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https://www.readbyqxmd.com/read/28429604/intra-arterial-verapamil-post-thrombectomy-is-feasible-safe-and-neuroprotective-in-stroke
#1
Justin F Fraser, Michael Maniskas, Amanda Trout, Doug Lukins, Lindsey Parker, W Lane Stafford, Abdulnasser Alhajeri, Jill Roberts, Gregory J Bix
Large vessel ischemic stroke represents the most disabling subtype. While t-PA and endovascular thrombectomy can recanalize the occluded vessel, good clinical outcomes are not uniformly achieved. We propose that supplementing endovascular thrombectomy with superselective intra-arterial (IA) verapamil immediately following recanalization could be safe and effective. Verapamil, a calcium channel blocker, has been shown to be an effective IA adjunct in a pre-clinical mouse focal ischemia model. To demonstrate translational efficacy, mechanism, feasibility, and safety, we conducted a group of translational experiments...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28427054/preceding-intravenous-thrombolysis-in-patients-receiving-endovascular-therapy
#2
Hong-Kyun Park, Jong-Won Chung, Jeong-Ho Hong, Min Uk Jang, Hyun-Du Noh, Jong-Moo Park, Kyusik Kang, Soo Joo Lee, Youngchai Ko, Jae Guk Kim, Jae-Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Moon-Ku Han, Beom Joon Kim, 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, Ki-Hyun Cho, Joon-Tae Kim, Dong-Eog Kim, Wi-Sun Ryu, Jay Chol Choi, Wook-Joo Kim, Dong-Ick Shin, Min-Ju Yeo, Sung Il Sohn, Ji Sung Lee, Juneyoung Lee, Byung-Woo Yoon, Hee-Joon Bae
BACKGROUND: The beneficial effects of endovascular therapy (EVT) in acute ischemic stroke have been demonstrated in recent clinical trials using new-generation thrombectomy devices. However, the comparative effectiveness and safety of preceding intravenous thrombolysis (IVT) in this population has rarely been evaluated. METHODS: From a prospective multicenter stroke registry database in Korea, we identified patients with acute ischemic stroke who were treated with EVT within 8 h of onset and admitted to 14 participating centers during 2008-2013...
April 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28426903/the-therapeutic-efficacy-of-botulinum-toxin-in-treating-scleroderma-associated-raynaud-s-phenomenon-a-randomized-double-blind-placebo-controlled-clinical-trial-assessing
#3
Ricardo J Bello, Carisa M Cooney, Eitan Melamed, Keith Follmar, Gayane Yenokyan, Gwendolyn Leatherman, Ami A Shah, Fredrick M Wigley, Laura K Hummers, Scott D Lifchez
Objective To assess the therapeutic efficacy of local injections with Botulinum Toxin Type-A (Btx-A) in improving blood flow to the hands of patients with Raynaud's Phenomenon (RP) secondary to scleroderma. Methods In this randomized, double-blind, placebo-controlled clinical trial (http://ClinicalTrials.gov #NCT02165111), patients with scleroderma-associated RP received Btx-A (50 units in 2.5 mL) in one randomly selected hand and sterile saline (2.5 mL) in the opposite hand. Follow-up at 1 and 4 months post-injection included Laser Doppler Imaging (LDI) of hands, patient-reported outcomes, and physical exam...
April 20, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28423529/pif-promotes-brain-re-myelination-locally-while-regulating-systemic-inflammation-clinically-relevant-multiple-sclerosis-m-smegmatis-model
#4
Giuseppe Migliara, Martin Mueller, Alessia Piermattei, Chaya Brodie, Michael J Paidas, Eytan R Barnea, Francesco Ria
Neurologic disease diagnosis and treatment is challenging. Multiple Sclerosis (MS) is a demyelinating autoimmune disease with few clinical forms and uncertain etiology. Current studies suggest that it is likely caused by infection(s) triggering a systemic immune response resulting in antigen/non-antigen-related autoimmune response in central nervous system (CNS). New therapeutic approaches are needed. Secreted by viable embryos, PreImplantation Factor (PIF) possesses a local and systemic immunity regulatory role...
March 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28419304/incorporating-a-modified-graeb-score-to-the-modified-fisher-scale-for-improved-risk-prediction-of-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage
#5
Matt E Eagles, Blessing N R Jaja, R Loch Macdonald
BACKGROUND: Delayed cerebral ischemia (DCI) is a cause of poor outcome after aneurysmal subarachnoid hemorrhage. Risk scales to predict DCI have scarcely been evaluated for predictive accuracy. Accounting for volume of intraventricular hemorrhage (IVH) in the modified Fischer scale (mFS) may improve its predictive accuracy. OBJECTIVE: To compare the modified Graeb score (mGS) to the mFS for risk prediction of DCI, and to investigate whether incorporating an mGS cut-point into the mFS could improve predictive accuracy...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28417897/oral-magnesium-supplementation-reduces-the-incidence-of-gastrointestinal-complications-following-cardiac-surgery-a-randomized-clinical-trial
#6
Seyed Tayeb Moradian, Mohammad Saeid Ghiasi, Alireza Mohamadpour, Yadollah Siavash
Gastrointestinal complications are common after coronary artery bypass graft surgery. These complications are ranged from nausea and vomiting to mesenteric ischemia and liver failure. It seems that nausea, vomiting, and constipation are related to magnesium deficiency. This study was designed to examine the effect of oral magnesium supplementation on the incidence of gastrointestinal complications in patients undergoing cardiac surgery. In a single blinded randomized clinical trial, 102 patients who were undergoing coronary artery bypass graft surgery were randomly allocated into two groups, 52 patients in the intervention and 50 patients in control group...
February 1, 2017: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
https://www.readbyqxmd.com/read/28413187/noninvasive-fractional-flow-reserve-derived-from-coronary-computed-tomography-angiography%C3%A3-is-this-just-another-new-diagnostic-test-or-the-long-awaited-game-changer
#7
Hiromasa Otake, Charles A Taylor, Hitoshi Matsuo, Nobuhiro Tanaka, Takashi Akasaka
Despite the clinical importance of ischemia evaluation, obtaining fractional flow reserve (FFR) value has, heretofore, only been available during invasive cardiac catheterization. Although there is a clear linkage between morphology and physiology, a significant gap still exists. FFR derived from coronary computed tomography angiography (FFRCT) is a novel method of quantifying the hemodynamic significance of coronary artery stenoses by translating morphological information into hemodynamic data. Improved diagnostic performance of FFRCThas been repeatedly demonstrated in comparison with coronary computed tomography angiography alone with an invasive FFR reference standard...
April 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28411244/long-term-follow-up-of-the-padi-trial-percutaneous-transluminal-angioplasty-versus-drug-eluting-stents-for-infrapopliteal-lesions-in-critical-limb-ischemia
#8
Marlon I Spreen, Jasper M Martens, Bob Knippenberg, Lukas C van Dijk, Jean-Paul P M de Vries, Jan Albert Vos, Gert Jan de Borst, Evert-Jan P A Vonken, Okker D Bijlstra, Jan J Wever, Randolph G Statius van Eps, Willem P Th M Mali, Hendrik van Overhagen
BACKGROUND: Clinical outcomes reported after treatment of infrapopliteal lesions with drug-eluting stents (DESs) have been more favorable compared with percutaneous transluminal angioplasty with a bailout bare metal stent (PTA-BMS) through midterm follow-up in patients with critical limb ischemia. In the present study, long-term results of treatment of infrapopliteal lesions with DESs are presented. METHODS AND RESULTS: Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA-BMS or DESs with paclitaxel...
April 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28407722/induced-hypothermia-is-associated-with-reduced-circulating-subunits-of-mitochondrial-dna-in-cardiac-arrest-patients
#9
Hamid Aslami, Charlotte J P Beurskens, Anita M Tuip, Janneke Horn, Nicole P Juffermans
Induced hypothermia may protect from ischemia reperfusion injury. The mechanism of protection is not fully understood and may include an effect on mitochondria. Here we describe the effect of hypothermia on circulating mitochondrial (mt) DNA in a substudy of a multicenter randomized trial (the Target Temperature Management trial). Circulating levels of mtDNA were elevated in patients with cardiac arrest at all-time points compared to healthy controls. After 24 h of temperature management, patients kept at 33 °C had significantly lower levels of COX3, NADH1 and NADH2 compared to baseline, in contrast to those kept at 36 °C...
April 13, 2017: Mitochondrial DNA. Part A. DNA Mapping, Sequencing, and Analysis
https://www.readbyqxmd.com/read/28407473/trimodal-rescue-of-hind-limb-ischemia-with-growth-factors-cells-and-nanocarriers-fundamentals-to-clinical-trials
#10
Rajesh Laksmanan, Gopi Ukani, Muhammad Tipu Rishi, Nilanjana Maulik
Peripheral Artery Disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation...
April 13, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28403531/short-term-effects-of-extracorporeal-graft-rinse-versus-circulatory-graft-rinse-in-living-donor-liver-transplantation-a-prospective-randomized-controlled-trial
#11
Amr M Yassen, Waleed R Elsarraf, Mohamed A Elmorshedi, Mohamed Abdel Wahab, Tarek Salah, Ahmed M Sultan, Ahmed N Elghawalby, Mohamed M Elshobari, Mohamed Elsadany, Khaled Zalata, Usama Shiha
BACKGROUND: Living donor liver transplantation has shorter cold ischemia time, less preservative volume and lower metabolic load compared to transplantation from deceased donors. We investigated the impact of rinsing the graft contents into the systemic circulation on operative course and post-operative outcomes. PATIENTS AND METHODS: Donors had right hepatectomy and grafts were preserved with cold Histidine-Tryptophan-Ketoglutarate solution. On ending portal vein anastomosis, grafts were flushed by patient's portal blood; either through incompletely anastomosed hepatic vein (Extracorporeal Rinse group, EcRg, n=40) or into systemic circulation (Circulatory Rinse group, CRg, n=40)...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28403095/effects-of-prostaglandin-e1-on-reperfusion-injury-patients-a-meta-analysis-of-randomized-controlled-trials
#12
Houyong Zhu, Xiaoqun Xu, Yu Ding, Liang Zhou, Jinyu Huang
BACKGROUND: Prostaglandin E1 (PGE1) is widely used as a pretreatment for myocardial reperfusion injury in animal experiments. However, the cardioprotective effects of PGE1 in patients have not been established. We performed a meta-analysis to investigate whether PGE1 is cardioprotective, based on the reduction of correlative reperfusion injury events (CRIE), major adverse cardiac events (MACE), and biomarker release in patients with ischemia reperfusion injury. METHODS: The Medline, EMBASE, and Cochrane databases were searched for randomized clinical trials confirming the effects of PGE1...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28401075/repeated-remote-ischemic-conditioning-effect-on-ankle-brachial-index-in-diabetic-patients-a-randomized-control-trial
#13
Najmeh Shahvazian, Mansour Rafiee, Masoud Rahmanian, Seyed Kazem Razavi-Ratki, Mohammad Hadi Farahzadi
BACKGROUND: Remote ischemic preconditioning (RIPC) is a phenomenon where a short period of ischemia in one organ protects against further ischemia in the other organs. We hypothesized that RIPC occurring in diabetic patients with ankle brachial index (ABI) between 0.70 and 0.90 were included with peripheral arterial disease, would make the better coronary flow resulted in the increasing ABI. MATERIALS AND METHODS: This randomized clinical trial study was done in the Afshar Cardiovascular Hospital in Yazd between 2013 and 2014...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28400487/vascular-anatomy-predicts-the-risk-of-cerebral-ischemia-in-patients-randomized-to-carotid-stenting-versus-endarterectomy
#14
Mandy D Müller, Frank J Ahlhelm, Alexander von Hessling, David Doig, Paul J Nederkoorn, Sumaira Macdonald, Philippe A Lyrer, Aad van der Lugt, Jeroen Hendrikse, Christoph Stippich, H Bart van der Worp, Toby Richards, Martin M Brown, Stefan T Engelter, Leo H Bonati
BACKGROUND AND PURPOSE: Complex vascular anatomy might increase the risk of procedural stroke during carotid artery stenting (CAS). Randomized controlled trial evidence that vascular anatomy should inform the choice between CAS and carotid endarterectomy (CEA) has been lacking. METHODS: One-hundred eighty-four patients with symptomatic internal carotid artery stenosis who were randomly assigned to CAS or CEA in the ICSS (International Carotid Stenting Study) underwent magnetic resonance (n=126) or computed tomographic angiography (n=58) at baseline and brain magnetic resonance imaging before and after treatment...
April 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#15
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28399648/the-highly-selective-caspase-1-inhibitor-vx-765-provides-additive-protection-against-myocardial-infarction-in-rat-hearts-when-combined-with-a-platelet-inhibitor
#16
Xi-Ming Yang, James M Downey, Michael V Cohen, Nicole A Housley, Diego F Alvarez, Jonathon P Audia
Use of ischemic postconditioning and other related cardioprotective interventions to treat patients with acute myocardial infarction (AMI) has failed to improve outcomes in clinical trials. Because P2Y12 inhibitors are themselves postconditioning mimetics, it has been postulated that the loading dose of platelet inhibitors routinely given to patients treated for AMI masks the anti-infarct effect of other intended cardioprotective interventions. To further improve outcomes of patients with AMI, an intervention must be able to provide additive protection in the presence of a P2Y12 platelet inhibitor...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28397407/sanguinate-pegylated-carboxyhemoglobin-bovine-mechanism-of-action-and-clinical-update
#17
Abraham Abuchowski
Historically, blood substitutes were under development that would provide oxygen carrying capacity as well as fluid replacement for both trauma and surgical indications. Their development was halted by the inability of the products to deliver therapeutic amounts of oxygen targeted to hypoxic tissue as well as from the inherent toxicity of the molecules. This led to the concept of an oxygen therapeutic that would be targeted for indications caused by anemia/ischemia/hypoxia but would not exhibit the toxicity that plagued earlier products...
April 2017: Artificial Organs
https://www.readbyqxmd.com/read/28397127/a-novel-strategy-to-enhance-angiogenesis-in-vivo-using-the-small-vegf-binding-peptide-pr1p
#18
Avner Adini, Irit Adini, Zai-Long Chi, Ratmir Derda, Amy E Birsner, Benjamin D Matthews, Robert J D'Amato
Therapeutic angiogenesis is an experimental frontier in vascular biology that seeks to deliver angiogenic growth factors to ischemic or injured tissues to promote targeted formation of new blood vessels as an alternative approach to surgical revascularization procedures. Vascular endothelial growth factor (VEGF) is a potent angiogenic signal protein that is locally upregulated at sites of tissue injury. However, therapies aimed at increasing VEGF levels experimentally by injecting VEGF gene or protein failed to improve outcomes in human trials in part due to its short half-life and systemic toxicity...
April 10, 2017: Angiogenesis
https://www.readbyqxmd.com/read/28395175/oxygen-and-oxidative-stress-in-the-perinatal-period
#19
REVIEW
Isabel Torres-Cuevas, Anna Parra-Llorca, Angel Sánchez-Illana, Antonio Nuñez-Ramiro, Julia Kuligowski, Consuelo Cháfer-Pericás, María Cernada, Justo Escobar, Máximo Vento
Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes. In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage...
March 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28393614/current-and-future-perspectives-on-the-treatment-of-cerebral-ischemia
#20
REVIEW
Brandon R Christophe, Shyle H Mehta, Andrew L A Garton, Jonathan Sisti, E Sander Connolly
After heart disease and combined forms of cancer, stroke is the leading cause of death in the United States. Currently, tissue-plasminogen activator (tPA) thrombolysis is the only thrombolytic therapy that has been shown to improve patient outcome. Presently, the only antithrombotic drug treatment that has proven effective at improving acute ischemic stroke patient outcome is aspirin administration. Despite these studies, no clinical trials have yet demonstrated a reliably effective pharmacological treatment...
April 2017: Expert Opinion on Pharmacotherapy
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