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Cerebrovascular anatomy

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https://www.readbyqxmd.com/read/29719557/stent-reconstruction-of-carotid-tonsillar-loop-dissection-using-telescoping-peripheral-stents
#1
Benjamin M Zussman, Bradley A Gross, William J Ares, Cynthia L Kenmuir, Gregory M Weiner, David M Panczykowski, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Background: Endovascular treatment options for internal carotid artery (ICA) dissection with tandem intracranial occlusion are evolving. We report 2 cases of stent reconstruction of carotid loop dissections. Methods: Two patients with symptomatic ICA dissections of true 360° tonsillar loops and tandem intracranial occlusions were treated with manual aspiration thrombectomy (MAT) and telescoping Zilver self-expanding peripheral stents. Patient demographics, clinical presentations, endovascular techniques, and clinical outcomes were reviewed...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29709754/incidentally-found-double-aortic-arch-while-treating-a-posterior-inferior-cerebellar-artery-aneurysm-conversion-from-femoral-to-radial-artery-access
#2
Mayank Patel, Joe Iwananga, Josh Bentley, Bill H Wang, Akil Patel, R Shane Tubbs, Steve Monteith
Asymptomatic double aortic arches are a unique occurrence. An incidental finding of a double aortic arch in an elderly male was discovered during work up of a transient ischemic attack. The following case presentation details an effective treatment approach in cerebrovascular stenting in a patient with variant aortic arch anatomy. The initial diagnostic cerebral angiogram was performed via trans-femoral approach and was quite challenging. Faced with challenging anatomy, the radial artery approach is a viable option when navigating into the cerebrovascular anatomy for stenting when proximal variants such as a double aortic arch are identified...
April 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29675962/dual-wavelength-hybrid-optoacoustic-ultrasound-biomicroscopy-for-functional-imaging-of-large-scale-cerebral-vascular-networks
#3
Johannes Rebling, Héctor Estrada, Sven Gottschalk, Gali Sela, Michael Zwack, Georg Wissmeyer, Vasilis Ntziachristos, Daniel Razansky
A critical link exists between pathological changes of cerebral vasculature and diseases affecting brain function. Microscopic techniques have played an indispensable role in the study of neurovascular anatomy and functions. Yet, investigations are often hindered by sub-optimal trade-offs between the spatiotemporal resolution, field-of-view and type of contrast offered by the existing optical microscopy techniques. We present a hybrid dual-wavelength optoacoustic biomicroscope capable of rapid transcranial visualization of large-scale cerebral vascular networks...
April 19, 2018: Journal of Biophotonics
https://www.readbyqxmd.com/read/29675634/investigation-of-circle-of-willis-variants-and-hemodynamic-parameters-in-twins-using-transcranial-color-coded-doppler-sonography
#4
Bianka Forgó, Ádám Domonkos Tárnoki, Dávid László Tárnoki, Levente Littvay, Corrado Fagnani, Maria Antonietta Stazi, Giorgio Meneghetti, Emanuela Medda, Filippo Farina, Claudio Baracchini
Morphological and hemodynamic variations of the circle of Willis (CW) may have an important impact on cerebrovascular events. However, the environmental and genetic influence remains unclear. For this reason we studied the variations and hemodynamic parameters of the CW in twins using transcranial color-coded sonography (TCCS). Sixty-four twins, 19 monozygotic (MZ) and 13 dizygotic (DZ) pairs from the Italian Twin Registry (average age 45.0 ± 13.7 years) underwent TCCS and risk factor assessment. We examined CW morphology and recorded peak systolic velocity (PSV), end-diastolic velocity (EDV) and pulsatility index (PI)...
April 19, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29610442/multicenter-registry-of-real-world-patients-with-severely-calcified-coronary-lesions-undergoing-orbital-atherectomy-1-year-outcomes
#5
Michael S Lee, Evan Shlofmitz, Alec Goldberg, Richard Shlofmitz
OBJECTIVES: We report the 1-year outcomes of real-world patients with severely calcified coronary arteries who underwent orbital atherectomy. BACKGROUND: Percutaneous coronary intervention of heavily calcified lesions is technically challenging and associated with worse clinical outcomes. Modification of severely calcified coronary lesions with orbital atherectomy facilitates stent delivery and expansion. Although we previously reported the safety of orbital atherectomy at 30 days in all comers with severely calcified coronary lesions, including patients who were excluded from the ORBIT II trial, longer-term follow-up is unknown...
April 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29561225/cerebrovascular-blood-oxygenation-level-dependent-pulsatility-at-baseline-and-following-acute-exercise-among-healthy-adolescents
#6
Athena E Theyers, Benjamin I Goldstein, Arron Ws Metcalfe, Andrew D Robertson, Bradley J MacIntosh
Arterial stiffness is linked to cerebral small vessel damage and neurodegeneration, but barriers to accessing deep cerebrovascular anatomy limit our ability to assess the brain. This study describes an adaptation of a cardiac-related scrubbing method as a means of generating blood oxygenation level-dependent pulsatility maps based on the cardiac cycle. We examine BOLD pulsatility at rest, based on the non-parametric deviation from null metric, as well as changes following acute physiological stress from 20 min of moderate-intensity cycling in 45 healthy adolescents...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29531770/critical-appraisal-of-cardiology-guidelines-on-revascularisation-clinical-practice
#7
REVIEW
David R Dobies, Kimberly R Barber
Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials...
2018: Open Heart
https://www.readbyqxmd.com/read/29524709/the-history-and-evolution-of-internal-maxillary-artery-bypass
#8
REVIEW
Long Wang, Li Cai, Shuaibin Lu, Hai Qian, Michael T Lawton, Xiang'en Shi
Internal maxillary artery (IMA) bypass has gained momentum in the last 5 years for the treatment of complex cerebrovascular disorders and skull base tumors. However, some issues regarding this treatment modality have been proposed. As one of the most experienced neurosurgical teams to perform internal maxillary artery bypass in the world (>100 clinical cases), we reviewed the literature in aspects of basic anatomy of maxillary artery with its variations to the lateral pterygoid muscle, initial anastomosis modalities, and subsequent exposure techniques in cadaver studies, preoperative arterial evaluation methods, optimal interposed graft selections, and surgical outcome in the management of complex aneurysms, skull base tumors, and steno-occlusive disorders...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29515376/cerebral-artery-diameter-in-inbred-mice-varies-as-a-function-of-strain
#9
Baogang Qian, Robert F Rudy, Tianxi Cai, Rose Du
Many strains of mice are utilized in mouse models of cerebrovascular diseases. Variations in vascular anatomy between these strains has been documented and may influence the phenotype in stroke models. To address inter-strain variations in the circle of Willis anatomy, the diameters of internal carotid, posterior communicating, anterior cerebral, and middle cerebral arteries in 144 mice from 32 inbred strains were measured. Arterial diameters were analyzed as a function of animal weight, age, and strain. Variations in the structure of the circle of Willis across strains were observed and noted...
2018: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29507782/eyes-and-stroke-the-visual-aspects-of-cerebrovascular-disease
#10
REVIEW
John H Pula, Carlen A Yuen
A large portion of the central nervous system is dedicated to vision and therefore strokes have a high likelihood of involving vision in some way. Vision loss can be the most disabling residual effect after a cerebral infarction. Transient vision problems can likewise be a harbinger of stroke and prompt evaluation after recognition of visual symptoms can prevent future vascular injury. In this review, we discuss the visual aspects of stroke. First, anatomy and the vascular supply of the visual system are considered...
December 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/29502793/a-meta-analysis-comparing-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-disease
#11
Vamsi Kodumuri, Senthil Balasubramanian, Aviral Vij, Sisir Siddamsetti, Ankur Sethi, Rommy Khalafallah, Sandeep Khosla
Coronary artery bypass grafting (CABG) is the preferred revascularization strategy for unprotected left main disease (UPLMD). Multiple small-scale trials and registry data showed that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is a noninferior strategy with a Class IIa American College of Cardiology/American Heart Association recommendation in patients with high surgical risk and favorable anatomy. However, 2 recent large-scale randomized trials showed conflicting evidence. We conducted a meta-analysis of the existing data to compare outcomes of PCI with DES versus CABG for UPLMD...
April 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29484629/the-geometry-of-the-circle-of-willis-anatomical-variants-as-a-potential-cerebrovascular-risk-factor
#12
Raluca Pascalau, Vlad Adrian Padurean, Dana BARTOș, Adrian BARTOș, Bianca Aurora Szabo
AIM: Anatomical variants of the circle of Willis are diverse and frequent and, although they are not a direct cause of cerebrovascular diseases, they are risk factors for impaired collateral perfusion and wall shear stress. This study aimed to correlate the anatomical variants with their effects on the hemodynamic and geometrical parameters responsible for the pathogenesis of neurological diseases. MATERIAL AND METHODS: The circle of Willis and the proximal segments of the main arteries were dissected and measured on ten formalin-fixed human brains...
February 7, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29479090/mra-based-evaluation-of-anatomical-variation-of-circle-of-willis-in-adult-pakistanis
#13
Rehana Shaikh, Saba Sohail
OBJECTIVE: To determine the frequency and patterns of normal anatomical variation of Circle of Willis on magnetic resonance angiogram in adults without cerebrovascular disease. METHODS: This descriptive cross-sectional study was conducted at the Radiology Department of Dow University of Health Sciences / Civil Hospital, Karachi, from January to December 2016, and comprised patients referred for magnetic resonance imaging of the brain and magnetic resonance angiogram without any clinical or radiological manifestation of cerebrovascular disease, primarily including those with suspected demyelination, infection, epilepsy or metastases...
February 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29365098/safety-of-perioperative-cerebral-oxygen-saturation-during-debranching-in-patients-with-incomplete-circle-of-willis
#14
Yosuke Takahashi, Takashi Murakami, Yasuyuki Sasaki, Yasuyuki Bito, Hiromichi Fujii, Shinsuke Nishimura, Toshihiko Shibata
OBJECTIVES: The consequences of common carotid artery (CCA) cross-clamping during debranching before thoracic endovascular aortic repair are unclear. We examined the safety of a simple CCA cross-clamping procedure under regional cerebral oxygen saturation monitoring (rSO2) in patients with a complete or incomplete circle of Willis (CoW) anatomy. METHODS: Twenty-eight patients with thoracic aneurysm underwent elective debranching thoracic endovascular aortic repair with bilateral frontal rSO2 monitoring at our institution between January 2012 and October 2015...
January 19, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29357762/outcome-and-selection-of-revascularization-strategy-in-left-main-coronary-artery-stenosis
#15
Thomas Gripenberg, Fadi Jokhaji, Nikolaos Östlund-Papadogeorgos, Christina Ekenbäck, Rikard Linder, Bassem Samad, Jonas Persson
OBJECTIVES: To investigate clinical outcome in unselected real-life patients with unprotected left main coronary artery (ULMCA) stenosis and determine factors associated with selection of revascularization strategy. DESIGN: Consecutive patients with ULMCA stenosis at our institution in 2009-2013 (n = 308) were retrospectively analyzed with propensity score adjusted Cox proportional hazards models for outcome. Baseline characteristics in relation to selection of revascularization strategy were analyzed with multivariate logistic regression...
April 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29302189/the-effect-of-demographic-features-on-aortic-arch-anatomy-and-its-role-in-the-etiology-of-cerebrovascular-disease
#16
Yılmaz İnanç, Yusuf İnanç, Halil Ay
Purpose: The aim of this study was to retrospectively evaluate the distribution of aortic arches, the relationship with demographic characteristics, and the results of carotid and vertebral artery stenting procedures in patients diagnosed with cerebrovascular disease through the intra-arterial digital subtraction angiography (DSA) technique. Methods: A retrospective examination was performed on 288 patients diagnosed with cerebrovascular disease, who underwent DSA in the Department of Neurology of Gaziantep University Medical Faculty and Kahramanmaraş¸ Sütçü Imam University Medical Faculty...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29242494/incidental-anatomic-finding-of-celiacomesenteric-trunk-associated-with-nutcracker-phenomenon-or-compression-of-the-left-renal-vein
#17
Joshua Peterson, Anthony N Hage, Stephan Diljak, Benjamin D Long, Daniel P Marcusa, John M Stribley, David W Brzezinski, Jonathan Eliason
BACKGROUND Celiacomesenteric trunk (CMT) is a very rare anatomic finding in which the celiac artery and the superior mesenteric artery (SMA) originate from the abdominal aorta through a common trunk. Clinical associations with CMT include arterial aneurysm, thrombosis, and celiac artery compression. However, an association between CMT and abdominal venous congestion caused by left renal vein compression, or 'nutcracker phenomenon,' has not been previously reported. CASE REPORT A 91-year-old woman, who died from a cerebrovascular accident (CVA), underwent a cadaveric examination at our medical school...
December 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29175567/flat-detector-computed-tomography-for-evaluation-of-intracerebral-vasculature-for-planning-of-stereoelectroencephalography-electrode-implantation
#18
Richard F Schmidt, Michael J Lang, Christian M Hoelscher, Pascal M Jabbour, Stavropoula I Tjoumakaris, Ashwini D Sharan, Chengyuan Wu
OBJECTIVE: Stereoelectroencephalography (sEEG) requires extensive preoperative planning to optimize placement of electrodes and limit the potential for complications. Flat-detector computed tomography (FD-CT) has previously been used for perioperative vascular imaging to guide the treatment of vascular lesions. This imaging modality provides a detailed depiction of cerebrovascular and bony cranial anatomy, which can be used to guide intracranial electrode implantation. We have developed a novel method to improve preoperative planning for sEEG electrode implantation and limit the potential for postoperative complications by using FD-CT imaging merged with preoperative magnetic resonance imaging (MRI)...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29149371/imaging-patterns-of-venous-related-brain-injury-in-children
#19
Luke L Linscott, James L Leach, Blaise V Jones, Todd A Abruzzo
Venous-related brain injury is a common form of cerebrovascular injury in children and encompasses a diverse group of cerebrovascular diagnoses. The purpose of this pictorial essay is to introduce the relevant anatomy, pathophysiology and various imaging patterns of venous-related cerebral injury in children. Unifying concepts to better understand the effects of venous hypertension in the developing brain will be emphasized. These unifying concepts will provide the imaging professional with a conceptual framework to better understand and confidently identify imaging patterns of venous-related cerebral injury...
December 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29113863/long-term-outcomes-after-carotid-artery-stenting-of-patients-with-prior-neck-irradiation-or-surgery
#20
Ho-Hin K Choy, Damianos G Kokkinidis, Ryan Cotter, Gagan D Singh, R Kevin Rogers, Stephen W Waldo, John R Laird, Ehrin J Armstrong
BACKGROUND: Carotid artery stenting (CAS) is often performed in patients with carotid artery stenosis who have relative contraindications to carotid endarterectomy (CEA), including hostile neck anatomy (e.g., history of neck irradiation or prior surgery). We examined the impact of hostile neck anatomy on long-term outcomes after CAS. METHODS: All carotid artery stent procedures performed at two institutions from 2006 to 2016 were reviewed. Routine duplex carotid ultrasound was used to assess target lesion restenosis at regular intervals...
September 21, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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