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https://www.readbyqxmd.com/read/28108793/effective-cerebrovascular-thrombectomy-requires-well-organized-structures-real-world-experiences-of-a%C3%A2-regional-stroke-network-between-2012-2015
#1
Maria Sophie Stockinger, Johannes Trenkler, Tim von Oertzen, Karin Nussbaumer, Michael Sonnberger, Wolfgang Schimetta, Anthony C Pereira, Gerhard Traxler, Claudia Dorninger, Hans-Peter Haring
BACKGROUND: The objective of this study was to analyse the Neurothrombectomy Network registry of the Neuromed Campus (NMC) of the Kepler University Hospital in Linz (Austria). The data were compared to the results of recently published thrombectomy trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, REVASCAT and THRACE). METHODS: We retrospectively studied 246 patients with acute ischemic stroke who underwent thrombectomy between January 2012 and December 2015 at the NMC in Upper Austria...
January 20, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28105087/long-term-prognostic-analysis-of-early-interventional-therapy-for-lower-extremity-deep-venous-thrombosis
#2
Qiang Li, Zongxue Yu, Jinjun Wang, Xiao Chen, Lin Li
The aim of the present study was to observe the long-term prognostic value of early interventional therapy for lower extremity deep venous thrombosis (LDVT). In total, 85 patients diagnosed with LDVT for the first time were consecutively selected (identified course of disease was <3 months), and were divided into the control group with 43 cases and the observation group with 42 cases according to different therapeutic methods. The control group received anticoagulation therapy and thrombolysis, or integrated surgical thrombectomy, a conventional open operation, while the observation group received comprehensive treatment, combining endovascular catheter-directed thrombolysis and thrombectomy...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104836/validating-a-predictive-model-of-acute-advanced-imaging-biomarkers-in-ischemic-stroke
#3
Andrew Bivard, Christopher Levi, Longting Lin, Xin Cheng, Richard Aviv, Neil J Spratt, Min Lou, Tim Kleinig, Billy O'Brien, Kenneth Butcher, Jingfen Zhang, Jim Jannes, Qiang Dong, Mark Parsons
BACKGROUND AND PURPOSE: Advanced imaging to identify tissue pathophysiology may provide more accurate prognostication than the clinical measures used currently in stroke. This study aimed to derive and validate a predictive model for functional outcome based on acute clinical and advanced imaging measures. METHODS: A database of prospectively collected sub-4.5 hour patients with ischemic stroke being assessed for thrombolysis from 5 centers who had computed tomographic perfusion and computed tomographic angiography before a treatment decision was assessed...
January 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28104770/decline-in-cardiovascular-mortality-possible-causes-and-implications
#4
REVIEW
George A Mensah, Gina S Wei, Paul D Sorlie, Lawrence J Fine, Yves Rosenberg, Peter G Kaufmann, Michael E Mussolino, Lucy L Hsu, Ebyan Addou, Michael M Engelgau, David Gordon
If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and stroke has been the success story of the century's past 4 decades. The early phase of this decline in coronary heart disease and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the US population aged. However, in 1978, the participants in a conference convened by the National Heart, Lung, and Blood Institute concluded that a significant recent downtick in coronary heart disease and stroke mortality rates had definitely occurred, at least in the US Since 1978, a sharp decline in mortality rates from coronary heart disease and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one third of their 1960s baseline by 2000...
January 20, 2017: Circulation Research
https://www.readbyqxmd.com/read/28102772/an-extensive-suprarenal-inferior-vena-cava-thrombosis-successfully-treated-with-catheter-directed-thrombolysis-in-a-postpartum-14-year-old-girl
#5
Roxana Cristina Rimbas, Simona Ionela Călin, Horatiu Ionescu, Bogdan Dorobat, Dragos Vinereanu, Mircea Cinteza
We report a case of extensive early postpartum acute suprarenal inferior vena cava thrombosis in a 14-year-old girl. Management included catheter-directed-thrombolysis, aiming to save renal function and prevent fatal pulmonary embolism. Treatment decisions were mostly based on adult guidelines, as guidelines for the paediatric population are not yet available.
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January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28102048/proteinuria-as-an-important-marker-in-the-evaluation-of-the-efficacy-and-safety-of-systemic-thrombolysis-in-patients-with-acute-ischaemic-stroke
#6
EDITORIAL
P Sobolewski
No abstract text is available yet for this article.
February 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28101942/the-use-of-hemodynamic-support-in-massive-pulmonary-embolism
#7
Neal Kumar Bhatia, Neal W Dickert, Habib Samady, Vasilis Babaliaros
Massive pulmonary embolism is life threatening and can present as cardiogenic shock and cardiac arrest. We report a case of a 47-year-old male who arrested during his postoperative hospitalization and was found to have a massive pulmonary embolism with bilateral involvement of the pulmonary arteries. Given his profound shock and right ventricular failure, an Impella RP was used to stabilize his acute right ventricular failure while percutaneous embolectomy and thrombolysis was used to treat the pulmonary embolism...
January 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28100973/endovascular-treatment-of-superior-vena-cava-syndrome-via-balloon-in-balloon-catheter-technique-with-a-palmaz-stent
#8
Wassim Shatila, Abdelkader Almanfi, Mehran Massumi, Kathryn G Dougherty, Dhaval R Parekh, Neil E Strickman
Superior vena cava syndrome is a well-known disease entity that carries substantial rates of morbidity and mortality. Although most cases of superior vena cava syndrome are secondary to a malignant process, additional causes (such as mediastinal fibrosis, pacemaker lead implantation, or central venous catheter placement) have been reported. Multiple treatment options include percutaneous transluminal angioplasty, stent implantation, thrombolysis, mechanical thrombectomy, and venous grafting. We present a case of superior vena cava syndrome in a symptomatic 30-year-old woman who obtained complete relief of obstruction and marked symptomatic improvement through venoplasty and stenting, aided by our use of a balloon-in-balloon catheter system...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28100764/drip-n-ship-versus-mothership-for-endovascular-treatment-modeling-the-best-transportation-options-for-optimal-outcomes
#9
Matthew S W Milne, Jessalyn K Holodinsky, Michael D Hill, Anders Nygren, Chao Qiu, Mayank Goyal, Noreen Kamal
BACKGROUND AND PURPOSE: There is uncertainty regarding the best way for patients outside of endovascular-capable or Comprehensive Stroke Centers (CSC) to access endovascular treatment for acute ischemic stroke. The role of the nonendovascular-capable Primary Stroke Centers (PSC) that can offer thrombolysis with alteplase but not endovascular treatment is unclear. A key question is whether average benefit is greater with early thrombolysis at the closest PSC before transportation to the CSC (Drip 'n Ship) or with PSC bypass and direct transport to the CSC (Mothership)...
January 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28097310/combined-intravenous-thrombolysis-and-thrombectomy-vs-thrombectomy-alone-for-acute-ischemic-stroke-a-pooled-analysis-of-the-swift-and-star-studies
#10
Jonathan M Coutinho, David S Liebeskind, Lee-Anne Slater, Raul G Nogueira, Wayne Clark, Antoni Dávalos, Alain Bonafé, Reza Jahan, Urs Fischer, Jan Gralla, Jeffrey L Saver, Vitor M Pereira
Importance: Mechanical thrombectomy (MT) improves clinical outcomes in patients with acute ischemic stroke (AIS) caused by a large vessel occlusion. However, it is not known whether intravenous thrombolysis (IVT) is of added benefit in patients undergoing MT. Objective: To examine whether treatment with IVT before MT with a stent retriever is beneficial in patients undergoing MT. Design, Setting, and Participants: This post hoc analysis used data from 291 patients treated with MT included in 2 large, multicenter, prospective clinical trials that evaluated MT for AIS (Solitaire With the Intention for Thrombectomy performed from January 1, 2010, through December 31, 2011, and Solitaire Flow Restoration Thrombectomy for Acute Revascularization from January 1, 2010, through December 31, 2012)...
January 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28096210/pace-of-progress-in-stroke-thrombolysis-are-hospitals-running-to-stand-still
#11
EDITORIAL
Scott J Mendelson, Shyam Prabhakaran
No abstract text is available yet for this article.
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096032/creation-of-an-intensive-care-unit-and-organizational-changes-in-an-adult-emergency-department-impact-on-acute-stroke-management
#12
Laurent Puy, Chantal Lamy, Sandrine Canaple, Audrey Arnoux, Nicolas Laine, Ella Iacob, Jean-Marc Constans, Olivier Godefroy
BACKGROUND AND PURPOSE: Following the reorganization of a University Medical Center onto a single campus, an Intensive Care Unit was created within the adult Emergency Department (ED ICU). We assessed the effects of these organizational changes on acute stroke management and the intravenous administration of recombinant tissue plasminogen activator (IV rtPA), as characterized by the thrombolysis rate, door-to-needle time (DNT) and outcome at 3months. METHODS: Between October 2013 and September 2015, we performed a retrospective, observational, single-center, comparative study of patients admitted for ischemic stroke and treated with IV rtPA during two 321-day periods (before and after the creation of the ED ICU)...
January 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28095449/does-antiplatelet-therapy-during-bridging-thrombolysis-increase-rates-of-intracerebral-hemorrhage-in-stroke-patients
#13
Anne Broeg-Morvay, Pasquale Mordasini, Agnieszka Slezak, Kai Liesirova, Julia Meisterernst, Gerhard Schroth, Marcel Arnold, Simon Jung, Heinrich P Mattle, Jan Gralla, Urs Fischer
BACKGROUND: Symptomatic intracerebral hemorrhage (sICH) after bridging thrombolysis for acute ischemic stroke is a devastating complication. We aimed to assess whether the additional administration of aspirin during endovascular intervention increases bleeding rates. METHODS: We retrospectively compared bleeding complications and outcome in stroke patients who received bridging thrombolysis with (tPA+ASA) and without (tPA-ASA) aspirin during endovascular intervention between November 2008 and March 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28092248/-pulmonary-thromboembolism-recent-experience-of-4-years-at-a-cardiology-hospital
#14
Erick Ramírez-Arias, Martin Rosas-Peralta, Gabriela Borrayo-Sánchez, Luis Antonio Moreno-Ruiz, Jorge Guillermo Arenas-Fonseca, Víctor Manuel Arzola-Covarrubias, Luis Efrén Santos-Martínez, Efraín Arizmendi-Uribe
It comprised a series of cases over a period of 4 years, held at the Hospital of Cardiology of the Centro Médico Nacional Siglo XXI, IMSS. From 2008 to 2011, admitted to Emergency 184 patients with suspected pulmonary embolism, of which 41 were removed; of the 143 remaining cases, only 127 patients was diagnosed with PE. The other 16 patients had other diagnoses. In 86% of patients showed electrocardiographic pattern S1Q3T3 and 39% had RBBB, in 17 (13.3%) patients there was hemodynamic instability, and in 94...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#15
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28089493/recent-advances-of-stroke-thrombolysis-in%C3%A2-taiwan-a-successful-interaction-between%C3%A2-physicians-regulators-and-national-health-insurance-administration
#16
Cheng-Yang Hsieh, Ruey-Tay Lin, Han-Hua Hu
No abstract text is available yet for this article.
January 12, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28087804/clinical-selection-strategies-to-identify-ischemic-stroke-patients-with-large-anterior-vessel-occlusion-results-from-sits-istr-safe-implementation-of-thrombolysis-in-stroke-international-stroke-thrombolysis-registry
#17
Jan F Scheitz, Azmil H Abdul-Rahim, Rachael L MacIsaac, Charith Cooray, Heidi Sucharew, Dawn Kleindorfer, Pooja Khatri, Joseph P Broderick, Heinrich J Audebert, Niaz Ahmed, Nils Wahlgren, Matthias Endres, Christian H Nolte, Kennedy R Lees
BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) correlates with presence of large anterior vessel occlusion (LAVO). However, the application of the full NIHSS in the prehospital setting to select patients eligible for treatment with thrombectomy is limited. Therefore, we aimed to evaluate the prognostic value of simple clinical selection strategies. METHODS: Data from the Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry (January 2012-May 2014) were analyzed retrospectively...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28081270/outcome-and-treatment-effects-in-stroke-associated-with-acute-cervical-ica-occlusion
#18
Michael Gliem, John-Ih Lee, Aurica Barckhan, Bernd Turowski, Hans-Peter Hartung, Sebastian Jander
BACKGROUND: Endovascular therapy (EVT) with stent retrievers in addition to i.v. thrombolysis (IVT) has proven effective in acute stroke patients with middle cerebral artery (MCA, M1 segment) and distal internal carotid artery (ICA) occlusion. Limited data exist concerning acute cervical ICA occlusion, either alone or in combination with intracranial ICA occlusion (tandem occlusion). Therefore we analyzed outcome and treatment effects in stroke associated with cervical ICA occlusion, with specific focus on the impact of intracranial ICA or M1 patency...
2017: PloS One
https://www.readbyqxmd.com/read/28081269/morphine-does-not-affect-myocardial-salvage-in-st-segment-elevation-myocardial-infarction
#19
Hye Bin Gwag, Taek Kyu Park, Young Bin Song, Eun Kyoung Kim, Woo Jin Jang, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Yeon Hyeon Choe, Joonghyun Ahn, Keumhee Chough Carriere, Hyeon-Cheol Gwon
Recent studies have proposed intravenous (IV) morphine is associated with delayed action of antiplatelet agents in acute myocardial infarction. However, it is unknown whether morphine results in increased myocardial damage in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated myocardial salvage index (MSI) to determine whether IV morphine affects myocardial injury adversely in STEMI patients undergoing primary PCI. 299 STEMI patients underwent contrast-enhanced magnetic resonance imaging a median of 3 days after PCI...
2017: PloS One
https://www.readbyqxmd.com/read/28079139/blood-occludin-level-as-a-potential-biomarker-for-early-blood-brain-barrier-damage-following-ischemic-stroke
#20
Rong Pan, Kewei Yu, Theodore Weatherwax, Handong Zheng, Wenlan Liu, Ke Jian Liu
Concern about intracerebral hemorrhage (ICH) is the primary reason for withholding tPA therapy from patients with ischemic stroke. Early blood brain barrier (BBB) damage is the major risk factor for fatal post-thrombolysis ICH, but rapidly assessing BBB damage before tPA administration is highly challenging. We recently reported that ischemia induced rapid degradation of tight junction protein occludin in cerebromicrovessels. The present study investigates whether the cleaved occludin is released into the blood stream and how blood occludin levels correlate to the extent of BBB damage using a rat model of ischemic stroke...
January 12, 2017: Scientific Reports
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