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https://www.readbyqxmd.com/read/29780226/cerebral-border-zone-infarction-an-etiological-study
#1
Tarek Mohammed El-Gammal, Wafik Said Bahnasy, Osama Abd Allah Ragab, Ayman Mohammed Al-Malt
Background: Border zone infarcts (BZI) are ischemic lesions at the junction between two main arterial territories which may be either cortical or internal BZI. Methods: This study was conducted on 76 cerebral BZI patients and 20 healthy control subjects. Patients were divided to group I included 26 internal BZI, group II included 19 cortical BZI and group III included 21 mixed internal/cortical BZI patients. Included subjects were submitted to neurological examination, laboratory investigations, ECG, echocardiogram, brain CT and/or MRI and extra and intracranial blood vessels imaging by duplex and CT angiography...
2018: Egypt J Neurol Psychiatr Neurosurg
https://www.readbyqxmd.com/read/29761219/intracranial-rescue-stent-angioplasty-after-stent-retriever-thrombectomy-multicenter-experience
#2
Robert Forbrig, Hannah Lockau, Fabian Flottmann, Tobias Boeckh-Behrens, Christoph Kabbasch, Maximilian Patzig, Anastasios Mpotsaris, Jens Fiehler, Thomas Liebig, Goetz Thomalla, Oezguer A Onur, Silke Wunderlich, Kornelia Kreiser, Moriz Herzberg, Frank A Wollenweber, Sascha Prothmann, Franziska Dorn
PURPOSE: Stent-retriever thrombectomy (SRT) for acute intracranial large artery occlusion (LAO) may not result in permanent recanalization in rare cases, e.g. due to an underlying stenosis or dissection. In this specific patient group, rescue stent angioplasty (RSA) may be the only treatment option to achieve permanent vessel patency and potentially a good clinical outcome. To date, the experience with RSA is limited. METHODS: In this retrospective analysis, interventional and clinical data of patients with acute intracranial LAO of the anterior and posterior circulation who underwent RSA after SRT due to an underlying lesion between 2012-2017 in four neurovascular centers were studied...
May 14, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29760293/-safety-of-dual-antiplatelet-therapy-with-argatroban-in-patients-with-acute-ischemic-stroke
#3
Yoshinari Nagakane, Eijirou Tanaka, Shinji Ashida, Yuta Kojima, Shiori Ogura, Keiko Maezono, Yasumasa Yamamoto
To prevent early neurological worsening or recurrence in stroke patients with intracranial arterial stenosis or branch atheromatous disease, aggressive antithrombotic therapy, such as dual antiplatelet therapy (DAPT) with or without anticoagulant therapy, is warranted. Such an aggressive antithrombotic therapy, however, may increase the bleeding risk. We studied the risks of DAPT with the anticoagulant argatroban in patients with acute ischemic stroke or transient ischemic attack (TIA). Between October 2011 and September 2015, 341 patients with stroke or TIA, who received DAPT with argatroban within 48 hours after onset, were retrospectively studied...
May 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29752070/rnf213-p-r4810k-polymorphism-and-the-risk-of-moyamoya-disease-intracranial-major-artery-stenosis-occlusion-and-quasi-moyamoya-disease-a-meta-analysis
#4
Yue Wang, Michael Mambiya, Qian Li, Luping Yang, He Jia, Yibo Han, Wanyang Liu
BACKGROUND: Accumulating studies have reported that there is an association between the Ring finger protein 213 (RNF213) p.R4810K (rs112735431, c.14576G>A) single nucleotide polymorphism and the predisposition of moyamoya disease (MMD), intracranial major artery stenosis/occlusion (ICASO), quasi-moyamoya disease (quasi-MMD), and other vascular diseases. However, to this day, analyses about this association have remained scarce in the literature. We attempted to conduct a meta-analysis to systematically summarize and clarify the issue...
May 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29747323/-efficacy-of-bare-metal-stent-for-treating-focal-coronary-artery-aneurysm-complicating-with-severe-stenosis-in-single-coronary-artery
#5
S B Qiao, J Li, J G Cui, J S Yuan, S W Liu, J Zhao, F H Hu, W X Yang, H B Liu, Z W Sun, R L Gao
Objective: To investigate the efficacy of bare metal stent for treating focal coronary artery aneurysm complicating with severe stenosisin single coronary artery. Methods: This retrospective analysis was performed in 7 patients who were diagnosed as local coronary artery aneurysm complicating with severe stenosis(≥70%) in single coronary artery and treated with bare metal stent during the period from December 2012 to June 2015 in Fuwai Hospital. All 7 patients were male with age of (62±11) years old. During the interventional operation, the narrow parts were pre-expanded,and all patients received bare metal stents implantation to cover aneurysms...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29725389/imaging-characteristics-and-pathogenesis-of-intracranial-artery-stenosis-in-patients-with-acute-cerebral-infarction
#6
Wenyuan Xu, Ning Xie, Cheng Zhang, Qin Huang
The current study aimed to investigate the imaging characteristics and pathogenesis of intracranial artery stenosis in patients with acute cerebral infarction. In total, 84 patients diagnosed with acute cerebral infarction were recruited. Magnetic resonance angiography was performed to detect the existence of intracranial artery stenosis or occlusion. In addition, magnetic resonance imaging and diffusion weighted imaging were employed to analyze the infarction types and characteristics. In the majority of patients, the infarction resulted from internal carotid stenosis (77 cases; 91...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29715587/ex-vivo-vessel-wall-thickness-measurements-of-the-human-circle-of-willis-using-7t-mri
#7
Anita A Harteveld, Nerissa P Denswil, Wim Van Hecke, Hugo J Kuijf, Aryan Vink, Wim G M Spliet, Mat J Daemen, Peter R Luijten, Jaco J M Zwanenburg, Jeroen Hendrikse, Anja G van der Kolk
BACKGROUND AND AIMS: MRI can detect intracranial vessel wall thickening before any luminal stenosis is present. Apart from representing a vessel wall lesion, wall thickening could also reflect normal (age-related) variations in vessel wall thickness present throughout the intracranial arterial vasculature. The aim of this study was to perform vessel wall thickness measurements of the major intracranial arteries in ex vivo circle of Willis (CoW) specimens using 7T MRI, to obtain more detailed information about wall thickness variations of the intracranial arteries...
April 24, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29701913/the-influence-of-abcb1-and-p2y12-genetic-variants-on-clinical-outcomes-in-chinese-intracranial-artery-stenosis-patients
#8
Xingang Li, Liqun Jiang, Shusen Sun, Wei Li, Xiaoqing Li, Zhongrong Miao, Zhigang Zhao, Ning Ma
For intracranial artery stenosis patients, high inter-individual variability in response to antiplatelet drug therapy results in recurrent ischemic events. We aimed to evaluate the association of drug-related genetic polymorphisms with adverse clinical outcomes. We consecutively enrolled 157 patients receiving dual-antiplatelet therapy (aspirin plus clopidogrel), and adverse clinical events occurred in 10 patients during the one year follow-up. The P2Y12 polymorphisms (rs9859538 and rs10935842) were associated with increased likelihood of relapse events (OR=2...
April 27, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29700047/multicentric-experience-in-distal-to-proximal-revascularization-of-tandem-occlusion-stroke-related-to-internal-carotid-artery-dissection
#9
G Marnat, M Bühlmann, O F Eker, J Gralla, P Machi, U Fischer, C Riquelme, M Arnold, A Bonafé, S Jung, V Costalat, P Mordasini
BACKGROUND AND PURPOSE: Internal carotid dissection is a frequent cause of ischemic stroke in young adults. It may cause tandem occlusions in which cervical carotid obstruction is associated with intracranial proximal vessel occlusion. To date, no consensus has emerged concerning endovascular treatment strategy. Our aim was to evaluate our endovascular "distal-to-proximal" strategy in the treatment of this stroke subtype in the first large multicentric cohort. MATERIALS AND METHODS: Prospectively managed stroke data bases from 2 separate centers were retrospectively studied between 2009 and 2014 for records of tandem occlusions related to internal carotid dissection...
April 26, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29685407/staged-carotid-artery-stenting-in-patients-with-severe-carotid-stenosis-multicenter-experience
#10
Dong Hyun Yoo, Hong Gee Roh, See-Sung Choi, Jusun Moon, Jeongjun Lee, Young Dae Cho, Moon Hee Han, Keun-Hwa Jung, Byung-Woo Yoon, Hyun-Seung Kang
Cerebral hyperperfusion syndrome (CHS) is serious complication after carotid artery stenting (CAS) caused by decreased cerebral vasoreactivity (CVR) due to long standing hypoperfusion of the brain. We hypothesized that partial dilatation of carotid stenosis would allow the recovery of CVR, and prevent CHS when definitive angioplasty with stent is performed afterward. In this study, we aimed to evaluate the safety and efficacy of staged CAS in patients with severe carotid artery stenosis with evident hemodynamic compromise in regard to preventing hyperperfusion syndrome...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29684514/an-analysis-of-radiation-effects-in-digital-subtraction-angiography-of-intracranial-artery-stenosis
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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