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https://www.readbyqxmd.com/read/28416412/successful-treatment-of-symptomatic-intracranial-carotid-artery-stenosis-using-a-24-mm-long-bare-metal-coronary-stent
#1
Azeem A Rehman, Ryan C Turner, Brandon P Lucke-Wold, SoHyun Boo
BACKGROUND: Intracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis. CASE DESCRIPTION: We present a case of a 42-year-old male with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management...
April 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28412909/prolonged-perfusion-predicts-recurrent-ischemic-stroke-but-not-transient-ischemic-attack-in-patients-with-symptomatic-intracranial-stenosis
#2
Linfang Lan, Xinyi Leng, Vincent Ip, Thomas Leung, Yannie Soo, Jill Abrigo, Ka Sing Wong
BACKGROUND: Intracranial arterial stenosis (ICAS) is the dominant cause for ischemic stroke worldwide, with hemodynamic compromise as a crucial contributor. Prolonged perfusion is commonly observed in ICAS patients on CT perfusion (CTP) maps, while the clinical significance of this perfusion pattern has not been elucidated. METHODS: Patients having symptomatic ICAS of 50-99% stenosis with sustained downstream cerebral blood flow (CBF) were enrolled into this study...
April 13, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28388675/impact-of-mca-stenosis-on-the-early-outcome-in-acute-ischemic-stroke-patients
#3
Jiann-Shing Jeng, Fang-I Hsieh, Hsu-Ling Yeh, Wei-Hung Chen, Hou-Chang Chiu, Sung-Chun Tang, Chung-Hsiang Liu, Huey-Juan Lin, Shih-Pin Hsu, Yuk-Keung Lo, Lung Chan, Chih-Hung Chen, Ruey-Tay Lin, Yu-Wei Chen, Jiunn-Tay Lee, Chung-Hsin Yeh, Ming-Hui Sun, Ta-Chang Lai, Yu Sun, Mu-Chien Sun, Po-Lin Chen, Tsuey-Ru Chiang, Shinn-Kuang Lin, Bak-Sau Yip, Chin-I Chen, Chi-Huey Bai, Sien-Tsong Chen, Hung-Yi Chiou, Li-Ming Lien, Chung Y Hsu
BACKGROUND: Asians have higher frequency of intracranial arterial stenosis. The present study aimed to compare the clinical features and outcomes of ischemic stroke patients with and without middle cerebral artery (MCA) stenosis, assessed by transcranial sonography (TCS), based on the Taiwan Stroke Registry (TSR). METHODS: Patients with acute ischemic stroke or transient ischemic attack registered in the TSR, and received both carotid duplex and TCS assessment were categorized into those with stenosis (≥50%) and without (<50%) in the extracranial internal carotid artery (ICA) and MCA, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28385886/preliminary-experience-with-stent-assisted-coiling-of-aneurysms-arising-from-small-2-5-mm-cerebral-vessels-using-the-low-profile-visualized-intraluminal-support-device
#4
C-C Wang, W Li, Z-Z Feng, B Hong, Y Xu, J-M Liu, Q-H Huang
BACKGROUND AND PURPOSE: The Low-Profile Visualized Intraluminal Support (LVIS) stent is a new device recently introduced for the treatment of wide-neck intracranial aneurysms. This single-center study presents the authors' preliminary experience using the LVIS stent to treat saccular aneurysms with parent arteries smaller than 2.5 mm. MATERIALS AND METHODS: Aneurysms with a LVIS stent used in a small parent vessel (<2.5 mm in diameter) between October 2014 and April 2016 were included...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28383307/the-thrombolytic-effect-of-diagnostic-ultrasound-induced-microbubble-cavitation-in-acute-carotid-thromboembolism
#5
Thomas R Porter, Feng Xie, John Lof, Jeffry Powers, Francois Vignon, William Shi, Matthew White
BACKGROUND: Acute ischemic stroke is often due to thromboembolism forming over ruptured atherosclerotic plaque in the carotid artery (CA). The presence of intraluminal CA thrombus is associated with a high risk of thromboembolic cerebral ischemic events. The cavitation induced by diagnostic ultrasound high mechanical index (MI) impulses applied locally during a commercially available intravenous microbubble infusion has dissolved intravascular thrombi, especially when using longer pulse durations...
April 5, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28377257/special-endovascular-treatment-for-acute-large-artery-occlusion-resulting-from-atherosclerotic-disease
#6
Ting-Yu Yi, Wen-Huo Chen, Yan-Min Wu, Mei-Fang Zhang, Yue-Hong Chen, Zong-Zhong Wu, Yan-Chuan Shi, Bai-Ling Chen
BACKGROUND: and Purpose: Acute intracranial atherosclerotic disease (IAD)-related large artery occlusion (LAO) is typically refractory to mechanical thrombectomy. We evaluated the feasibility and safety of emergency balloon-assisted or stent-assisted angioplasty performed with tirofiban administration for acute IAD-related LAO. METHODS: We identified, from among 55 consecutive patients who underwent endovascular treatment for LAO, 12 patients with acute IAD-related LAO who underwent balloon-assisted or stent-assisted angioplasty with (n = 3) or without passage of a stent retriever...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28373708/association-between-high-density-lipoprotein-cholesterol-levels-and-the-prevalence-of-asymptomatic-intracranial-arterial-stenosis
#7
Xin Li, Anxin Wang, Jing Wang, Jianwei Wu, Dandan Wang, Xiang Gao, Shouling Wu, Xingquan Zhao
Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke, and a low level of high-density lipoprotein cholesterol (HDL-C) is also considered to be a predictor for stroke. However, the association between the HDL-C level and asymptomatic ICAS is uncertain. From 2010 to 2011, a random sample of 5,351 participants were enrolled in the Asymptomatic Polyvascular Abnormalities Community (APAC) study. The recruited participants were then separated into 5 roughly uniform-sized factions with varying HDL-C levels...
April 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28368084/neurovascular-ultrasound-in-emergency-settings-diagnostic-and-therapeutic-aspects
#8
REVIEW
T Santos, M Veloso, P Barros
INTRODUCTION: Neurovascular ultrasound is a non-invasive, portable and fast imaging method that, when performed by an experienced neurosonologist, offers reliable and reproducible information on the morphological and hemodynamic status of cervical and intracranial vessels. AIM: To review the available evidence regarding the use of this tool in the approach to acute stroke. DEVELOPMENT: Neurovascular ultrasound can be used in one of two ways: diagnostic and therapeutic...
April 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28367905/4d-flow-mr-imaging-of-ophthalmic-artery-flow-in-patients-with-internal-carotid-artery-stenosis
#9
Tetsuro Sekine, Ryo Takagi, Yasuo Amano, Yasuo Murai, Erika Orita, Yoshimitsu Fukushima, Yoshio Matsumura, Shin-Ichiro Kumita
BACKGROUND AND PURPOSE: To assess the clinical feasibility of time-resolved three-dimensional phase contrast (4D Flow) magnetic resonance imaging (MRI) assessment of the ophthalmic artery (OphA) flow in patients with internal carotid artery stenosis (ICS). MATERIALS AND METHODS: Twenty-one consecutive patients with unilateral ICS were recruited. 4D Flow MRI and acetazolamide-stress brain perfusion single photon emission computed tomography (SPECT) were performed...
March 27, 2017: Magnetic Resonance in Medical Sciences: MRMS
https://www.readbyqxmd.com/read/28362885/long-term-clinical-and-angiographic-outcomes-following-pipeline-embolization-device-treatment-of-complex-internal-carotid-artery-aneurysms-five-year-results-of-the-pipeline-for-uncoilable-or-failed-aneurysms-trial
#10
Tibor Becske, Waleed Brinjikji, Matthew B Potts, David F Kallmes, Maksim Shapiro, Christopher J Moran, Elad I Levy, Cameron G McDougall, István Szikora, Giuseppe Lanzino, Henry H Woo, Demetrius K Lopes, Adnan H Siddiqui, Felipe C Albuquerque, David J Fiorella, Isil Saatci, Saruhan H Cekirge, Aaron L Berez, Daniel J Cher, Zsolt Berentei, Miklós Marosfoi, Peter K Nelson
BACKGROUND: Early and mid-term safety and efficacy of aneurysm treatment with the Pipeline Embolization Device (PED) has been well demonstrated in prior studies. OBJECTIVE: To present 5-yr follow-up for patients treated in the Pipeline for Uncoilable or Failed Aneurysms clinical trial. METHODS: In our prospective, multicenter trial, 109 complex internal carotid artery (ICA) aneurysms in 107 subjects were treated with the PED. Patients were followed per a standardized protocol at 180 d and 1, 3, and 5 yr...
January 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28357169/low-profile-visualized-intraluminal-support-junior-device-for-the-treatment-of-intracranial-aneurysms
#11
Mihir Gupta, Vincent J Cheung, Peter Abraham, Arvin R Wali, David R Santiago-Dieppa, Brandon C Gabel, Abdulrahman Almansouri, J Scott Pannell, Alexander A Khalessi
OBJECTIVE: Early case series suggest that the recently introduced Low-profile Visualized Intraluminal Support Junior (LVIS Jr.) device (MicroVention-Terumo, Inc., Tustin, CA) may be used to treat wide-necked aneurysms that would otherwise require treatment with intrasaccular devices or open surgery. We report our single-center experience utilizing LVIS Jr. to treat intracranial aneurysms involving 1.8-2.5 mm parent arteries. METHODS: We retrospectively reviewed records of patients treated with the LVIS Jr...
February 17, 2017: Curēus
https://www.readbyqxmd.com/read/28355722/-a-clinical-analysis-of-5-patients-with-infratentorial-primary-angiitis-of-central-nervous-system
#12
L J Peng, H R Qian, L L Mao, D Y Xia, X K Qi
Objective: To explore the clinical characteristics of infratentorial primary angiitis in central nervous system(PACNS). Methods: A total of 5 cases diagnosed as infratentorial PACNS in the neurology department of Navy General Hospital of PLA in 2015 were enrolled in the study. The clinical, imaging and pathological data were collected and analyzed. Results: All the 5 cases were male with the median onset age of thirty-four. Five cases presented with dizziness, two with headache, three with walking unstable, two with facial numbness and one with dysarthria...
April 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28347575/validation-of-a-basic-neurosonology-laboratory-for-detecting-cervical-carotid-artery-stenosis
#13
C de la Cruz Cosme, M S Dawid Milner, G Ojeda Burgos, A Gallardo Tur, M Márquez Martínez, T Segura
INTRODUCTION: Most of the cases of ischaemic stroke in our setting are of atherothrombotic origin. Detecting intracranial and cervical carotid artery stenosis in patients with ischaemic stroke is therefore essential. Ultrasonography has become the tool of choice for diagnosing carotid artery stenosis because it is both readily accessibility and reliable. However, use of this technique must be validated in each laboratory. The purpose of this study is to validate Doppler ultrasound in our laboratory as a means of detecting severe carotid artery stenosis...
March 24, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28345540/epidemiological-features-of-nontraumatic-spontaneous-subarachnoid-hemorrhage-in-china-a-nationwide-hospital-based-multicenter-study
#14
Jian-Ping Song, Wei Ni, Yu-Xiang Gu, Wei Zhu, Liang Chen, Bin Xu, Bin Leng, Yan-Long Tian, Ying Mao
BACKGROUND: Nontraumatic spontaneous subarachnoid hemorrhage (SAH) is associated with a high mortality. This study was conducted to investigate the epidemiological features of nontraumatic spontaneous SAH in China. METHODS: From January 2006 to December 2008, the clinical data of patients with nontraumatic SAH from 32 major neurosurgical centers of China were evaluated. Emergent digital subtraction angiography (DSA) was performed for the diagnosis of SAH sources in the acute stage of SAH (≤3 days)...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28330958/intracranial-atherosclerosis-and-dementia-the-atherosclerosis-risk-in-communities-aric-study
#15
Jennifer L Dearborn, Yiyi Zhang, Ye Qiao, Muhammad Fareed K Suri, Li Liu, Rebecca F Gottesman, Andreea M Rawlings, Thomas H Mosley, Alvaro Alonso, David S Knopman, Eliseo Guallar, Bruce A Wasserman
OBJECTIVE: To explore the association of intracranial atherosclerotic disease (ICAD) with mild cognitive impairment (MCI) and dementia. METHODS: From 2011 to 2013, 1,744 participants completed high-resolution vessel wall MRI from the population-based Atherosclerosis Risk in Communities Study by a sampling strategy that allowed weighting back to the cohort. We defined ICAD by plaque features (presence, territory, stenosis, number). Trained clinicians used an algorithm incorporating information from interviews and neuropsychological and neurologic examinations to adjudicate for MCI and dementia...
March 22, 2017: Neurology
https://www.readbyqxmd.com/read/28327940/the-nationwide-burden-of-neurological-conditions-requiring-emergency-neurosurgery
#16
Rafael De la Garza Ramos, C Rory Goodwin, Jonathan Nakhla, Rani Nasser, Reza Yassari, Eugene S Flamm, Ali Bydon, Geoffrey Colby, Daniel M Sciubba
BACKGROUND: Neurosurgical emergencies are an important cause of disability and mortality. OBJECTIVE: To examine the nationwide burden of neurological conditions requiring emergency neurosurgery. METHODS: The Nationwide Inpatient Sample database (2002-2011) was queried to identify adult patients with a primary discharge diagnosis of a neurosurgical condition who were admitted urgently/emergently or through a trauma center and underwent surgical intervention within 2 days of admission...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28319156/differential-impact-of-serum-total-bilirubin-level-on-cerebral-atherosclerosis-and-cerebral-small-vessel-disease
#17
Jonguk Kim, Seung-Jae Yoon, Min-Hee Woo, Sang-Heum Kim, Nam-Keun Kim, Jinkwon Kim, Ok-Joon Kim, Seung-Hun Oh
BACKGROUND: A low serum total bilirubin (T-bil) level is associated with an increased risk of atherosclerosis. However, the differential impact of the serum T-bil level on cerebral atherosclerosis and cerebral small vessel disease (SVD) is still unclear. METHODS: We evaluated serum T-bil levels from 1,128 neurologically healthy subjects. Indices of cerebral atherosclerosis (extracranial arterial stenosis [ECAS] and intracranial arterial stenosis [ICAS]), and indices of SVD (silent lacunar infarct [SLI], and moderate-to-severe white matter hyperintensities [msWMH]) were evaluated by the use of brain magnetic resonance imaging (MRI) and MR angiography...
2017: PloS One
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#18
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28302611/site-and-rate-of-occlusive-disease-in-cervicocerebral-arteries-a-ct-angiography-study-of-2209-patients-with-acute-ischemic-stroke
#19
D C Rotzinger, P J Mosimann, R A Meuli, P Maeder, P Michel
BACKGROUND AND PURPOSE: CTA can rapidly and accurately detect and localize occlusive disease in patients with ischemic stroke. We have used CTA to assess arterial stenosis and occlusion in an ischemic stroke population arriving at a tertiary stroke center within 24 hours of symptom onset in order to obtain a comprehensive picture of occlusive disease pattern, and to determine the proportion of eligible candidates for endovascular treatment. MATERIALS AND METHODS: Data from consecutive patients with acute ischemic stroke admitted to a single center between 2003 and 2012, collected in the Acute Stroke Registry and Analysis of Lausanne data base, were retrospectively analyzed...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28302605/quantifying-intracranial-internal-carotid-artery-stenosis-on-mr-angiography
#20
H Baradaran, P Patel, G Gialdini, K Al-Dasuqi, A Giambrone, H Kamel, A Gupta
BACKGROUND AND PURPOSE: Intracranial atherosclerosis is a common cause of ischemic stroke. Intracranial stenosis is most commonly quantified by the Warfarin-Aspirin Symptomatic Intracranial Disease method, which involves calculating a ratio of luminal diameter measurements on conventional angiography. Our purpose was to determine whether a single linear measurement of the narrowest caliber of the intracranial ICA on MRA can accurately predict Warfarin-Aspirin Symptomatic Intracranial Disease stenosis measurements...
March 16, 2017: AJNR. American Journal of Neuroradiology
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