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https://www.readbyqxmd.com/read/28641383/neuroprotection-in-stroke-the-importance-of-collaboration-and-reproducibility
#1
Ain A Neuhaus, Yvonne Couch, Gina Hadley, Alastair M Buchan
Acute ischaemic stroke accounts for 6.5 million deaths per year, and by 2030 will result in the annual loss of over 200 million disability-adjusted life years globally. There have been considerable recent advances in the gold standard of acute ischaemic stroke treatment, some aspects of which-aspirin to prevent recurrence, and treating patients in specialized stroke wards-are widely applicable. Recanalization of the occluded artery through thrombolysis and/or endovascular thrombectomy is restricted to only a small proportion of patients, due to contra-indications and the costs associated with establishing the infrastructure to deliver these treatments...
June 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28640874/risk-factors-are-different-for-deep-and-lobar-remote-hemorrhages-after-intravenous-thrombolysis
#2
Luis Prats-Sanchez, Alejandro Martínez-Domeño, Pol Camps-Renom, Raquel Delgado-Mederos, Daniel Guisado-Alonso, Rebeca Marín, Laura Dorado, Salvatore Rudilosso, Alejandra Gómez-González, Francisco Purroy, Manuel Gómez-Choco, David Cánovas, Dolores Cocho, Moises Garces, Sonia Abilleira, Joan Martí-Fàbregas
BACKGROUND AND PURPOSE: Remote parenchymal haemorrhage (rPH) after intravenous thrombolysis is defined as hemorrhages that appear in brain regions without visible ischemic damage, remote from the area of ischemia causing the initial stroke symptom. The pathophysiology of rPH is not clear and may be explained by different underlying mechanisms. We hypothesized that rPH may have different risk factors according to the bleeding location. We report the variables that we found associated with deep and lobar rPH after intravenous thrombolysis...
2017: PloS One
https://www.readbyqxmd.com/read/28633762/usefulness-of-mean-platelet-volume-to-lymphocyte-ratio-for-predicting-angiographic-no-reflow-and-short-term-prognosis-after-primary-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction
#3
Alparslan Kurtul, Sadik Kadri Acikgoz
Primary percutaneous coronary intervention (pPCI) is associated with improved prognosis in patients with ST-segment elevation myocardial infarction (STEMI). However, no-reflow phenomenon limits the benefit of revascularization and predicts adverse outcomes. The specific mechanism for its occurrence is still not entirely clear, and it is believed at present that platelet activation and inflammation play a pivotal role in developing no-reflow. Both increased mean platelet volume (MPV), which is a platelet activation marker, and lymphopenia, which is an inflammation marker, have been linked to adverse events and poor prognosis after STEMI...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28631502/impact-of-acute-infarct-related-artery-patency-before-percutaneous-coronary-intervention-on-30-day-outcomes-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-in-the-euromax-trial
#4
Tomasz Rakowski, Dariusz Dudek, Arnoud van 't Hof, Jurrien Ten Berg, Louis Soulat, Uwe Zeymer, Frederic Lapostolle, Prodromos Anthopoulos, Debra Bernstein, Efthymios N Deliargyris, Philippe Gabriel Steg
AIMS: Early infarct-related artery patency has been associated with improved outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. However, it is unknown whether this relationship persists in contemporary practice with pre-hospital initiation of treatment, use of novel P2Y12 inhibitors and frequent use of drug-eluting stents. The purpose of the study was to determine the impact of early infarct-related artery patency on outcomes in the contemporary EUROMAX trial...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28628412/stratification-imaging-and-management-of-acute-massive-and-submassive-pulmonary-embolism
#5
Akhilesh K Sista, William T Kuo, Mark Schiebler, David C Madoff
While pulmonary embolism (PE) causes approximately 100 000-180 000 deaths per year in the United States, mortality is restricted to patients who have massive or submassive PEs. This state of the art review familiarizes the reader with these categories of PE. The review discusses the following topics: pathophysiology, clinical presentation, rationale for stratification, imaging, massive PE management and outcomes, submassive PE management and outcomes, and future directions. It summarizes the most up-to-date literature on imaging, systemic thrombolysis, surgical embolectomy, and catheter-directed therapy for submassive and massive PE and gives representative examples that reflect modern practice...
July 2017: Radiology
https://www.readbyqxmd.com/read/28627230/relationship-between-community-hospital-versus-pre-hospital-location-of-randomisation-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-insights-from-the-stream-study
#6
Robert C Welsh, Patrick Goldstein, Peter Sinnaeve, Miodrag C Ostojic, Yinggan Zheng, Thierry Danays, Cynthia M Westerhout, Frans Van de Werf, Paul W Armstrong
AIMS: The STREAM study randomly assigned ST-elevation myocardial infarction (STEMI) patients to receive a pharmacoinvasive versus primary percutaneous coronary intervention reperfusion strategy. We assessed whether there was an association between outcomes based on randomisation at a community hospital versus a prehospital location. METHODS/RESULTS: Community hospital patients (358/1866 (19.2%)) were compared to prehospital patients and their outcomes categorised into pharmacoinvasive according to their treatment assignment...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28624140/minor-nonintracranial-hemorrhage-and-poor-prognosis-among-stroke-patients-undergoing-intravenous-thrombolysis
#7
Xiaoming Qin, Songyao Zhao, Liujie Yin, Hailing Dou, Jie Chen, Yifan Wang, Mingzhe Li, Ruifang Chen, Gaiqing Yang, Xin Liu, Runqing Wang, Xinzhou Jia, Shufang Bu, Dongpu Ma, Baoyu Wang, Shize Li
BACKGROUND: Whether nonintracranial hemorrhage (NICH) associated with intravenous thrombolysis (IVT) is a predictor of intracranial hemorrhage (ICH) and poor prognosis is ambiguous. We sought to analyze the rate of NICH and the relationship between NICH and poor outcome in the ischemic stroke population undergoing IVT. METHODS: This is a single-center, hospital-based prospective study. All ischemic stroke patients undergoing IVT between December 2015 and November 2016 were included...
June 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28623638/urokinase-containing-locking-solution-in-the-prevention-of-dialysis-catheter-dysfunction-a-double-blind-randomized-controlled-trial
#8
Florence Bonkain, Freya Van Hulle, Peter Janssens, Concetta Catalano, Mandelina Allamani, Jean-Claude Stolear, Dominique Vandervelde, Mark Libertalis, Serge Treille, Marie M Couttenye, Annemie Dhondt, Wim Van Biesen, Jean François Fils, Christian Tielemans, Karl M Wissing
INTRODUCTION: The prophylactic use of recombinant tissue plasminogen activator once weekly reduces the incidence rate of tunneled cuffed catheter (TCC) malfunction and bacteremia as compared to the exclusive use of heparin as locking solution. Restricting the use of prophylactic thrombolytic agents to patients with a history of thrombotic TCC malfunction could be more cost effective. We conduct a multicenter, double-blind, randomized controlled trial and test the hypothesis that weekly use of urokinase lock will reduce the incidence of thrombotic malfunction by 50% in prevalent hemodialysis patients with a history of thrombotic malfunction...
June 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#9
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28621151/case-report-and-literature-review-on-contrast-induced-encephalopathy
#10
Mardi Hamra, Yasir Bakhit, Mahboob Khan, Roger Moore
Contrast-induced encephalopathy (CIE) is a rare neurological complication following the administration of injectable intravascular contrast media. Patients with CIE present a wide spectrum of symptoms such as headache, transient cortical blindness, seizure and focal neurological deficits. The diagnosis of CIE requires a high index of suspicion. Its early recognition is of paramount importance in instituting the appropriate supportive treatment in the form of intravenous fluids and also in avoiding unnecessary potentially harmful treatment such as intravenous thrombolysis for suspected ischemic stroke...
June 16, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28619989/low-versus-standard-dose-alteplase-in-patients-on-prior-antiplatelet-therapy-the-enchanted-trial-enhanced-control-of-hypertension-and-thrombolysis-stroke-study
#11
Thompson G Robinson, Xia Wang, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph P Broderick, Andrew M Demchuk, Geoffery A Donnan, Jong S Kim, Pablo M Lavados, Tsong-Hai Lee, Richard I Lindley, Sheila C O Martins, Veronica V Olavarria, Jeyaraj D Pandian, Mark W Parsons, Octavio M Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Thang H Nguyen, Ji-Guang Wang, Mark Woodward, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Many patients receiving thrombolysis for acute ischemic stroke are on prior antiplatelet therapy (APT), which may increase symptomatic intracerebral hemorrhage risk. In a prespecified subgroup analysis, we report comparative effects of different doses of intravenous alteplase according to prior APT use among participants of the international multicenter ENCHANTED study (Enhanced Control of Hypertension and Thrombolysis Stroke Study). METHODS: Among 3285 alteplase-treated patients (mean age, 66...
June 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28619988/another-enchantment-from-enchanted-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-are-savings-and-safety-more-salutary-than-efficacy
#12
EDITORIAL
Peter D Schellinger, Georgios Tsivgoulis
No abstract text is available yet for this article.
June 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28618846/comparison-of-direct-iliofemoral-stenting-following-angiojet-rheolytic-thrombectomy-vs-staged-stenting-after-angiojet-rheolytic-thrombectomy-plus-catheter-directed-thrombolysis-in-patients-with-acute-deep-vein-thrombosis
#13
Guang Liu, Jinbao Qin, Chaoyi Cui, Kaichuang Ye, Huihua Shi, Xiaobing Liu, Minyi Yin, Xintian Huang, Min Lu, Mier Jiang, Weimin Li, Xinwu Lu
PURPOSE: To compare the treatment outcomes in patients with acute proximal deep vein thrombosis (DVT) and iliofemoral stenosis who underwent either direct stenting after AngioJet rheolytic thrombectomy or staged stenting after AngioJet thrombectomy plus catheter-directed thrombolysis with urokinase. METHODS: From June 2014 to February 2016, 91 DVT patients underwent 2 treatments for duplex-verified iliofemoral stenosis: direct stenting (n = 46; mean age 54.8 years; 32 men) or staged stenting (n = 45; mean age 56...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28616647/outcomes-of-direct-stenting-in-patients-with-st-elevated-myocardial-infarction
#14
A Kalayci, V Oduncu, C Y Karabay, A Erkol, A C Tanalp, I H Tanboga, O Candan, C Gecmen, I A Izgi, C Kirma
BACKGROUND: We compared direct stenting (DS) with conventional stenting (CS) - i.e., stenting after predilation - during primary percutaneous coronary intervention (P-PCI) in terms of procedural results and long-term mortality in patients with ST-elevated myocardial infarction (STEMI). METHODS: We retrospectively analyzed 2306 patients (mean age 59 years, 22% female) who underwent P‑PCI within 12 h of symptom onset. Patients were then followed up prospectively for clinical events...
June 14, 2017: Herz
https://www.readbyqxmd.com/read/28615907/successful-revascularization-of-acute-middle-cerebral-artery-occlusion-by-intravenous-thrombolysis-while-on-apixaban
#15
Vivek K Nambiar, T S Dhanya, Amrutha V Ajai
No abstract text is available yet for this article.
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28615645/intravascular-forward-looking-ultrasound-transducers-for-microbubble-mediated-sonothrombolysis
#16
Jinwook Kim, Brooks D Lindsey, Wei-Yi Chang, Xuming Dai, Joseph M Stavas, Paul A Dayton, Xiaoning Jiang
Effective removal or dissolution of large blood clots remains a challenge in clinical treatment of acute thrombo-occlusive diseases. Here we report the development of an intravascular microbubble-mediated sonothrombolysis device for improving thrombolytic rate and thus minimizing the required dose of thrombolytic drugs. We hypothesize that a sub-megahertz, forward-looking ultrasound transducer with an integrated microbubble injection tube is more advantageous for efficient thrombolysis by enhancing cavitation-induced microstreaming than the conventional high-frequency, side-looking, catheter-mounted transducers...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#17
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28612911/short-term-efficacy-and-safety-of-three-different-antiplatelet-regimens-in-diabetic-patients-treated-with-primary-percutaneous-coronary-intervention-a-randomized-study
#18
Yang Liu, Hengliang Liu, Yibin Hao, Zhenxuan Hao, Guoying Geng, Wenjie Han, Qi Chen, Danli Wang, Lingzhi Liu, Kailong Jia, Yuxin Zhou
BACKGROUND: This study aimed to investigate the efficacy and safety of dual and triple antiplatelet therapy (DAPT and TAPT) in patients with diabetes and acute ST segment elevation myocardial infarction (D-STEMI), who had undergone primary percutaneous coronary intervention (PCI). METHODS: We designed a phase IV, single-center, randomized, double-blind, placebo-controlled study. The D-STEMI patients (N=258) were randomly divided into three groups. Control group A (85 patients), was treated with aspirin and clopidogrel; group B (87 patients) received aspirin, clopidogrel, and tirofiban; and group C (86 patients) was treated with aspirin, ticagrelor, and tirofiban...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28611834/mechanical-thrombectomy-in-pregnancy-report-of-2-cases-and-review-of-the-literature
#19
REVIEW
Pervinder Bhogal, Marta Aguilar, Muhammad AlMatter, Ulrich Karck, Hansjörg Bäzner, Hans Henkes
BACKGROUND: Mechanical thrombectomy has recently proved extremely effective in improving the outcome of patients with large vessel occlusion. Despite this, questions still remain over certain cohorts of patients that were excluded from the large randomised controlled trials. One such cohort includes pregnant patients. Although thromboembolic stroke is uncommon in pregnancy, the outcome from this pathology can be devastating. SUMMARY: We present 2 cases of mechanical thrombectomy in pregnancy both of which underwent successful flow restoration without complications...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28610742/interventional-treatment-for-hepatic-artery-thrombosis-after-liver-transplantation
#20
Hua Zhang, Sheng Qian, Rong Liu, Wei Yuan, Jian-Hua Wang
PURPOSE: To evaluate short-term and long-term effectiveness of interventional treatment for hepatic artery thrombosis (HAT). MATERIALS AND METHODS: From March 2003 to October 2015, 34 patients (32 male and 2 female; mean age, 45 y; range 7-64 y) with HAT were identified 0-21d (mean 6.5 d ± 6.0) after liver transplantation and underwent interventional treatments. Technical success, clinical success, complications, hepatic artery patency, and survival time were assessed...
June 11, 2017: Journal of Vascular and Interventional Radiology: JVIR
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