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Intracranial stenosis artery

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https://www.readbyqxmd.com/read/29684514/an-analysis-of-radiation-effects-in-digital-subtraction-angiography-of-intracranial-artery-stenosis
#1
Chaoqun Guo, Xiaolei Shi, Xianhui Ding, Zhiming Zhou
BACKGROUND: Intracranial artery stenosis (IAS) is the most common cause for acute cerebral accidents. Digital subtraction angiography (DSA) is the gold standard to detect IAS, and usually brings excess radiation exposure to examinees and examiners. The artery pathology might influence the interventional procedure, causing a prolonged radiation effects. However, no studies are available on the association between IAS pathology and operational parameters. METHODS: A retrospective analysis was conducted on 93 patients with first-ever stroke/transient ischemic attack (TIA), who received DSA examination within 3 months from onset in this single center...
April 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29681886/importance-of-collateralization-in-patients-with-large-artery-intracranial-occlusive-disease-long-term-longitudinal-assessment-of-cerebral-hemodynamic-function
#2
Larissa McKetton, Lakshmikumar Venkatraghavan, Julien Poublanc, Olivia Sobczyk, Adrian P Crawley, Casey Rosen, Frank L Silver, James Duffin, Joseph A Fisher, David J Mikulis
Patients with large artery intracranial occlusive disease (LAICOD) are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR) using blood oxygen level-dependent (BOLD) MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29680819/a-single-center-experience-in-the-endovascular-treatment-of-carotid-siphon-aneurysms-using-the-willis-covered-stent-a-retrospective-analysis
#3
Lin Ma, Ji-Chong Xu, Shuo Yan, Hao Feng, Hong-Jie Han, Hua-Qiao Tan, Chun Fang, Hong-En Huang
OBJECTIVE: To report the clinical results and initial clinical experience of endovascular isolation with the Willis covered stent for carotid siphon aneurysms. METHODS: Between November 2013 and December 2016, a total of 57 patients who presented with carotid siphon aneurysms were treated with the Willis covered stent. Results of the procedures, technical events, and complications were recorded. Clinical and imaging follow-ups were performed at 3 months following the endovascular procedures...
April 21, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29661647/which-ischemic-stroke-subtype-is-associated-with-hyperhomocysteinemia
#4
Levent Gungor, Murat Polat, Mehlika Berra Ozberk, Bahattin Avci, Ummet Abur
BACKGROUND: Stroke is still a major global health problem in both developed and developing countries. Defining stroke subtype and underlying etiologies is a major step to choose the best method for prophylaxis. Homocysteine is an endothelial toxin and elevated levels have been associated with stroke risk. In this study, we hypothesized that serum total homocysteine level may be related with specific atherothrombotic ischemic stroke subtypes and aimed to find if high serum homocysteine levels are correlated with any specific ischemic stroke subtype...
April 13, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29643681/mismatch-in-brain-perfusion-and-metabolism-detected-with-99m-tc-hexamethyl-propylene-amine-oxime-single-photon-emission-computed-tomography-and-18-f-fluorodeoxyglucose-positron-emission-tomography-in-moyamoya-disease
#5
Justo Serrano Vicente, Luis Fernández Prudencio, José Rafael Infante Torre, Juan Ignacio Rayo Madrid
We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with "puff of smoke" suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29627791/endovascular-recanalisation-with-drug-coated-balloon-for-chronic-symptomatic-middle-cerebral-artery-total-occlusion
#6
Jun Zhang, Xiao Zhang, Jin-Ping Zhang, Ju Han
The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29627787/tyrosine-kinase-inhibitor-induced-rapidly-progressive-vasculopathy-after-intracranial-stent-placement
#7
Ching-Jen Chen, Brian J Sorace, Aria Shakeri, Min S Park, Andrew M Southerland, Bradford B Worrall, M Yashar S Kalani
Tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia (CML) has been associated with progressive peripheral arterial disease and, more recently, rare cases of intracranial vascular stenosis have been reported. We report the fourth case of TKI treatment associated intracranial vasculopathy and rapid progression of intracranial vascular stenosis following intracranial stent placement. This was a 49-year-old woman who developed right-sided weakness, paresthesias, numbness, and speech difficulties 7 years following TKI treatment for CML...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29624153/occlusion-rates-of-intracranial-aneurysms-treated-with-the-pipeline-embolization-device-the-role-of-branches-arising-from-the-sac
#8
Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Alexandre Cordeiro Ulhôa, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Daniel Giansante Abud
OBJECTIVE The aim of this study was to compare the clinical and angiographic outcomes of intracranial aneurysms with and without branches arising from the sac after Pipeline embolization device (PED) treatment. METHODS This retrospective 2-center comparative study included 116 patients with 157 aneurysms that were treated with PEDs. Aneurysms were divided into 2 groups: one group had branches arising from the sac and the other group did not. Study end points included total aneurysm occlusion assessed by angiography at 6 and 12 months, death or stroke, technical complications, in-stent stenosis, patency of covered branches, and transient ischemia...
April 6, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29622556/accuracy-of-ct-angiography-for-differentiating-pseudo-occlusion-from-true-occlusion-or-high-grade-stenosis-of-the-extracranial-ica-in-acute-ischemic-stroke-a-retrospective-mr-clean-substudy
#9
M Kappelhof, H A Marquering, O A Berkhemer, J Borst, A van der Lugt, W H van Zwam, J A Vos, G Lycklama À Nijeholt, C B L M Majoie, B J Emmer
BACKGROUND AND PURPOSE: The absence of opacification on CTA in the extracranial ICA in acute ischemic stroke may be caused by atherosclerotic occlusion, dissection, or pseudo-occlusion. The latter is explained by sluggish or stagnant flow in a patent artery caused by a distal intracranial occlusion. This study aimed to explore the accuracy of CTA for differentiating pseudo-occlusion from true occlusion of the extracranial ICA. MATERIALS AND METHODS: All patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) with an apparent ICA occlusion on CTA and available DSA images were included...
April 5, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29615434/tyrosine-kinase-inhibitor-induced-rapidly-progressive-vasculopathy-after-intracranial-stent-placement
#10
Ching-Jen Chen, Brian J Sorace, Aria Shakeri, Min S Park, Andrew M Southerland, Bradford B Worrall, M Yashar S Kalani
Tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia (CML) has been associated with progressive peripheral arterial disease and, more recently, rare cases of intracranial vascular stenosis have been reported. We report the fourth case of TKI treatment associated intracranial vasculopathy and rapid progression of intracranial vascular stenosis following intracranial stent placement. This was a 49-year-old woman who developed right-sided weakness, paresthesias, numbness, and speech difficulties 7 years following TKI treatment for CML...
April 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29602861/relationship-between-stroke-recurrence-infarct-pattern-and-vascular-distribution-in-patients-with-symptomatic-intracranial-stenosis
#11
Karthikram Raghuram, Aditya Durgam, Jennifer Kohlnhofer, Ayush Singh
OBJECTIVE: In view of recent literature suggesting that stroke recurrence and risks related to intervention may be related to plaque physiology/instability, our study sought to discern the pattern of stroke and rates of stoke recurrence as they relate to the anatomy and presentation of the underlying stenosis. METHODS: Retrospective chart as well as CT and MR angiographic imaging review of patients in the institutional stroke database was performed, including identification of patient risk factors, medical therapeutic optimization, compliance, serum cholesterol (low density lipoprotein) levels, blood pressure, physical therapy referrals, follow-up clinical status (using the modified Rankin Scales), and rate of recurrent stroke...
March 30, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29601146/quantification-of-near-wall-hemodynamic-risk-factors-in-large-scale-cerebral-arterial-trees
#12
Mahsa Ghaffari, Ali Alaraj, Xinjian Du, Xiaohong Joe Zhou, Fady T Charbel, Andreas A Linninger
In the last decade, detailed hemodynamic analysis of blood flow in pathological segments close to aneurysm and stenosis has provided physicians with invaluable information about the local flow patterns leading to vascular disease. However, these diseases have both local and global effects on the circulation of the blood within the cerebral tree. The aim of this paper is to demonstrate the importance of extending subject-specific hemodynamic simulations to the large-scale cerebral arterial tree with hundreds of bifurcations and vessels, as well as evaluate hemodynamic risk factors and waveform shape characteristics throughout the cerebral arterial trees...
March 30, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29599173/parent-artery-reconstruction-for-large-or-giant-cerebral-aneurysms-using-the-tubridge-flow-diverter-a-multicenter-randomized-controlled-clinical-trial-parat
#13
J-M Liu, Y Zhou, Y Li, T Li, B Leng, P Zhang, G Liang, Q Huang, P-F Yang, H Shi, J Zhang, J Wan, W He, C Liang, G Zhu, Y Xu, B Hong, X Yang, W Bai, Y Tian, H Zhang, Z Li, Q Li, R Zhao, Y Fang, K Zhao
BACKGROUND AND PURPOSE: Although flow diverters have been reported with favorable clinical and angiographic outcomes in various literatures, randomized trials determining their true effectiveness and safety are still in lack. The Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter (PARAT) trial was designed to evaluate the safety and efficacy of the Tubridge flow diverter in the treatment of large or giant aneurysms in comparison with Enterprise stent-assisted coiling...
March 29, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29581240/intracranial-arterial-dolichoectasia-and-stenosis-risk-factors-and-relation-to-cerebral-small-vessel-disease
#14
Fei-Fei Zhai, Shuang Yan, Ming-Li Li, Fei Han, Quan Wang, Li-Xin Zhou, Jun Ni, Ming Yao, Shu-Yang Zhang, Li-Ying Cui, Zheng-Yu Jin, Yi-Cheng Zhu
BACKGROUND AND PURPOSE: Intracranial arterial dolichoectasia (IADE) is a poorly understood arteriopathy compared with intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the risk factors of IADE and ICAS and their relationship with neuroimaging markers of cerebral small vessel disease in a population-based study. METHODS: This study comprised 1237 participants (aged 57.2±9.4 years, 37.6% men) who underwent brain magnetic resonance imaging and magnetic resonance angiography...
March 26, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29576013/omega-3-fatty-acid-supplement-reduces-activation-of-nadph-oxidase-in-intracranial-atherosclerosis-stenosis
#15
Jiamei Shen, Radhika Rastogi, Longfei Guan, Fengwu Li, Huishan Du, Xiaokun Geng, Yuchuan Ding
Objectives Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of stroke worldwide. We adapted a rat model of atherosclerosis to study brain intracranial atherosclerosis, and further investigated how omega-3 fatty acids (O3FA) attenuated the development of ICAS by reducing the generation of reactive oxygen species (ROS) and the activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) activity. Methods Adult male Sprague-Dawley rats were divided into control normal-cholesterol or high-cholesterol diet groups with or without O3FA for up to 6 weeks...
March 24, 2018: Neurological Research
https://www.readbyqxmd.com/read/29568681/role-of-slox-1-in-intracranial-artery-stenosis-and-in-predicting-long-term-prognosis-of-acute-ischemic-stroke
#16
Xian-Mei Li, Ping-Ping Jin, Jie Xue, Jie Chen, Qin-Fen Chen, Xiao-Qian Luan, Zeng-Rui Zhang, Tie-Er Yu, Zheng-Yi Cai, Kai Zhao, Bei Shao
Objective: The role of sLOX-1 in acute ischemic stroke still remains unclear. This study aims to demonstrate the value of sLOX-1 in evaluating degrees of intracranial artery stenosis and to predict prognosis in stroke. Methods: Two hundred and seventy-two patients were included in this study and basic data were collected within 72 hr on admission. We assessed the association between sLOX-1 levels and stroke conditions in one-year duration. After adjusting for potential confounders, regression analyses were performed...
January 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29568679/immediate-and-late-outcomes-of-stenting-for-severe-extracranial-internal-carotid-artery-stenosis-in-octogenarian-patients
#17
Jin-Hai Duan, Shu-Wen Xu, Chengbo Dai, Hao Xiao, Jiayi Zhong, Faxin Ma, Jian-Wei Mo, Shuyuan Wang, Xiong Zhang, Zhanyi Lin
Background: Multiple studies suggest that internal carotid artery stenting can be performed safely in octogenarians with low periprocedural complication rates. However, great concern still exists as to whether these patients will gain long-term benefits from this procedure given their advanced age and uncertain life expectancy. We decided to conduct a retrospective study to determine short-and long-term clinical outcomes and to analyze survival duration in this population. Methods and Results: Sixty-nine consecutive elderly patients with either symptomatic or asymptomatic stenosis ≥70% underwent 86 procedures...
January 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29555729/catheter-exchange-technique-for-the-wingspan-stent-technical-note
#18
W S Lesley, R Rangaswamy
BACKGROUND AND PURPOSE: The only Food and Drug Administration-approved implant for managing intracranial stenosis is the Wingspan stent. Modification of the standard Wingspan stent delivery procedure has not been previously reported. MATERIAL AND METHODS: Retrospective, single-patient, technical report. RESULTS: Following uneventful balloon angioplasty, a symptomatic intracranial vertebral artery stenosis was inaccessible to Wingspan stent delivery using standard procedural protocol because of poor proximal guide catheter purchase...
April 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29545420/endovascular-recanalisation-with-drug-coated-balloon-for-chronic-symptomatic-middle-cerebral-artery-total-occlusion
#19
Jun Zhang, Xiao Zhang, Jin-Ping Zhang, Ju Han
The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29530461/long-term-outcome-of-balloon-angioplasty-without-stenting-for-symptomatic-middle-cerebral-artery-stenosis
#20
Toshihiro Ueda, Tatsuro Takada, Shinji Nogoshi, Tomohide Yoshie, Satoshi Takaishi, Takayuki Fukano
PURPOSE: A recent randomized controlled trial demonstrated that aggressive medical management was superior to angioplasty with stenting for intracranial stenosis. The purpose of this study was to assess initial and long-term outcomes of balloon angioplasty without stenting for symptomatic middle cerebral artery (MCA) stenosis. METHODS: We retrospectively analyzed the clinical data of 72 patients (mean age, 58.9 years old) with 84 balloon angioplasties without stenting for high-grade (>70%) atherosclerotic stenosis of the main trunk of the MCA...
March 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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