarct. METHODS: We retrospectively analyzed 108 consecutive patients presenting low ASPECTS on diffusion-weighted imaging. Sixty patients were treated by mechanical thrombectomy, including 34 patients who received simultaneously intravenous thrombolysis...
October 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29064776/carotid-stenosis-basing-treatment-on-individual-patients-needs-optimal-medical-therapy-alone-or-accompanied-by-stenting-or-endarterectomy
#14
Ralf Langhoff
Though carotid artery stenosis is a known origin of stroke, risk assessment and treatment modality are not yet satisfactorily established. Guideline updates according to latest evidence are expected shortly. Current clinical weakness concerns in particular the identification of "at-risk" patients. Beside the symptomatic status and the degree of stenosis, further signs of unstable plaque on carotid and cerebral imaging should be considered. Moreover, medical and endovascular therapy are continuously improving...
October 24, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29061453/prevention-of-the-rerupture-of-collateral-artery-aneurysms-on-the-ventricular-wall-by-early-surgical-revascularization-in-moyamoya-disease-report-of-two-cases-and-review-of-the-literature
#15
Fumiaki Kanamori, Syuntaro Takasu, Shinji Ota, Yukio Seki
BACKGROUND: Collateral artery aneurysms are a source of intracranial hemorrhage in moyamoya disease. Several reports have shown that surgical revascularization leads to the obliteration of collateral artery aneurysms. However, its effect on the prevention of rebleeding has not been established, and the optimal timing of the operation remains unclear. The purpose of the present study is to evaluate the effects of surgical revascularization and to investigate the optimal operation timing in patients with moyamoya disease who have ruptured collateral artery aneurysms on the ventricular wall...
October 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29056995/magnetic-resonance-imaging-and-clinical-outcome-in-patients-with-symptomatic-carotid-artery-stenosis-after-carotid-artery-revascularization
#16
Rafał Badacz, Anna Kabłak-Ziembicka, Małgorzata Urbańczyk-Zawadzka, Robert P Banyś, Piotr Musiałek, Piotr Odrowąż-Pieniążek, Mariusz Trystuła, Jan Ścigalski, Krzysztof Żmudka, Tadeusz Przewłocki
INTRODUCTION: About 30% of patients with carotid artery stenosis (CAS) develop dementia after a cerebral ischemic event (CIE), and 20-50% suffer from CIE recurrence during 6 months. Carotid artery revascularization (CAR) may prevent CIE recurrence, at the cost of new microembolic lesions (MES). The impact of CAR on cognitive function is debatable. AIM: To assess functional and cognitive outcome, cerebral flow on transcranial Doppler (TCD) and brain magnetic resonance imaging (MRI) in patients with symptomatic CAS referred for CAR...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29032219/emergency-extracranial-intracranial-bypass-to-revascularize-salvageable-brain-tissue-in-acute-ischemic-stroke-patients
#17
Jan-Karl Burkhardt, Sebastian Winklhofer, Jorn Fierstra, Susanne Wegener, Giuseppe Esposito, Andreas Luft, Oliver Bozinov, Luca Regli
INTRODUCTION: To present an algorithm based on clinical and radiological factors including MR perfusion/diffusion mismatch (MR-PDM) for the indication of urgent cerebral bypass in patients with acute ischemic stroke METHODS: Analysis of clinical and radiological data on eight consecutive patients undergoing urgent cerebral revascularization for acute ischemic stroke due to occlusion of the internal carotid or middle cerebral artery between 2012 and 2015. All patients were either not eligible or failed first line treatment with emergent endovascular revascularization...
October 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#18
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28991720/cerebral-hyperperfusion-syndrome-and-intracranial-hemorrhage-after-carotid-endarterectomy-or-carotid-stenting-a-meta-analysis
#19
REVIEW
George Galyfos, Argiri Sianou, Konstantinos Filis
INTRODUCTION: Cerebral hyperperfusion syndrome (CHS) and intracranial hemorrhage (ICH) after carotid revascularization have been associated with significant morbidity and mortality, although pooled data comparing these outcomes between open and endovascular treatment are lacking. Aim of this meta-analysis is to compare CHS and ICH risk between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS). METHODS: A systematic literature review was conducted conforming to established criteria, in order to identify eligible articles published prior to February 2017...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28989169/moyamoya-disease-in-an-18-month-old-female-caucasian-complicated-by-cerebral-hyperperfusion-syndrome-following-indirect-revascularization
#20
James Murchison, John M Wilson, Coby Ray, Jessica Ginsberg, Laszlo Nagy
BACKGROUND Cerebral hyperperfusion syndrome is a rare complication of indirect revascularization due to moyamoya disease, but has not been reported previously in the pediatric population. We present a case of an 18-month-old girl with moyamoya disease that was treated with bilateral pial synangiosis and had complications consistent with cerebral hyperperfusion syndrome. This case report discusses the pathophysiological mechanisms involved in cerebral hyperperfusion in moyamoya syndrome. CASE REPORT An 18-month-old female Caucasian presented with seizures and weakness of the left side...
October 9, 2017: American Journal of Case Reports
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