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https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#1
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28641848/the-use-of-embolic-protection-devices-is-associated-with-a-lower-stroke-and-death-rate-after-carotid-stenting
#2
Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVES: The aim of this study was to analyze the association between intraprocedural and periprocedural variables and in-hospital stroke or death rate after carotid artery stenting. BACKGROUND: In Germany, all open surgical and endovascular procedures on the extracranial carotid artery must be documented in a statutory nationwide quality assurance database. METHODS: A total of 13,086 carotid artery stenting procedures for asymptomatic (63...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28641383/neuroprotection-in-stroke-the-importance-of-collaboration-and-reproducibility
#3
Ain A Neuhaus, Yvonne Couch, Gina Hadley, Alastair M Buchan
Acute ischaemic stroke accounts for 6.5 million deaths per year, and by 2030 will result in the annual loss of over 200 million disability-adjusted life years globally. There have been considerable recent advances in the gold standard of acute ischaemic stroke treatment, some aspects of which-aspirin to prevent recurrence, and treating patients in specialized stroke wards-are widely applicable. Recanalization of the occluded artery through thrombolysis and/or endovascular thrombectomy is restricted to only a small proportion of patients, due to contra-indications and the costs associated with establishing the infrastructure to deliver these treatments...
June 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28640874/risk-factors-are-different-for-deep-and-lobar-remote-hemorrhages-after-intravenous-thrombolysis
#4
Luis Prats-Sanchez, Alejandro Martínez-Domeño, Pol Camps-Renom, Raquel Delgado-Mederos, Daniel Guisado-Alonso, Rebeca Marín, Laura Dorado, Salvatore Rudilosso, Alejandra Gómez-González, Francisco Purroy, Manuel Gómez-Choco, David Cánovas, Dolores Cocho, Moises Garces, Sonia Abilleira, Joan Martí-Fàbregas
BACKGROUND AND PURPOSE: Remote parenchymal haemorrhage (rPH) after intravenous thrombolysis is defined as hemorrhages that appear in brain regions without visible ischemic damage, remote from the area of ischemia causing the initial stroke symptom. The pathophysiology of rPH is not clear and may be explained by different underlying mechanisms. We hypothesized that rPH may have different risk factors according to the bleeding location. We report the variables that we found associated with deep and lobar rPH after intravenous thrombolysis...
2017: PloS One
https://www.readbyqxmd.com/read/28634647/erratum-to-training-guidelines-for-endovascular-stroke-intervention-an-international-multi-society-consensus-document
#5
S D Lavine, K Cockroft, B Hoh, N Bambakidis, A A Khalessi, H Woo, H Riina, A Siddiqui, J A Hirsch, W Chong, H Rice, J Wenderoth, P Mitchell, A Coulthard, T J Signh, C Phatouros, M Khangure, P Klurfan, K Ter Brugge, D Iancu, T Gunnarsson, O Jansen, M Muto, I Szikora, L Pierot, P Brouwer, J Gralla, S Renowden, T Andersson, J Fiehler, F Turjman, P White, A C Januel, L Spelle, Z Kulcsar, R Chapot, A Biondi, S Dima, C Taschner, M Szajner, A Krajina, N Sakai, Y Matsumaru, S Yoshimura, M Ezura, T Fujinaka, K Iihara, A Ishii, T Higashi, M Hirohata, A Hyodo, Y Ito, M Kawanishi, H Kiyosue, E Kobayashi, S Kobayashi, N Kuwayama, Y Matsumoto, S Miyachi, Y Murayama, I Nagata, I Nakahara, S Nemoto, Y Niimi, H Oishi, J Satomi, T Satow, K Sugiu, M Tanaka, T Terada, H Yamagami, O Diaz, P Lylyk, M V Jayaraman, A Patsalides, C D Gandhi, S K Lee, T Abruzzo, B Albani, S A Ansari, A S Arthur, B W Baxter, K R Bulsara, M Chen, J E Delgado Almandoz, J F Fraser, D V Heck, S W Hetts, M S Hussain, R P Klucznik, T M Leslie-Mawzi, W J Mack, R A McTaggart, P M Meyers, J Mocco, C J Prestigiacomo, G L Pride, P A Rasmussen, R M Starke, P J Sunenshine, R W Tarr, D F Frei, M Ribo, R G Nogueira, O O Zaidat, T Jovin, I Linfante, D Yavagal, D Liebeskind, R Novakovic, S Pongpech, G Rodesch, M Soderman, A Taylor, T Krings, D Orbach, L Picard, D C Suh, H Q Zhang
No abstract text is available yet for this article.
June 20, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28629575/outcome-of-patients-with-proximal-vessel-occlusion-of-the-anterior-circulation-and-dwi-pwi-mismatch-is-time-dependent
#6
Sibu Mundiyanapurath, Sascha Diatschuk, Sarah Loebel, Johannes Pfaff, Mirko Pham, Markus Alfred Möhlenbruch, Wolfgang Wick, Martin Bendszus, Peter A Ringleb, Alexander Radbruch
BACKGROUND AND PURPOSE: Patients with ischemic stroke and large vessel occlusion are assumed to benefit from endovascular therapy (ET) independent of the symptom onset-to-treatment time (OTT) if they present with a mismatch of diffusion- and perfusion-weighted imaging (DWI-PWI mismatch). We aimed at studying the influence of OTT on clinical outcome in these patients. METHODS: Retrospective database review in a tertiary care university hospital. All patients presented with proximal vessel occlusion of the anterior circulation and DWI-PWI mismatch...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28626412/congenital-bilateral-c2-transverse-foramina-stenosis-causing-adult-onset-vertebrobasilar-insufficiency-and-posterior-circulation-stroke
#7
Ajeet Gordhan, Catherine Lockhart
Vertebrobasilar insufficiency leading to posterior circulation infarcts caused by congenital hypoplasia of the bilateral transverse foramina at the C2 level, affecting the caliber and flow of the bilateral distal cervical vertebral arteries in an adult, has not been previously reported. A 41-year-old male presented with episodic dizziness for a period of 1 year prior to consultation. Computed tomography angiography of the head and neck demonstrated congenital hypoplasia of the bilateral C2 transverse foramina, with absence of the vertebral arteries in each of the foramina and collateral reconstitution of diminutive intracranial vertebral artery segments...
May 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28626056/early-reperfusion-after-brain-ischemia-has-beneficial-effects-beyond-rescuing-neurons
#8
Masaki Tachibana, Tetsuro Ago, Yoshinobu Wakisaka, Junya Kuroda, Masahiro Shijo, Yoji Yoshikawa, Motohiro Komori, Ataru Nishimura, Noriko Makihara, Kuniyuki Nakamura, Takanari Kitazono
BACKGROUND AND PURPOSE: Recent studies show that successful endovascular thrombectomy 6 to 12 hours after stroke onset enhances functional outcomes 3 months later. In this study, we investigated the effects of reperfusion after ischemia on repair processes in the ischemic areas, as well as on functional recovery, using mouse stroke models. METHODS: We examined time-dependent histological changes and functional recovery after transient middle cerebral artery occlusion of different durations, including permanent middle cerebral artery occlusion, using the CB-17 (CB-17/lcr-+/+Jcl) mouse strain, which has poor pial collateral blood flow...
June 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28625383/the-assessment-of-the-watchman-device-in-patients-unsuitable-for-oral-anticoagulation-asap-too-trial
#9
David R Holmes, Vivek Y Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W Bergmann, Boris Schmidt, Jacqueline Saw
BACKGROUND: Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. STUDY OBJECTIVES: The ASAP-TOO study is designed to establish the safety and effectiveness of the Watchman left atrial appendage closure device in patients with nonvalvular AF who are deemed ineligible for OAC...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28619833/ct-angiography-aspects-predicts-outcome-much-better-than-noncontrast-ct-in-patients-with-stroke-treated-endovascularly
#10
F Sallustio, C Motta, S Pizzuto, M Diomedi, B Rizzato, M Panella, F Alemseged, M Stefanini, S Fabiano, R Gandini, R Floris, P Stanzione, G Koch
BACKGROUND AND PURPOSE: Noncontrast CT ASPECTS has been investigated as a predictor of outcome in patients with acute ischemic stroke. Our purpose was to investigate whether CTA source images are a better predictor of clinical and radiologic outcomes than NCCT ASPECTS in candidates for endovascular stroke therapy. MATERIALS AND METHODS: CT scans of patients (n = 124) were independently evaluated by 2 readers for baseline NCCT and CTA source image ASPECTS and for follow-up ASPECTS...
June 15, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28615904/endovascular-stroke-treatment-is-it-everybody-s-cup-of-tea
#11
Kamble Rajeev, Moudgil Sandeep, Gupta Vivek
No abstract text is available yet for this article.
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28615192/access-to-hyperacute-stroke-services-across-canadian-provinces-a-geospatial-analysis
#12
Prasanna Venkatesan Eswaradass, Richard H Swartz, Jamey Rosen, Michael D Hill, M Patrice Lindsay
BACKGROUND: Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets. METHODS: We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS) base centres to which one can drive in 3...
June 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28611835/risk-of-intracranial-hemorrhage-after-endovascular-treatment-for-acute-ischemic-stroke-systematic-review-and-meta-analysis
#13
REVIEW
Yonggang Hao, Zhizhong Zhang, Hao Zhang, Lili Xu, Zusen Ye, Qiliang Dai, Xinfeng Liu, Gelin Xu
BACKGROUND: Intracranial hemorrhage is a major complication of endovascular treatment in patients with acute ischemic stroke. Controlled clinical trials reported varied incidences of intracranial hemorrhage after endovascular treatment. This meta-analysis aimed to estimate whether endovascular treatment, compared with medical treatment, increases the risk of intracranial hemorrhage in patients with acute ischemic stroke. METHODS: The current publications on endovascular treatment for acute ischemic stroke were systematically reviewed...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611830/endovascular-therapy-demonstrates-benefit-over-intravenous-recombinant-tissue-plasminogen-activator-based-on-repeatedly-measured-national-institutes-of-health-stroke-scale
#14
Liqiong Fan, Sharon D Yeatts, Lydia D Foster, Pooja Khatri, Thomas Tomsick, Joseph P Broderick, Yuko Y Palesch
BACKGROUND AND PURPOSE: The Interventional Management of Stroke (IMS) III trial was a randomized controlled trial designed to compare the effect of endovascular therapy after intravenous recombinant tissue plasminogen activator (i.v. rt-PA) as compared to i.v. rt-PA alone. The primary outcome was modified Rankin Scale at 90 days. Secondary outcomes included National Institutes of Health Stroke Scale (NIHSS), which was assessed repeatedly through 90 days. The objective of this analysis is to evaluate the treatment effect of endovascular therapy over time on NIHSS...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611829/stent-retriever-mediated-manual-aspiration-thrombectomy-for-acute-ischemic-stroke
#15
Ashutosh P Jadhav, Amin Aghaebrahim, Anat Horev, Dan-Victor Giurgiutiu, Andrew F Ducruet, Brian Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: Stent retriever thrombectomy and manual aspiration thrombectomy (MAT) have each been shown to lead to high rates of recanalization as single-modality endovascular stroke therapy. We sought to describe the safety and efficacy of a multimodal approach combining these two techniques termed 'stent retriever-mediated manual aspiration thrombectomy' (SMAT) and compared them to MAT alone. METHODS: Retrospective review of a prospectively acquired acute endovascular stroke database...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611828/heads-up-a-novel-provocative-maneuver-to-guide-acute-ischemic-stroke-management
#16
Latisha K Ali, Julius K Weng, Sidney Starkman, Jeffrey L Saver, Doojin Kim, Bruce Ovbiagele, Brian H Buck, Nerses Sanossian, Paul Vespa, Oh Young Bang, Reza Jahan, Gary R Duckwiler, Fernando Viñuela, David S Liebeskind
BACKGROUND: A common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making. METHODS: A prospective cohort study of <7.5 h of acute anterior circulation territory ischemia patients with minimal deficits despite middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611827/repeated-mechanical-thrombectomy-in-recurrent-large-vessel-occlusion-acute-ischemic-stroke
#17
Mehdi Bouslama, Diogo C Haussen, Leticia C Rebello, Jonathan A Grossberg, Michael R Frankel, Raul G Nogueira
BACKGROUND: Endovascular therapy has been proven effective for the treatment of large vessel occlusion strokes (LVOS). However, the feasibility and potential benefits of repeat thrombectomy for recurrent stroke is unclear. We aim to report our experience with repeat thrombectomy for recurrent LVOS. METHODS: We reviewed our prospectively collected endovascular database for patients who underwent repeated mechanical thrombectomy. Baseline characteristics, procedural data and outcomes were evaluated...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611097/epidemiology-endovascular-treatment-and-prognosis-of-cerebral-venous-thrombosis-us-center-study-of-152-patients
#18
Kristin Salottolo, Jeffrey Wagner, Donald F Frei, David Loy, Richard J Bellon, Kathryn McCarthy, Judd Jensen, Christopher Fanale, David Bar-Or
BACKGROUND: Cerebral venous thrombosis is a rare cause of stroke that poses diagnostic, therapeutic, and prognostic challenges. Mainstay treatment is systemic anticoagulation, but endovascular treatment is increasingly advocated. Our objectives were to describe the epidemiology, treatment, and prognosis of 152 patients with cerebral venous thrombosis. METHODS AND RESULTS: This was a retrospective study of consecutive cerebral venous thrombosis cases from 2006 to 2013 at a comprehensive stroke center through hospital discharge...
June 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28607929/treatment-of-cervical-artery-dissection-antithrombotics-thrombolysis-and-endovascular-therapy
#19
REVIEW
Jing Peng, Zunjing Liu, Chunxia Luo, Lin Chen, Xianhua Hou, Li Xiao, Zhenhua Zhou
Cervical artery dissection (CAD) is an important cause of stroke for young patients, accounting for 5-22% of strokes in patients <45 years of age, which presents not only a great burden to the stroke victims but also a financial burden to the family and society. Because CAD can lead to different clinical lesions, including neuropathy, acute ischemic stroke, and subarachnoid hemorrhage, and is an arterial dissection with a self-healing tendency, the treatment options depend on the clinical manifestations...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28604188/correlation-between-clot-density-and-recanalization-success-or-stroke-etiology-in-acute-ischemic-stroke-patients
#20
Manoj Jagani, David F Kallmes, Waleed Brinjikji
Background Predicting recanalization success for patients undergoing endovascular treatment for acute ischemic stroke is of significant interest. Studies have previously correlated the success of recanalization with the density of the clot. We evaluated clot density and its relationship to revascularization success and stroke etiology. Methods We conducted a retrospective review of 118 patients undergoing intra-arterial therapy for acute ischemic stroke. Mean and maximum thrombus density was measured by drawing a circular region of interest on an axial slice of a non-contrast computed tomography scan...
June 2017: Interventional Neuroradiology
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