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Stroke reperfusion

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https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#1
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29146873/mobile-interventional-stroke-teams-lead-to-faster-treatment-times-for-thrombectomy-in-large-vessel-occlusion
#2
Daniel Wei, Thomas J Oxley, Dominic A Nistal, Justin R Mascitelli, Natalie Wilson, Laura Stein, John Liang, Lena M Turkheimer, Jacob R Morey, Claire Schwegel, Ahmed J Awad, Hazem Shoirah, Christopher P Kellner, Reade A De Leacy, Stephan A Mayer, Stanley Tuhrim, Srinivasan Paramasivam, J Mocco, Johanna T Fifi
BACKGROUND AND PURPOSE: Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model...
November 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29146830/mechanical-thrombectomy-performs-similarly-in-real-world-practice-a-2016-nationwide-study-from-the-czech-republic
#3
Ondrej Volny, Antonin Krajina, Silvie Belaskova, Michal Bar, Petra Cimflova, Roman Herzig, Daniel Sanak, Ales Tomek, Martin Köcher, Miloslav Rocek, Radek Padr, Filip Cihlar, Miroslava Nevsimalova, Lubomir Jurak, Roman Havlicek, Martin Kovar, Petr Sevcik, Vladimir Rohan, Jan Fiksa, Bijoy K Menon, Robert Mikulik
BACKGROUND: Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. METHODS: Available nationwide data for the CR from 2016 from the Safe Implementation of Treatments in Stroke-Thrombectomy (SITS-TBY) registry for patients with terminal internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusions were compared with data from HERMES...
November 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29146434/cerebral-hyperperfusion-syndrome-after-endovascular-reperfusion-therapy-in-a-patient-with-acute-internal-carotid-artery-and-middle-cerebral-artery-occlusions
#4
Tetsuya Hashimoto, Shoji Matsumoto, Mitsushige Ando, Hideo Chihara, Atsushi Tsujimoto, Taketo Hatano
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) is known to be a rare but devastating complication of carotid artery revascularization. Because patients with acute ischemic stroke due to acute major cerebral and/or cervical artery occlusion treated with endovascular reperfusion therapy may have impaired autoregulation in the cerebral vasculature, these patients may also develop CHS. Despite the growing number of endovascular reperfusion procedures for acute ischemic stroke, this complication has only rarely been reported...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29145742/improving-mechanical-thrombectomy-time-metrics-in-the-angiography-suite-stroke-cart-parallel-workflows-and-conscious-sedation
#5
Fabio Settecase, David B McCoy, Robert Darflinger, Matthew D Alexander, Daniel L Cooke, Christopher F Dowd, Steven W Hetts, Randall T Higashida, Van V Halbach, Matthew R Amans
Purpose Earlier reperfusion of large-vessel occlusion (LVO) stroke improves functional outcomes. We hypothesize that use of a stroke cart in the angiography suite, containing all commonly used procedural equipment in a mechanical thrombectomy, combined with parallel staff workflows, and use of conscious sedation when possible, improve mechanical thrombectomy time metrics. Methods We identified 47 consecutive LVO patients who underwent mechanical thrombectomy at our center, retrospectively and prospectively from implementation of these three workflow changes (19 pre- and 28 post-)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29138802/in-vitro-investigation-of-the-mechanism-underlying-the-effect-of-ginsenoside-on-the-proliferation-and-differentiation-of-neural-stem-cells-subjected-to-oxygen-glucose-deprivation-reperfusion
#6
Jian Gao, Huajing Bai, Qiang Li, Jian Li, Feng Wan, Mo Tian, Yuanyuan Li, Yilun Song, Jianping Zhang, Yinchu Si
The present study comprised a series of experiments to investigate the mechanism underlying the effect of ginsenoside on the self-renewal, proliferation and differentiation of neural stem cells (NSCs) undergoing oxygen-glucose deprivation/reperfusion (OGD/R) in vitro. The NSCs, which were isolated from the hippocampus of embryonic day 17 embryo rats, were subjected to OGD/R to establish an in vitro model of brain ischemia-reperfusion, following which different doses of ginsenoside were administered to the model...
November 13, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29136153/reverse-ncx-attenuates-cellular-sodium-loading-in-metabolically-compromised-cortex
#7
Niklas J Gerkau, Cordula Rakers, Simone Durry, Gabor C Petzold, Christine R Rose
In core regions of ischemic stroke, disruption of blood flow causes breakdown of ionic gradients and, ultimately, calcium overload and cell death. In the surrounding penumbra, cells may recover upon reperfusion, but recovery is hampered by additional metabolic demands imposed by peri-infarct depolarizations (PIDs). There is evidence that sodium influx drives PIDs, but no data exist on PID-related sodium accumulations in vivo. Here, we found that PIDs in mouse neocortex are associated with propagating sodium elevations in neurons and astrocytes...
November 9, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/29135347/relative-cerebral-blood-volume-is-associated-with-collateral-status-and-infarct-growth-in-stroke-patients-in-swift-prime
#8
Juan F Arenillas, Elisa Cortijo, Pablo García-Bermejo, Elad I Levy, Reza Jahan, Mayank Goyal, Jeffrey L Saver, Gregory W Albers
We aimed to evaluate how predefined candidate cerebral perfusion parameters correlate with collateral circulation status and to assess their capacity to predict infarct growth in patients with acute ischemic stroke (AIS) eligible for endovascular therapy. Patients enrolled in the SWIFT PRIME trial with baseline computed tomography perfusion (CTP) scans were included. RAPID software was used to calculate mean relative cerebral blood volume (rCBV) in hypoperfused regions, and hypoperfusion index ratio (HIR). Blind assessments of collaterals were performed using CT angiography in the whole sample and cerebral angiogram in the endovascular group...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29134984/evaluation-of-neuroprotective-effect-of-hibiscus-sabdariffa-linn-aqueous-extract-against-ischaemic-reperfusion-insult-by-bilateral-common-carotid-artery-occlusion-in-adult-male-rats
#9
Olatunde Owoeye, Micheal Oluwatosin Gabriel
Ischaemic brain injury continues to be devastating, causing social, medical and relationship disruption. Oxidativedamage has been reported to be one of the mechanisms for brain damage following ischaemic stroke. The antioxidant activityof Hibiscus sabdariffa L. was investigated for a possible protective effect against ischaemia-induced brain damage in rats.Adult male Wistar rats (n=35) were divided into five groups of 7 rats per group. Group 1 served as control was given tapwater; Group 2: 500 mg/kg daily of Hibiscus sabdariffa L...
June 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
https://www.readbyqxmd.com/read/29133696/the-influence-of-initial-stroke-severity-on-mortality-overall-functional-outcome-and-in-hospital-placement-at-90-days-following-acute-ischemic-stroke-a-tertiary-hospital-stroke-register-study
#10
Sonu Bhaskar, Peter Stanwell, Andrew Bivard, Neil Spratt, Rhonda Walker, Gemma H Kitsos, Mark W Parsons, Malcolm Evans, Louise Jordan, Michael Nilsson, John Attia, Christopher Levi
BACKGROUND AND PURPOSE: Epidemiological studies on the extent of the interaction and/or influence of stroke severity on clinical outcomes are important. The aim of the present study was to investigate the putative (and degree of) impact of initial stroke severity in predicting the overall functional outcome, in-hospital placement, and mortality in acute ischemic stroke (AIS) in comparison with age, admission to the stroke unit and thrombolytic treatment. MATERIALS AND METHODS: The John Hunter Hospital acute stroke register was used to collect a retrospective cohort of AIS patients being assessed for reperfusion therapy and admitted between January 2006 and December 2013...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29131464/interferon-regulatory-factor-4-5-signaling-impacts-on-microglial-activation-after-ischemic-stroke-in-mice
#11
Abdullah Al Mamun, Anjali Chauhan, Haifu Yu, Yan Xu, Romana Sharmeen, Fudong Liu
Microglial activation is a key element in initiating and perpetuating inflammatory responses to stroke. Interferon regulatory factor 5 (IRF5) and IRF4 signaling have been found critical in mediating macrophage pro-inflammatory (M1) and anti-inflammatory (M2) phenotypes respectively in peripheral inflammation. We hypothesize that the IRF5/4 regulatory axis also mediates microglial activation after stroke. C57BL6 mice of 8-12 weeks were subject to a 90-minute middle cerebral artery occlusion and the brains evaluated at 24h, 3d, 10d and 30d after reperfusion...
November 13, 2017: European Journal of Neuroscience
https://www.readbyqxmd.com/read/29127194/dump-the-pump-manual-aspiration-thrombectomy-mat-with-a-syringe-is-technically-effective-expeditious-and-cost-efficient
#12
Bradley A Gross, Ashutosh P Jadhav, Tudor G Jovin, Brian Thomas Jankowitz
INTRODUCTION: Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. OBJECTIVE: To present in vitro and clinical results of MAT with a syringe. METHODS: An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29126723/design-synthesis-and-evaluation-of-ndga-analogues-as-potential-anti-ischemic-stroke-agents
#13
Lili Huang, Jiabing Wang, Liping Chen, Min Zhu, Shoubiao Wu, Shenghui Chu, Yuantie Zheng, Ziliang Fan, Jiafeng Zhang, Wulan Li, Dahui Chen, Xiufei Yang, Sicen Wang, Peihong Qiu, Jianzhang Wu
Exogenous supplementation of antioxidants with ROS scavenging activity would be a potential therapy to cerebral ischemia-reperfusion injury in stroke. In the present study, a series of NDGA analogues with attenuation oxidative stress by directly scavenging ROS and indirectly through keap1/Nrf2/ARE pathway activation were designed and synthesized. All analogues were found to effectively remove ROS directly by DPPH radical scavenging assay, and compound 3a conferred potent protection from the oxidative injury in PC12 cells via promoting Nrf2 to translocate into nucleus and increasing expression of heme oxygenase-1(HO-1), where strongly reduced intracellular ROS level indirectly...
October 16, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29125039/astrocyte-autophagy-flux-protects-neurons-against-oxygen-glucose-deprivation-and-ischemic-reperfusion-injury
#14
Xue Liu, Fengfeng Tian, Shiquan Wang, Feng Wang, Lize Xiong
The role of autophagy varies with the type of acute brain injury. In general, autophagy mediates a clear neuroprotective effect in intoxication caused by various psychoactive agents, subarachnoid hemorrhage and spinal cord injury. In contrast, autophagic cell death has also been reported to actively contribute to neuronal loss in neonatal hypoxic ischemic encephalopathy. However, it still remains to be determined whether autophagy pays a cytoprotective or a cytotoxic role in stroke. Previous studies focused primarily on the role of neurons rather than the role of astrocytes in brain injury...
November 10, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/29123977/sodium-hydrosulfide-attenuates-cerebral-ischemia-reperfusion-injury-by-suppressing-overactivated-autophagy-in-rats
#15
Wen-Wu Jiang, Bai-Sheng Huang, Yang Han, Lv-Hong Deng, Li-Xiang Wu
Ischemic stroke is a leading cause of death and disability worldwide, and autophagy may be involved in the pathological process of cerebral ischemia/reperfusion injury. Hydrogen sulfide (H2S) is an endogenous gasotransmitter with protective effects against multiple diseases. Here, we tested the effect of H2S on cerebral ischemia/reperfusion injury in rats. Sodium hydrosulfide (NaHS), an H2S donor, improved neurological function and reduced the size of the infarcts induced by transient middle cerebral artery occlusion (MCAO) followed by reperfusion in rats...
November 2017: FEBS Open Bio
https://www.readbyqxmd.com/read/29123466/neuroprotective-effect-of-%C3%AE-caryophyllene-on-cerebral-ischemia-reperfusion-injury-via-regulation-of-necroptotic-neuronal-death-and-inflammation-in-vivo-and-in-vitro
#16
Mei Yang, Yongjiu Lv, Xiaocui Tian, Jie Lou, Ruidi An, Qian Zhang, Minghang Li, Lu Xu, Zhi Dong
Necrotic cell death is a hallmark feature of ischemic stroke and it may facilitate inflammation by releasing intracellular components after cell-membrane rupture. Previous studies reported that β-caryophyllene (BCP) mitigates cerebral ischemia-reperfusion (I/R) injury, but the underlying mechanism remains unclear. We explored whether BCP exerts a neuroprotective effect in cerebral I/R injury through inhibiting necroptotic cell death and inflammation. Primary neurons with and without BCP (0.2, 1, 5, 25 μM) treatment were exposed to oxygen-glucose deprivation and re-oxygenation (OGD/R)...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29122651/downregulation-of-lipocalin-2-and-bim-expression-after-remote-limb-preconditioning-in-the-ischemic-rat-brain
#17
Mingli Liu, Jing Chen, Shufan Zhang, Chuancheng Ren
Although it has been proved that remote limb preconditioning (RPC) can exert neurological protection effects after ischemic cerebral stroke (ICS), the underlying mechanisms of RPC still need to be elucidated for its better transformation to clinical application. Lipocalin-2 (LCN2) was upregulated after cerebral ischemia and mediated reperfusion injury in the models of ischemic stroke. So here, we investigated that whether RPC could downregulate the levels of LCN2 protein and its receptor resulting from cerebral ischemia reperfusion (I/R) injury...
November 6, 2017: Brain Research
https://www.readbyqxmd.com/read/29120921/pregnancy-and-ischemic-stroke-a-practical-guide-to-management
#18
Mayte E van Alebeek, Roel de Heus, Anil M Tuladhar, Frank-Erik de Leeuw
PURPOSE OF REVIEW: Ischemic stroke during pregnancy or the puerperium is a devastating disease during a crucial period in life and warrants a specific approach. To date, current practice is mainly based on expert opinion because of a lack of randomized controlled trials and high-quality observational studies. The present review is intended as a practical guide to (acute) management of ischemic stroke during pregnancy and puerperium. RECENT FINDINGS: Recent findings showed that the incidence of stroke during pregnancy is rising...
November 7, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29120327/capillary-pericytes-mediate-coronary-no-reflow-after-myocardial-ischaemia
#19
Fergus M O'Farrell, Svetlana Mastitskaya, Matthew Hammond-Haley, Felipe Freitas, Wen Rui Wah, David Attwell
After cardiac ischaemia, a prolonged decrease of coronary microvascular perfusion often occurs even after flow is restored in an upstream artery. This 'no-reflow' phenomenon worsens patient prognosis. In the brain, after stroke, a similar post-ischaemic 'no-reflow' has been attributed to capillary constriction by contractile pericytes. We now show that occlusion of a rat coronary artery, followed by reperfusion, blocks 40% of cardiac capillaries and halves perfused blood volume within the affected region. Capillary blockages colocalised strongly with pericytes, where capillary diameter was reduced by 37%...
November 9, 2017: ELife
https://www.readbyqxmd.com/read/29118796/a-comparison-of-mechanical-thrombectomy-in-the-m1-and-m2-segments-of-the-middle-cerebral-artery-a-review-of-585-consecutive-patients
#20
Pervinder Bhogal, Philipp Bücke, Muhammad AlMatter, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar Pérez
Background: Mechanical thrombectomy for anterior-circulation large-vessel occlusion has shown benefit; however, the question of whether this technique is safe and effective in the distal vasculature remains unanswered. We sought to compare the outcome data from mechanical thrombectomy of the M2 branches of the middle cerebral artery (MCA) with those of the M1 segment. Methods: We performed a retrospective analysis of prospectively collected data of patients with acute ischaemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA between August 2008 and August 2016...
October 2017: Interventional Neurology
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