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Intracranial stenosis artery

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https://www.readbyqxmd.com/read/29044753/development-of-a-quantitative-intracranial-vascular-features-extraction-tool-on-3d-mra-using-semiautomated-open-curve-active-contour-vessel-tracing
#1
Li Chen, Mahmud Mossa-Basha, Niranjan Balu, Gador Canton, Jie Sun, Kristi Pimentel, Thomas S Hatsukami, Jenq-Neng Hwang, Chun Yuan
PURPOSE: To develop a quantitative intracranial artery measurement technique to extract comprehensive artery features from time-of-flight MR angiography (MRA). METHODS: By semiautomatically tracing arteries based on an open-curve active contour model in a graphical user interface, 12 basic morphometric features and 16 basic intensity features for each artery were identified. Arteries were then classified as one of 24 types using prediction from a probability model...
October 17, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29037013/angioplasty-stenting-and-other-potential-treatments-of-atherosclerotic-stenosis-of-the-intracranial-arteries-past-present-and-future
#2
REVIEW
Ashley Wabnitz, Marc Chimowitz
Although there is an intuitive appeal to treat symptomatic stenotic intracranial arteries with endovascular therapies such as angioplasty and stenting, current data from randomized trials show intensive medical therapy is far superior for preventing stroke. This is in large part due to the high risk of peri-procedural stroke from angioplasty and stenting. If angioplasty and stenting is to emerge as a proven treatment for intracranial stenosis, endovascular techniques will need to become much safer, identification of patients with intracranial stenosis who are at particularly high risk of stroke despite intensive medical therapy will need to be targeted, and well-designed randomized trials will be necessary to show endovascular therapy is superior to medical therapy in these high-risk patients...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29037012/medical-treatment-of-intracranial-atherosclerosis-an-update
#3
REVIEW
Jong S Kim, Oh Young Bang
For patients with symptomatic intracranial atherosclerosis (ICAS), antithrombotic agents are the mainstay of therapy. Anticoagulation (warfarin) is not widely used since it is not more effective than aspirin and carries a high risk of bleeding. New oral anticoagulants are showing promise, but their use has not been investigated in appropriate clinical trials. Since the recurrent stroke risk is high with aspirin monotherapy, dual antiplatelets are considered in the early stage of symptomatic ICAS. Based on the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) results, aspirin plus clopidogrel has been recommended...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29021314/augmented-3d-venous-navigation-for-neuroendovascular-procedures
#4
Raphaël Blanc, Robert Fahed, Pascal Roux, Stanislas Smajda, Gabriele Ciccio, Jean-Philippe Desilles, Hocine Redjem, Mikael Mazighi, Humain Baharvahdat, Michel Piotin
BACKGROUND: Endovascular venous access is increasingly used for the treatment of many cerebrovascular diseases. The quality of venous roadmapping through arterial injection can be problematic because of contrast media dilution, slow flow velocity, and unilateral opacification of the venous system. OBJECTIVE: To describe our experience with the VesselNavigator (Philips Healthcare, Best, The Netherlands) in performing live 3D roadmapping for intracranial venous procedures...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#5
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#6
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28974634/one-year-outcomes-after-minor-stroke-or-high-risk-transient-ischemic-attack-korean-multicenter-stroke-registry-analysis
#7
Hong-Kyun Park, Beom Joon Kim, Moon-Ku Han, Jong-Moo Park, Kyusik Kang, Soo Joo Lee, Jae Guk Kim, Jae-Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Tai Hwan Park, Sang-Soon Park, Kyung Bok Lee, Jun Lee, Keun-Sik Hong, Yong-Jin Cho, Byung-Chul Lee, Kyung-Ho Yu, Mi-Sun Oh, Joon-Tae Kim, Kang-Ho Choi, Dong-Eog Kim, Wi-Sun Ryu, Jay Chol Choi, Saga Johansson, Su Jin Lee, Won Hee Lee, Ji Sung Lee, Juneyoung Lee, Hee-Joon Bae
BACKGROUND AND PURPOSE: Patients with minor ischemic stroke or transient ischemic attack are at high risk of recurrent stroke and vascular events, which are potentially disabling or fatal. This study aimed to evaluate contemporary subsequent vascular event risk after minor ischemic stroke or transient ischemic attack in Korea. METHODS: Patients with minor ischemic stroke or high-risk transient ischemic attack admitted within 7 days of symptom onset were identified from a Korean multicenter stroke registry database...
October 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28969739/hyperhomocysteinemia-presenting-with-complete-unilateral-intracranial-and-extracranial-carotid-occlusion-in-a-young-patient
#8
Farheen Niazi, Abdul Rahman, Uzma Batool
Hyperhomocysteinemia has been associated with premature peripheral vascular, cerebrovascular, and coronary artery disease. It has been associated with vascular diseases including cerebrovascular disease, particularly in subjects with significant carotid stenosis. However, hyperhomocysteinemia causing unilateral complete occlusion of whole of internal carotid, common carotid, and external carotid has been rarely reported. We report a case of an adult patient aged 35-year with complete occlusion of right common carotid, internal carotid, both intracranial and extracranial part, presented with recurrent TIAs and stroke and was found to be having hyperhomocysteinemia as the cause of this complete occlusion and showed marked clinical recovery with appropriate treatment...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28958688/what-influenced-the-lesion-patterns-and-hemodynamic-characteristics-in-patients-with-internal-carotid-artery-stenosis-a-retrospective-study
#9
Jinjie Liu, Hong Wang, Meiyan Zhang, Xiaowen Sui, Furong Li, Zanhua Liu, Sibo Liu, Hongling Zhao
OBJECTIVES: This study aimed to explore the dynamic changes of lesion patterns and hemodynamic characteristics in patients with internal carotid artery stenosis (ICAS). PATIENTS AND METHODS: Patients who had suffered an acute ischemic stroke in the distribution of ipsilateral ICAS were included. Computed tomography (CT) and transcranial doppler ultrasound (TCD) were conducted to evaluate the degree of ICAS and the hemodynamic characteristics of the intracranial and extracranial arteries...
August 23, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28954339/-concomitant-unruptured-intracranial-aneurysms-and-ischemic-cerebrovascular-diseases-a-surgical-experience-of-31-cases
#10
Y R Zheng, C Wu, H Zhang, Z Xue, H W Wang, Z H Sun
Objective: To summarize the clinic experience of preventing cerebral ischemic events during perioperative period in patients which concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases. Methods: The clinical materials of 31 consecutive patients with concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases from April 2010 to April 2014 were retrospectively reviewed.A total of 35 aneurysms were detected, and all of them were unruptured aneurysms.Among them, 17 cases were located on the ipsilateral side of artery stenosis or occlusion, and 18 cases were detected in the contralateral side...
September 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28945817/distribution-of-atherosclerotic-stenosis-determining-early-neurologic-deterioration-in-acute-ischemic-stroke
#11
Seung-Jae Lee, Dong-Geun Lee
BACKGROUND AND PURPOSE: Early neurologic deterioration (END) during the acute stage of stroke is clinically important because of its association with poor outcomes. The purpose of this study was (1) to investigate variables associated with END, (2) to determine the distribution of atherosclerotic stenosis associated with END, and (3) to clarify the relationship between END and clinical outcomes. METHODS: 516 patients with acute ischemic stroke were included. The median follow-up period was 31...
2017: PloS One
https://www.readbyqxmd.com/read/28943539/leptomeningeal-collaterals-strongly-correlate-with-reduced-cerebrovascular-reactivity-measured-by-acetazolamide-challenged-single-photon-emission-computed-tomography-using-a-stereotactic-extraction-estimation-analysis-in-patients-with-unilateral-internal-carotid
#12
Takenobu Kunieda, Kosuke Miyake, Hiroki Sakamoto, Yuko Iwasaki, Shin Iida, Satoshi Morise, Kengo Fujita, Masataka Nakamura, Satoshi Kaneko, Hirofumi Kusaka
Objective To assess the correlation between the angiographic appearance of cerebral collateral pathways or the degree of internal carotid artery stenosis (ICAS) and reduced cerebrovascular reactivity (CVR) estimated by single-photon emission computed tomography (SPECT) image analysis in patients with unilateral ICAS. Methods A retrospective analysis was performed in 42 patients with unilateral ICAS who underwent cerebral angiography and acetazolamide-challenged SPECT of the brain. Cerebral blood flow quantitation was performed using the quantitative SPECT/dual-table autoradiography method...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28943006/outcomes-of-mini-incision-eversion-carotid-endarterectomy-combined-with-nontouch-isolation-technique-of-the-internal-carotid-artery
#13
Kota Shukuzawa, Takao Ohki, Yuji Kanaoka, Makoto Sumi, Koji Maeda, Naoki Toya, Hirotsugu Ozawa
OBJECTIVE: We developed a mini-incision eversion carotid endarterectomy (CEA) procedure (the Jikei method CEA) to prevent perioperative embolic stroke. The aim of this study was to retrospectively analyze perioperative and midterm outcomes after the Jikei method CEA. METHODS: We evaluated patients with the Jikei method CEA at our institution between January 2006 and June 2014. The primary end point was a major adverse event, which included death, stroke, intracranial hemorrhage, and myocardial infarction, within 30 days of CEA...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28939676/the-protective-effect-of-middle-cerebral-artery-calcification-on-symptomatic-middle-cerebral-artery-infarction
#14
Jang-Hyun Baek, Joonsang Yoo, Dongbeom Song, Young Dae Kim, Hyo Suk Nam, Ji Hoe Heo
BACKGROUND AND PURPOSE: The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification. METHODS: We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory...
September 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28939539/falxuplication-a-novel-method-for-wrap-clipping-a-fusiform-aneurysm-a-technical-note
#15
Martin M Mortazavi, Tania Hassanzadeh, Kianoush Khalili, Sajid S Suriya, M Asif Taqi, Salman A Fard, R Shane Tubbs
BACKGROUND: Various techniques have been used for wrap-clipping a ruptured, fusiform intracranial aneurysm. However, there is no available literature on use of the falx cerebri for wrap-clipping. OBJECTIVE: We present a review of the literature with an illustrative case, with a ruptured fusiform pericallosal artery aneurysm firmly attached to the lower edge of the falx cerebri and not amenable to endovascular intervention. METHODS: While the firm attachment between the inferior falx and the fusiform aneurysm was maintained, a section of the lower thinner part of the falx cerebri firmly attached to the aneurysm was dissected and wrapped around the fusiform aneurysm, stabilized with a fenestrated clip...
September 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28925313/hemodynamics-and-oxygen-extraction-in-chronic-large-artery-steno-occlusive-disease-clinical-applications-for-predicting-stroke-risk
#16
Colin P Derdeyn
Depending on the adequacy of collateral sources of blood flow, arterial stenosis or occlusion may lead to reduced perfusion pressure and ultimately reduced blood flow in the distal territory supplied by that vessel. There are two well-defined compensatory mechanisms to reduced pressure or flow - autoregulatory vasodilation and increased oxygen extraction fraction. Other changes, such as metabolic downregulation, are likely. The positive identification of autoregulatory vasodilation and increased oxygen extraction fraction in humans is an established risk factor for future ischemic stroke in some disease states such as atherosclerotic carotid stenosis and occlusion...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28893252/association-between-carotid-plaque-characteristics-and-acute-cerebral-infarction-determined-by-mri-in-patients-with-type-2-diabetes-mellitus
#17
Beibei Sun, Xiao Li, Xiaosheng Liu, Xiaoqian Ge, Qing Lu, Xihai Zhao, Jun Pu, Jianrong Xu, Huilin Zhao
BACKGROUND: Type 2 diabetes mellitus (T2DM) might aggravate the carotid plaque vulnerability, and increase the risk for ischemic stroke. Few studies reported the acute stroke subtype with carotid plaque characteristics in T2DM patients. This study aimed to investigate the association between carotid plaque characteristics and acute cerebral infarct (ACI) lesion features determined by MRI in T2DM patients. METHODS: Patients with acute cerebrovascular syndrome in internal carotid artery territory were recruited...
September 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28881113/cerebral-arterial-stenosis-in-patients-with-spontaneous-intracerebral-hemorrhage
#18
Pil-Wook Chung, Yu Sam Won
OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) and ischemic stroke share common vascular risk factors such as aging and hypertension. Previous studies suggested that the rate of recurrent ICH and ischemic stroke might be similar after ICH. Presence of cerebral arterial stenosis is a potential risk factor for future ischemic stroke. This study investigated the prevalence and factors associated with cerebral arterial stenosis in Korean patients with spontaneous ICH. METHODS: A total of 167 patients with spontaneous ICH were enrolled...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28867358/radiation-induced-large-vessel-cerebral-vasculopathy-in-pediatric-patients-with-brain-tumors-treated-with-proton-radiation-therapy
#19
Stephen F Kralik, Gordon A Watson, Chie-Schin Shih, Chang Y Ho, Whitney Finke, Jeffrey Buchsbaum
PURPOSE: The purpose of this research was to evaluate the incidence, time to development, imaging patterns, risk factors, and clinical significance of large vessel cerebral vasculopathy in pediatric patients with brain tumors treated with proton radiation therapy. METHODS AND MATERIALS: A retrospective study was performed on 75 consecutive pediatric patients with primary brain tumors treated with proton radiation therapy. Radiation-induced large vessel cerebral vasculopathy (RLVCV) was defined as intracranial large vessel arterial stenosis or occlusion confirmed on magnetic resonance angiography, computed tomographic angiography, catheter angiography, or a combination of these within an anatomic region with previous exposure to proton beam therapy and not present before radiation therapy...
July 12, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28861416/etiology-of-intracranial-stenosis-in-young-patients-a-high-resolution-magnetic-resonance-imaging-study
#20
Yu-Yuan Xu, Ming-Li Li, Shan Gao, Zheng-Yu Jin, Zhao-Yong Sun, Jie Chen, Bo Hou, Hai-Long Zhou, Feng Feng, Wei-Hai Xu
BACKGROUND: Using high-resolution magnetic resonance imaging (HRMRI), we sought to investigate the underlying etiology of intracranial stenosis in young patients. METHODS: We retrospectively studied 122 Chinese young adult patients (from 18 to 45 years old, mean age 36.2±7.5 years) with unilateral middle cerebral artery (MCA) stenosis based on a prospectively established HRMRI database. The eccentricity, degree of stenosis, and remodeling types of MCA lesions were analyzed...
August 2017: Annals of Translational Medicine
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