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Stroke reperfusion

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https://www.readbyqxmd.com/read/29350803/thrombectomy-outcomes-for-acute-stroke-patients-with-anterior-circulation-tandem-lesions-a-clinical-registry-and-an-update-of-systematic-review-with-meta-analysis
#1
Udi Sadeh-Gonik, Noam Tau, Tal Friehmann, Serge Bracard, René Anxionnat, Anne-Laure Derelle, Romain Tonnelet, Liang Lia, Sébastien Richard, Xavier Armoiry, Benjamin Gory
BACKGROUND AND PURPOSE: Although mechanical thrombectomy (MT) appears to be superior in stroke patients with extracranial carotid disease (ECD) compared to thrombolysis alone, the impact of emergent carotid stenting during MT remains unclear. We assessed the MT outcomes in anterior stroke patients with ECD, especially when combined with carotid stenting. METHODS: We performed a retrospective analysis of our registry and conducted an update of a systematic review and meta-analysis of MT studies with or without stenting for anterior circulation stroke with ECD published between November 2010 and April 2017...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29348262/dawn-of-a-new-era-for-stroke-treatment-implications-of-the-dawn-study-for-acute-stroke-care-and-stroke-systems-of-care
#2
Mark J Alberts, Martin D Ollenschleger, Amre Nouh
Until recently, the selection of patients with large artery occlusion and ischemic stroke for reperfusion therapy was based on time criteria (typically within 6 hours) and basic imaging protocols (head CT, CT angiogram, ASPECTS score). The recently published DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo) study has changed this paradigm by using a tissue-based selection criteria and a greatly expanded treatment time window (up to 24 hours)...
January 18, 2018: Circulation
https://www.readbyqxmd.com/read/29344983/anti-inflammatory-effect-of-4-methylcyclopentadecanonein-rats-submitted-to-ischemic-stroke
#3
Yan Jin, Fang Wei, Xiaoli Dai, Min Qi, Yukui Ma
The present study aimed to investigate the anti-inflammatory effect of 4-methylcyclopentadecanone (4-MCPC) in rats suffering from a cerebral ischemia/ reperfusion (I/R) injury. In this study, the focal cerebral ischemia in rats was induced by middle cerebral artery occlusion (MCAO) for 2 h, and the rats were treated with 4-MCPC (8 mg/kg) just 0.5 h before reperfusion. The ischemic infarct volume was recorded 24 h after the MCAO. In addition, myeloperoxidase (MPO) activity and TNF-α and IL-1β levels in the ischemic cerebral cortex were determined by ELISA, while nuclear translocation of NF-κB p65 subunit and expression of p-IκBα were investigated by western blotting...
January 18, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29340574/effect-of-general-anesthesia-and-conscious-sedation-during-endovascular-therapy-on-infarct-growth-and-clinical-outcomes-in-acute-ischemic-stroke-a-randomized-clinical-trial
#4
Claus Z Simonsen, Albert J Yoo, Leif H Sørensen, Niels Juul, Søren P Johnsen, Grethe Andersen, Mads Rasmussen
Importance: Endovascular therapy (EVT) is the standard of care for select patients who had a stroke caused by a large vessel occlusion in the anterior circulation, but there is uncertainty regarding the optimal anesthetic approach during EVT. Observational studies suggest that general anesthesia (GA) is associated with worse outcomes compared with conscious sedation (CS). Objective: To examine the effect of type of anesthesia during EVT on infarct growth and clinical outcome...
January 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29340078/differential-gene-expression-profiles-between-two-subtypes-of-ischemic-stroke-with-blood-stasis-syndromes
#5
Tian-Long Liu, Min-Na Liu, Xin-Liang Xu, Wen-Xing Liu, Pei-Jin Shang, Xiao-Hu Zhai, Hang Xu, Yi Ding, Yu-Wen Li, Ai-Dong Wen
Ischemic stroke is a cerebrovascular thrombotic disease with high morbidity and mortality. Qi deficiency blood stasis (QDBS) and Yin deficiency blood stasis (YDBS) are the two major subtypes of ischemic stroke according to the theories of traditional Chinese medicine. This study was conducted to distinguish these two syndromes at transcriptomics level and explore the underlying mechanisms. Male rats were randomly divided into three groups: sham group, QDBS/MCAO group and YDBS/MCAO group. Morphological changes were assessed after 24 h of reperfusion...
December 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/29338750/reperfusion-therapy-in-acute-ischemic-stroke-dawn-of-a-new-era
#6
REVIEW
Sonu Bhaskar, Peter Stanwell, Dennis Cordato, John Attia, Christopher Levi
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed...
January 16, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29337840/targeted-temperature-management-at-33%C3%A2-c-or-36%C3%A2-c-produces-equivalent-neuroprotective-effects-in-the-middle-cerebral-artery-occlusion-rat-model-of-ischemic-stroke
#7
Jung Ho Lee, Jisoo Lim, Yong Eun Chung, Sung Phil Chung, Incheol Park, Chul Hoon Kim, Je Sung You
Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke...
January 15, 2018: Shock
https://www.readbyqxmd.com/read/29337146/apelin-13-attenuates-er-stress-mediated-neuronal-apoptosis-by-activating-g%C3%AE-i-g%C3%AE-q-ck2-signaling-in-ischemic-stroke
#8
Fei Wu, Jian Qiu, Yang Fan, Qiuling Zhang, Baohua Cheng, Yili Wu, Bo Bai
Cerebral ischemia/reperfusion (I/R) injury-induced neuronal apoptosis contributes to the death and disability in patients with ischemic stroke. However, underlying mechanisms remain elusive and it lacks effective treatment. Here we reported that the expression of casein kinase 2 (CK2) was significantly reduced in brains of middle cerebral artery occlusion/reperfusion (MACO/R) model rats and oxygen-glucose deprivation/reperfusion (OGD/R) model neurons, which was associated with the activation of eIF2-ATF4-CHOP signaling pathway, leading to neuronal apoptosis...
January 11, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29336466/magnolol-protects-against-ischemic-reperfusion-brain-damage-following-oxygen-glucose-deprivation-and-transient-focal-cerebral-ischemia
#9
Sheng-Yang Huang, Shih-Huang Tai, Che-Chao Chang, Yi-Fang Tu, Chih-Han Chang, E-Jian Lee
In the present study, the neuroprotective potential of magnolol against ischemia-reperfusion brain injury was examined via in vivo and in vitro experiments. Magnolol exhibited strong radical scavenging and antioxidant activity, and significantly inhibited the production of interleukin‑6, tumor necrosis factor‑a and nitrite/nitrate (NOX) in lipopolysaccharide-stimulated BV2 and RAW 264.7 cells when applied at concentrations of 10 and 50 µM, respectively. Magnolol (100 µM) also significantly attenuated oxygen‑glucose deprivation‑induced damage in neonatal rat hippocampal slice cultures, when administered up to 4 h following the insult...
January 15, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29335483/pilot-study-to-assess-visualization-and-therapy-of-inflammatory-mechanisms-after-vessel-reopening-in-a-mouse-stroke-model
#10
Ebba Beller, Laura Reuter, Anne Kluge, Christine Preibisch, Ute Lindauer, Alexei Bogdanov, Friederike Lämmer, Claire Delbridge, Kaspar Matiasek, Benedikt J Schwaiger, Tobias Boeckh-Behrens, Claus Zimmer, Alexandra S Gersing
After reperfusion therapy in stroke patients secondary inflammatory processes may increase cerebral damage. In this pilot study, effects of anti-inflammatory therapy were assessed in a middle cerebral artery occlusion (MCAO) mouse model after reperfusion. 1 hour after MCAO, the artery was reopened and tacrolimus or NaCl were administered intra-arterially. Perfusion-weighted (PWI) and diffusion-weighted images (DWI) were obtained by MRI during MCAO. DWI, T2- and T1-weighted images with and without Bis-5HT-DTPA administration were obtained 24 hours after MCAO...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29334161/the-role-of-neurosonology-in-the-diagnosis-and-management-of-patients-with-carotid-artery-disease-a-review
#11
REVIEW
Odysseas Kargiotis, Apostolos Safouris, Georgios Magoufis, Maria Georgala, Andromachi Roussopoulou, Eleftherios Stamboulis, Konstantinos G Moulakakis, Andreas Lazaris, George Geroulakos, Spyros Vasdekis, Georgios Tsivgoulis
Carotid artery disease (CAD) is a common cause of ischemic stroke with high rates of recurrence. Carotid endarterectomy (CEA) or carotid artery stenting (CAS) are highly recommended for the secondary prevention of symptomatic CAD during the first 14 days following the index event of transient ischemic attack or minor stroke. CEA or CAS may also be offered in selected cases with severe asymptomatic stenosis. Herein, we review the utility of neurosonology in the diagnosis and pre-/peri-interventional assessment of CAD patients who undergo carotid revascularization procedures...
January 15, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29332028/possible-erythrocyte-contributions-to-and-exacerbation-of-the-post-thrombolytic-no-reflow-phenomenon
#12
Shang-Jen Yu, James P Buerck, Edgar A O'Rear, Thomas L Whitsett
BACKGROUND: Reperfusion injury often occurs with therapeutic intervention addressing the arterial occlusions causing acute myocardial infarction and stroke. The no-reflow phenomenon has been ascribed to leukocyte plugging and blood vessel constriction in the microcirculation. OBJECTIVE: To assess possible red cell contributions to post thrombolytic no-reflow phenomenon. METHODS: Blood clots were formed by recalcifying 1 ml of citrated fresh human venous blood and then lysed by adding 1,000 units of streptokinase (SK) at several intervals within 1 hour...
January 11, 2018: Biorheology
https://www.readbyqxmd.com/read/29331305/tigar-inhibits-ischemia-reperfusion-induced-inflammatory-response-of-astrocytes
#13
Jieyu Chen, Ding-Mei Zhang, Xing Feng, Jian Wang, Yuan-Yuan Qin, Tian Zhang, Qiao Huang, Rui Sheng, Zhong Chen, Mei Li, Zheng-Hong Qin
The inflammatory response of glial cells contributes to neuronal damage or repair after brain ischemia/reperfusion insult. We previously demonstrated a protective role of TP53-induced glycolysis and apoptosis regulator (TIGAR) in ischemic neuronal injury through increasing the flow of pentose phosphate pathway (PPP). The present study investigated the possible role of TIGAR in ischemia/reperfusion-induced inflammatory response of astrocytes. Male ICR mice were subjected to middle cerebral artery occlusion for 2 h followed by 24 h reperfusion and cultured primary astrocytes were subjected to oxygen glucose deprivation for 9 h followed by 24 h reoxygenation (OGD/R)...
January 10, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29329654/uhplc-ltq-orbitrap-based-metabolomics-coupled-with-metabolomics-pathway-analysis-method-for-exploring-the-protection-mechanism-of-kudiezi-injection-in-a-rat-anti-ischemic-cerebral-reperfusion-damage-model
#14
Si-Yi Liu, Wei Cai, Fei Wang, Ying Liu, Zhan-Peng Shang, Xiu-Ping Zhang, Zi-Jian Wang, Jian-Qiu Lu, Jia-Yu Zhang
Kudiezi injection has been used extensively in the treatment of cerebrovascular and cardiovascular diseases. However, its therapeutic effects and underlying mechanism of action are not fully understood. The aim of the present study was to clarify the protective mechanisms of Kudiezi injection on cerebral ischemic injury, using metabolomics methods. Middle cerebral artery occlusion (MCAO) was introduced in rats to build the cerebral ischemic damage. UHPLC-LTQ-Orbitrap-based analytical method was established for analysis of the metabolites...
December 2017: Chinese Journal of Natural Medicines
https://www.readbyqxmd.com/read/29327997/mechanical-thrombectomy-in-basilar-artery-occlusion-influence-of-reperfusion-on-clinical-outcome-and-impact-of-the-first-line-strategy-adapt-vs-stent-retriever
#15
Benjamin Gory, Mikael Mazighi, Raphael Blanc, Julien Labreuche, Michel Piotin, Francis Turjman, Bertrand Lapergue
OBJECTIVE Several randomized trials have been focused on patients with anterior circulation stroke, whereas few data on posterior circulation stroke are available. Thus, new mechanical thrombectomy (MT) strategies, including a direct-aspiration first-pass technique (ADAPT), remain to be evaluated in basilar artery occlusion (BAO) patients. The authors here assessed the influence of reperfusion on outcome in BAO patients and examined whether ADAPT improves the reperfusion rate compared with stent retriever devices...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29323038/electroacupuncture-improves-neurovascular-unit-reconstruction-by-promoting-collateral-circulation-and-angiogenesis
#16
Lei Shi, Hong-Mei Cao, Ying Li, Shi-Xin Xu, Yan Zhang, Yang Zhang, Zhe-Feng Jin
Acupuncture at Shuigou (GV26) shows good clinical efficacy for treating stroke, but its mechanism remains poorly understood. In this study, a cerebral infarction model of ischemia/reperfusion injury received electroacupuncture at GV26 (15 Hz and 1 mA, continuous wave [biphasic pulses], for 5 minutes). Electroacupuncture effectively promoted regional cerebral blood flow on the infarct and non-infarct sides, increased infarct lesions, lectin, and number of blood vessels, upregulated von Willebrand factor and cell proliferation marker Ki67 expression, and diminished neurological severity score...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29322481/influence-of-thrombolysis-on-the-safety-and-efficacy-of-blocking-platelet-adhesion-or-secretory-activity-in-acute-ischemic-stroke-in-mice
#17
Michael K Schuhmann, Peter Kraft, Michael Bieber, Axel Haarmann, György A Homola, Mirko Pham, Bernhard Nieswandt, Guido Stoll
In acute ischemic stroke (AIS), there is an alarming discrepancy between recanalization rates of up to 70% by combined recombinant tissue-type plasminogen activator (rt-PA) therapy and mechanical thrombectomy, and no clinical benefit in at least every second stroke patient. This is partly due to ischemia/reperfusion (I/R) injury. In a translational approach, we used mice lacking dense- (Unc13d -/- ) or α-granules (Nbeal2 -/- ) and mice after blocking of platelet glycoprotein receptor (GP) Ib conferring protection from I/R injury...
January 10, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#18
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29322070/fuzzy-c-means-segmentation-of-major-vessels-in-angiographic-images-of-stroke
#19
Christopher W Haddad, Karen Drukker, Rebecca Gullett, Timothy J Carroll, Gregory A Christoforidis, Maryellen L Giger
Patients suffering from ischemic stroke develop varying degrees of pial arterial supply (PAS), which can affect patient response to reperfusion therapy and risk of hemorrhage. Since vessel segmentation may be an important part in identifying PAS, we present a fuzzy c-means (FCM) clustering method to segment major vessels in x-ray angiograms. Our approach consists of semiautomatic region of interest (ROI) delineation, separation of major vessels from capillary blush and/or background noise through FCM clustering, and identification of the major vessel category...
January 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29315561/faim2-contributes-to-neuroprotection-by-erythropoietin-in-transient-brain-ischemia
#20
Daniel Komnig, Karen Gertz, Pardes Habib, Kay W Nolte, Tareq Meyer, Marc A Brockmann, Matthias Endres, Birgit Rathkolb, Martin Hrabě de Angelis, Jörg B Schulz, Björn H Falkenburger, Arno Reich
Delayed cell death in the penumbra region of acute ischemic stroke occurs through apoptotic mechanisms, making it amenable to therapeutic interventions. Fas/CD95 mediates apoptotic cell death in response to external stimuli. In mature neurons, Fas/CD95 signaling is modulated by Fas-apoptotic inhibitory molecule 2 (Faim2), which reduces cell death in animal models of stroke, meningitis, and Parkinson disease. Erythropoietin (EPO) has been studied as a therapeutic strategy in ischemic stroke. Erythropoietin stimulates the phosphatidylinositol-3 kinase/Akt (PI3K/Akt) pathway, which regulates Faim2 expression...
January 8, 2018: Journal of Neurochemistry
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