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https://www.readbyqxmd.com/read/28425317/mortality-risk-factors-from-converting-off-pump-coronary-artery-bypass-to-on-pump-coronary-artery-bypass
#1
Na Miao, Feng Yang, Zhongtao Du, Chunjing Jiang, Xing Hao, Jinhong Wang, Yu Jiang, Xiaofang Yang, Haixiu Xie, Xiaotong Hou
INTRODUCTION: A number of large-scale retrospective studies revealed that off-pump coronary artery bypass (OPCAB) was superior to on-pump coronary artery bypass (ONCAB). The aim of the study was to investigate risk factors for mortality when OPCAB is converted to ONCAB. METHODS: Patients who underwent OPCAB conversion to ONCAB at the Beijing Anzhen Hospital between January 2003 and January 2013 were assigned to the non-survivor and survivor groups. Background demographics, illness history and preoperative, intraoperative and postoperative variables were compared...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28411965/dynamic-cerebral-autoregulation-assessment-using-extracranial-internal-carotid-artery-doppler-ultrasonography
#2
Nai-Fang Chi, Hsiao-Lun Ku, Chen-Yen Wang, Yanhui Liu, Lung Chan, Ying-Chin Lin, Chung-Kang Peng, Vera Novak, Han-Hwa Hu, Chaur-Jong Hu
Transcranial Doppler ultrasonography of the middle cerebral artery (MCA) is frequently used to assess dynamic cerebral autoregulation (dCA); however, this is difficult in patients with poor temporal bone windows. In the study described here, we investigated the agreement and sensitivity of dCA indices determined from the extracranial internal carotid artery (ICA) and those determined from the MCA. Measurements for 32 stroke patients and 59 controls were analyzed. Measurement of the mean flow correlation index (Mx) and transfer function analysis based on spontaneous blood pressure fluctuation were simultaneously performed for the extracranial ICA and MCA...
April 12, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28409735/quantitative-magnetic-resonance-angiography-as-a-potential-predictor-for-cerebral-hyperperfusion-syndrome-a-preliminary-study
#3
Lukas Andereggen, Sepideh Amin-Hanjani, Marwan El-Koussy, Rajeev K Verma, Kenya Yuki, Daniel Schoeni, Kety Hsieh, Jan Gralla, Gerhard Schroth, Juergen Beck, Andreas Raabe, Marcel Arnold, Michael Reinert, Robert H Andres
OBJECTIVE Cerebral hyperperfusion syndrome (CHS) is a rare but devastating complication of carotid endarterectomy (CEA). This study sought to determine whether quantitative hemodynamic assessment using MR angiography can stratify CHS risk. METHODS In this prospective trial, patients with internal carotid artery (ICA) stenosis were randomly selected for pre- and postoperative quantitative phase-contrast MR angiography (QMRA). Assessment was standardized according to a protocol and included Doppler/duplex sonography, MRI, and/or CT angiography and QMRA of the intra- and extracranial supplying arteries of the brain...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28352965/dual-energy-ct-to-diagnose-pseudoedema-in-contrast-induced-encephalopathy-following-cerebral-angiography
#4
Gabriel L Pagani-Estévez, Deena M Nasr, Waleed Brinjikji, Avital Perry, Jennifer E Fugate
BACKGROUND: Contrast-induced encephalopathy (CIE) is a syndrome that may be clinically unrecognized and misdiagnosed as cerebral edema. METHODS: Case report and review. RESULTS: A 72-year-old woman was admitted for elective endovascular embolization of a 10-mm left anterior communicating artery aneurysm. One hour post-procedure, she acutely developed global aphasia. Emergent head computed tomography (CT) and computed tomography-angiography (CTA) showed high attenuation of the left hemispheric subarachnoid spaces interpreted as hemispheric edema; emergent magnetic resonance imaging revealed left hemispheric punctate infarcts...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28333037/cerebral-hemodynamic-with-intra-aortic-balloon-pump-business-as-usual
#5
Juliana Caldas, Ronney B Panerai, Edson Bor-Seng-Shu, Juliano Almeida, Graziela Ferreira, Ligia Cunha, Ricardo Nogueira, Marcelo Oliveira, Fabio Jatene, Thompson Robinson, Ludhmila Hajjar
Intra-aortic balloon pump (IABP) is commonly used as mechanical support after cardiac surgery or cardiac shock. Although its benefits for cardiac function have been well documented, its effects on cerebral circulation are still controversial. We hypothesized that transfer function analysis (TFA) and continuous estimates of dynamic cerebral autoregulation (CA) provide consistent results in the assessment of cerebral autoregulation in patients with IABP. Continuous recordings of blood pressure (BP, intra-arterial line), end-tidal CO2, heart rate and cerebral blood flow velocity (CBFV, transcranial Doppler) were obtained i) 5 minutes with IABP ratio 1:3, ii) 5 minutes, starting 1 minute with the IABP-ON, and continuing for another 4 minutes without pump assistance (IABP-OFF)...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28258058/impact-of-mild-orthostatic-stress-on-aortic-cerebral-hemodynamic-transmission-insight-from-the-frequency-domain
#6
Jun Sugawara, Tsubasa Tomoto, Tomoko Imai, Seiji Maeda, Shigehiko Ogoh
High cerebral pressure and flow fluctuations could be a risk for future cerebrovascular disease. This study aims to determine whether acute systemic vasoconstriction affects the dynamic pulsatile hemodynamic transmission from the aorta to the brain. We applied a stepwise lower body negative pressure (LBNP) (-10, -20, and -30 mmHg) in 15 young men to induce systemic vasoconstriction. To elucidate the dynamic relationship between the changes in aortic pressure (AoP, estimated from the radial arterial pressure waveforms) and the cerebral blood flow velocity (CBFV) at the middle cerebral artery (via a transcranial Doppler), frequency-domain analysis characterized the beat-to-beat slow oscillation (0...
March 3, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28241129/how-should-we-lower-blood-pressure-after-cerebral-hemorrhage-a-systematic-review-and-meta-analysis
#7
Simona Lattanzi, Claudia Cagnetti, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The optimal treatment of high blood pressure (BP) after acute intra-cerebral hemorrhage (ICH) is controversial. SUMMARY: The aim of the study was to evaluate the safety and efficacy of early intensive vs. conservative BP lowering treatment in patients with ICH. Randomized controlled trials with active and control groups receiving intensive and conservative BP lowering treatments were identified. The following outcomes were assessed: 3-month mortality and combined death or major disability, 24-h hematoma growth, early neurological deterioration, occurrence of hypotension, severe hypotension, and serious treatment-emergent adverse events...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241107/technical-note-development-of-a-cranial-phantom-for-assessing-perfusion-diffusion-and-biomechanics
#8
Naoki Ohno, Tosiaki Miyati, Tomohiro Chigusa, Hikari Usui, Shota Ishida, Yuki Hiramatsu, Satoshi Kobayashi, Toshifumi Gabata, Noam Alperin
PURPOSE: A novel cranial phantom was developed to simulate the relationships among factors such as blood perfusion, water diffusion, and biomechanics in intracranial tissue. METHODS: The cranial phantom consisted of a high-density polypropylene filter (mimicking brain parenchyma) with intra- and extrafilter spaces (mimicking cerebral artery and vein, respectively), and a capacitor space (mimicking the cerebrospinal fluid space). Pulsatile and steady flow with different flow rates were applied to the cranial phantom using a programmable pump...
February 27, 2017: Medical Physics
https://www.readbyqxmd.com/read/28186430/cerebral-blood-flow-frontal-lobe-oxygenation-and-intra-arterial-blood-pressure-during-sprint-exercise-in-normoxia-and-severe-acute-hypoxia-in-humans
#9
David Curtelin, David Morales-Alamo, Rafael Torres-Peralta, Peter Rasmussen, Marcos Martin-Rincon, Mario Perez-Valera, Christoph Siebenmann, Ismael Pérez-Suárez, Evgenia Cherouveim, A William Sheel, Carsten Lundby, José Al Calbet
Cerebral blood flow (CBF) is regulated to secure brain O2 delivery while simultaneously avoiding hyperperfusion; however, both requisites may conflict during sprint exercise. To determine whether brain O2 delivery or CBF is prioritized, young men performed sprint exercise in normoxia and hypoxia (PIO2 = 73 mmHg). During the sprints, cardiac output increased to ∼22 L min(-1), mean arterial pressure to ∼131 mmHg and peak systolic blood pressure ranged between 200 and 304 mmHg. Middle-cerebral artery velocity (MCAv) increased to peak values (∼16%) after 7...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28184351/spontaneous-absorption-of-cerebral-air-embolus-developed-accidentally-during-an-intra-arterial-procedure
#10
Tae Ki Yang
Cerebral arterial air embolism (CAAE), although infrequent, is a complication that can occur at any time during an invasive medical procedure. We experienced two cases of CAAE during cerebral angiography accidentally. The author reports the two cases of CAAE wherein air emboli dissolved spontaneously and immediately under normal atmospheric pressure, not under therapeutic hyperbaric environment. One of the cases shows entire dissolution of the air embolus on the moving image. This report shows that arterial air embolus can be absorbed spontaneously, and air embolus size is one of the factors that influence air embolus dissolution besides hyperbaric oxygen condition...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28117180/the-role-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-as-an-adjunct-to-acls-in-non-traumatic-cardiac-arrest-a-review-of-key-concepts-physiology-current-evidence-and-future-directions
#11
James Daley, Jonathan James Morrison, John Sather, Lisa Hile
Non-traumatic cardiac arrest is a major public health problem that carries an extremely high mortality rate. If we hope to increase the survivability of this condition, it is imperative that alternative methods of treatment are given due consideration. Balloon occlusion of the aorta can be used as a method of circulatory support in the critically ill patient. Intra-aortic balloon pumps have been used to temporize patients in cardiogenic shock for decades. More recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized in the patient in hemorrhagic shock or cardiac arrest secondary to trauma...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27909604/effects-of-head-position-on-cerebral-oxygenation-and-blood-flow-velocity-during-thyroidectomy
#12
Ayten Saraçoğlu, Demet Altun, Ayşen Yavru, Nihat Aksakal, İsmail Cem Sormaz, Emre Camcı
OBJECTIVE: Determining the blood flow through intra and extra-cranial arteries during neck extension may be helpful but is a controversial issue. We aimed to elucidate the changes in cerebral blood flow related to head positioning during thyroid surgery by carotid Doppler examination and regional oxygen saturation variations. METHODS: Thirty patients were recruited to the study. Patients were positioned with a final position of thyroidectomy consisting a 30° semi Fowler with the extension of neck and head...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27869301/cerebral-amyloid-deposition-is-associated-with-gait-parameters-in-the-mayo-clinic-study-of-aging
#13
Alexandra M V Wennberg, Rodolfo Savica, Clinton E Hagen, Rosebud O Roberts, David S Knopman, John H Hollman, Prashanthi Vemuri, Clifford R Jack, Ronald C Petersen, Michelle M Mielke
OBJECTIVES: To determine the cross-sectional association between cerebral amyloid-beta (Aβ) deposition and gait. DESIGN: Cross-sectional. SETTING: Population-based cohort study in Olmsted County, MN. PARTICIPANTS: Cognitively normal individuals (n = 611), aged 50 to 69 years, enrolled in the Mayo Clinic Study of Aging with concurrent PiB-PET imaging and gait assessment. Participants with a history of stroke, alcoholism, Parkinson's disease, subdural hematoma, traumatic brain injury, or normal pressure hydrocephalus were excluded...
April 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27738950/patterns-of-intra-arterial-blood-pressure-monitoring-for-patients-undergoing-total-shoulder-arthroplasty-under-general-anesthesia-a-retrospective-analysis-of-23-073-patients
#14
Rodney A Gabriel, Anair Beverly, Richard P Dutton, Richard D Urman
Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on clinical judgment. We aimed to describe patient, surgical and institutional factors associated with the current use of blood pressure monitoring via an arterial line for TSA. We used de-identified patient data from the National Anesthesia Clinical Outcomes Registry between 2010 and 2015 to identify patients undergoing TSA under general anesthesia...
October 13, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27733961/simulator-based-angiography-and-endovascular-neurosurgery-curriculum-a-longitudinal-evaluation-of-performance-following-simulator-based-angiography-training
#15
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
https://www.readbyqxmd.com/read/27695548/a-cost-effectiveness-based-safety-and-efficacy-study-of-resterilized-intra-parenchymal-catheter-based-intracranial-pressure-monitoring-in-developing-world
#16
Deepak Kumar Gupta, Ajay Bisht, Priyam Batra, Purva Mathur, Ashok Kumar Mahapatra
BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters have the lowest incidence of infection compared to intra-ventricular/subdural catheters with reliable and accurate pressure recordings. The major disadvantage of the intra-parenchymal catheters is the cost, especially in developing nations...
October 2016: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/27668240/blood-pressure-in-acute-intra-cerebral-hemorrhage
#17
COMMENT
Simona Lattanzi, Mauro Silvestrini
No abstract text is available yet for this article.
August 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27557843/decreased-haemodynamic-response-and-decoupling-of-cortical-gamma-band-activity-and-tissue-oxygen-perfusion-after-striatal-interleukin-1-injection
#18
Natasha Bray, Fiona E Burrows, Myles Jones, Jason Berwick, Stuart M Allan, Ingo Schiessl
BACKGROUND: Neurovascular coupling describes the mechanism by which the energy and oxygen demand arising from neuronal activity is met by an increase in regional blood flow, known as the haemodynamic response. Interleukin 1 (IL-1) is a pro-inflammatory cytokine and an important mediator of neuronal injury, though mechanisms through which IL-1 exerts its effects in the brain are not fully understood. In this study, we set out to investigate if increased cerebral levels of IL-1 have a negative effect on the neurovascular coupling in the cortex in response to sensory stimulation...
August 24, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27544342/low-dose-intramuscular-diclofenac-sodium-for-fever-control-in-acute-brain-injury
#19
Edoardo Picetti, Franco Servadei, Cristiana Reverberi, Francesca De Carlo, Ilaria Rossi, Marta Velia Antonini, Maria Luisa Caspani
OBJECTIVE: To evaluate the cerebral and hemodynamic effects of low-dose intramuscular diclofenac sodium (DCFS) administered for fever control in patients with acute brain injury in the intensive care unit. METHODS: Inclusion criteria for this prospective clinical study were age ≥18 years; the ability to monitor intra-arterial blood pressure, core body temperature, and intracranial pressure; the placement of an indwelling jugular venous catheter for intermittent jugular venous oxygen saturation measurements; and a core body temperature ≥37...
November 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27403221/use-of-intra-aortic-balloon-pump-counterpulsation-in-patients-with-symptomatic-vasospasm-following-subarachnoid-hemorrhage-and-neurogenic-stress-cardiomyopathy
#20
Fawaz Al-Mufti, Nicholas Morris, Shouri Lahiri, William Roth, Jens Witsch, Iona Machado, Sachin Agarwal, Soojin Park, Philip M Meyers, E Sander Connolly, Jan Claassen
INTRODUCTION: Intra-aortic counterpulsation balloon pumps (IABPs) have been widely used to augment hemodynamics in critically ill patients with cardiogenic shock and have recently been proposed as a management strategy for subarachnoid hemorrhage (SAH) patients with neurogenic stress cardiomyopathy (NSC). Prior case series have described the use of IABP as a means to manage cardiogenic shock in this patient population; however, we sought to describe our experience with IABP as a means to wean vasopressor requirement while augmenting hemodynamics and maintaining pressures at goal...
June 2016: Journal of Vascular and Interventional Neurology
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