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Stroke reperfusion

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https://www.readbyqxmd.com/read/28319240/two-paradigms-for-endovascular-thrombectomy-after-intravenous-thrombolysis-for-acute-ischemic-stroke
#1
Gaspard Gerschenfeld, Ioan-Paul Muresan, Raphael Blanc, Michael Obadia, Marie Abrivard, Michel Piotin, Sonia Alamowitch
Importance: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) is recommended to treat acute ischemic stroke (AIS) with a large vessel occlusion (LVO). Most hospitals do not have on-site MT facilities, and most patients need to be transferred secondarily after IVT (drip and ship), which may have an effect on the neurologic outcome. Objective: To compare the functional independence at 3 months between patients treated under the drip-and-ship paradigm and those treated on site (mothership)...
March 20, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28316869/forced-arterial-suction-thrombectomy-using-distal-access-catheter-in-acute-ischemic-stroke
#2
Ho-Cheol Lee, Dong-Hun Kang, Yang-Ha Hwang, Yong-Sun Kim, Yong-Won Kim
Historical innovations in mechanical thrombectomy devices and strategies for ischemic stroke have resulted in improved angiographic outcomes and better clinical outcomes. Various devices have been used, but the two most common approaches are aspiration thrombectomy and stent-retrieval thrombectomy. Aspiration thrombectomy has advanced from the traditional Penumbra system to forced arterial suction thrombectomy and a direct aspiration first-pass technique. Newer generation aspiration catheters with flexible distal tips and a larger bore have demonstrated faster and better recanalization relative to older devices...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28315758/tat-pep-a-novel-blocker-of-pirb-enhances-the-recovery-of-cognitive-function-in-mice-after-transient-global-cerebral-ischemia
#3
Liya Li, Bin Deng, Shuang Li, Tao Jiang, Zhaoyang Xiao, Qiang Wang
Neuronal damage and axonal regeneration inhibition are the main reasons to poor functional recovery after ischemia. Nogo-A signals inhibit axon outgrowth through the PirB receptor after ischemic reperfusion injury in central nervous system. We use TAT-PEP, a novel protein which could pass through the blood brain barrier, to block the function of PirB and identify the long-term neurological and behavioral recovery after bilateral common carotid artery occlusion (BCCAO) in mice. We observed that TAT-PEP promoted neuron survival and inhibited neuronal apoptosis...
March 15, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28315303/neuroprotective-effect-of-2-hydroxy-arachidonic-acid-in-a-rat-model-of-transient-middle-cerebral-artery-occlusion
#4
I F Ugidos, M Santos-Galdiano, D Pérez-Rodríguez, B Anuncibay-Soto, E Font-Belmonte, D J López, M Ibarguren, X Busquets, A Fernández López
Stroke modifies the composition of cell membranes by eliciting the breakdown of membrane phospholipids whose products, such as arachidonic acid (AA), are released in the cytosol. The action of enzymes such as cyclooxygenases on AA leads to inflammatory stimuli and increases the cell oxidative stress. We report here the neuroprotective effect of 2-hydroxyarachidonic acid (2OAA), a cyclooxygenase inhibitor derived from AA, as a promising neuroprotective therapy against stroke. The effect of a single dose of 2OAA, administered intragastrically 1 hour after the ischaemic insult, in a rat model of transient middle cerebral artery occlusion (tMCAO) was tested after 24 hours of reperfusion...
March 14, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28303172/astragaloside-iv-for-experimental-focal-cerebral-ischemia-preclinical-evidence-and-possible-mechanisms
#5
REVIEW
Hui-Lin Wang, Qi-Hui Zhou, Meng-Bei Xu, Xiao-Li Zhou, Guo-Qing Zheng
Astragaloside IV (AST-IV) is a principal component of Radix Astragali seu Hedysari (Huangqi) and exerts potential neuroprotection in experimental ischemic stroke. Here, we systematically assessed the effectiveness and possible mechanisms of AST-IV for experimental acute ischemic stroke. An electronic search in eight databases was conducted from inception to March 2016. The study quality score was evaluated using the CAMARADES. Rev Man 5.0 software was used for data analyses. Thirteen studies with 244 animals were identified...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28302608/ipsilateral-prominent-thalamostriate-vein-on-susceptibility-weighted-imaging-predicts-poor-outcome-after-intravenous-thrombolysis-in-acute-ischemic-stroke
#6
X Zhang, S Zhang, Q Chen, W Ding, B C V Campbell, M Lou
BACKGROUND AND PURPOSE: The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis. MATERIALS AND METHODS: We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28300551/role-of-caveolin-1-vascular-endothelial-growth-factor-pathway-in-basic-fibroblast-growth-factor-induced-angiogenesis-and-neurogenesis-after-treadmill-training-following-focal-cerebral-ischemia-in-rats
#7
Qiongyi Pang, Huimei Zhang, Zhenzhen Chen, Yudan Wu, Min Yidian Bai Liu, Yun Zhao, Fengxia Tu, Chan Liu, Xiang Chen
Exercise is known to aid functional recovery following ischemia, though the mechanisms responsible for the beneficial effects of exercise on recovery from ischemic stroke are not fully understood. Basic fibroblast growth factor (bFGF) contributes to angiogenesis and promotes neurologic functional recovery after stroke. The present study aimed to investigate the possible mechanisms whereby treadmill exercise ameliorated impaired angiogenesis and neurogenesis following transient cerebral ischemia in middle cerebral artery occlusion (MCAO) rats...
March 11, 2017: Brain Research
https://www.readbyqxmd.com/read/28294064/knockdown-of-c-c-chemokine-receptor-5-ccr5-is-protective-against-cerebral-ischemia-and-reperfusion-injury
#8
Edna Constanza Gómez Victoria, Eliana Cristina de Brito Toscano, Ana Clara de Sousa Cardoso, Daniele Gonçalves da Silva, Aline Silva de Miranda, Lucíola da Silva Barcelos, Michelle Adriane Sugimoto, Lirlândia Pires Sousa, Isabel Vieira de Assis Lima, Antônio Carlos Pinheiro de Oliveira, Fátima Brant, Fabiana Simão Machado, Mauro Martins Teixeira, Antônio Lúcio Teixeira, Milene Alvarenga Rachid
BACKGROUND: Stroke is the second leading cause of death and a major cause of disability of adults worldwide. Inflammatory processes are known to contribute to the pathophysiology of cerebral ischemia, especially following reperfusion. Chemokines and their receptors are involved in migration of leukocytes and have been implicated in pathogenesis of ischemic stroke. OBJECTIVE: In the present study, we investigated the effects of C-C chemokine receptor type 5 (CCR5) deficiency on neurological outcome, brain damage and expression of pro-inflammatory chemokines: chemokine (C-X-C motif) ligand 1 (CXCL1), chemokine (CC motif) ligand 3 (CCL3) and chemokine (C-C motif) ligand 5 (CCL5), and the brain-derived neurotrophic factor (BDNF)...
March 13, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28293050/cerebral-ischemia-reperfusion-injury-in-the-hyperthyroid-rat
#9
Somaye Keshavarz, Gholam Abbas Dehghani
BACKGROUND: Hyperthyroidism as a risk factor for stroke is not conclusive. There are no definite data on the relationship between ischemic cerebrovascular injury and hyperthyroidism. This study was designed to define whether the outcomes of post-ischemic stroke injury are influenced by chronic hyperthyroidism. METHODS: Two groups of hyperthyroid (HT) and control euthyroid rats of equal numbers (n=22) were included in the study. Hyperthyroidism was induced for 4 weeks by adding L-thyroxine (300 μg/kg) to drinking water...
January 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28289148/admission-hyperglycemia-and-outcomes-in-large-vessel-occlusion-strokes-treated-with-mechanical-thrombectomy
#10
Nitin Goyal, Georgios Tsivgoulis, Abhi Pandhi, Kira Dillard, Aristeidis H Katsanos, Georgios Magoufis, Jason J Chang, Ramin Zand, Daniel Hoit, Apostolos Safouris, Asim Choudhri, Anne W Alexandrov, Andrei V Alexandrov, Adam S Arthur, Lucas Elijovich
BACKGROUND AND PURPOSE: Higher admission serum glucose levels have been associated with poor outcomes in patients with acute ischemic stroke (AIS) treated with IV thrombolysis. We sought to evaluate the association of admission serum glucose with early outcomes of patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT). METHODS: Consecutive AIS patients due to ELVO treated with MT in three tertiary stroke centers were evaluated...
March 13, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28288870/tia-model-is-attainable-in-wistar-rats-by-intraluminal-occlusion-of-the-mca-for-10-min-or-shorter
#11
A Durukan Tolvanen, E Tatlisumak, E Pedrono, U Abo-Ramadan, T Tatlisumak
Transient ischemic attack (TIA) has received only little attention in the experimental research field. Recently, we introduced a TIA model for mice, and here we set similar principles for simulating this human condition in Wistar rats. In the model: 1) transient nature of the event is ensured, and 2) 24 h after the event animals are free from any sensorimotor deficit and from any detectable lesion by magnetic resonance imaging (MRI). Animals experienced varying durations of ischemia (5, 10, 12.5, 15, 25, and-30 min, n=6-8 per group) by intraluminal middle cerebral artery occlusion (MCAO)...
March 10, 2017: Brain Research
https://www.readbyqxmd.com/read/28284901/the-application-and-neuroprotective-mechanisms-of-cerebral-ischemic-post-conditioning-a-review
#12
REVIEW
Zhixing Li, Hanlin Chen, Jinglei Lv, Renliang Zhao
Ischemic stroke is a serious cerebrovascular disease that leads to death and/or severe disability, and extensive research has been directed in search of appropriate treatment measures. One such potential treatment is the use of cerebral ischemic post-conditioning (IPostC), and its neuroprotective effects and controllability have been widely confirmed and validated. Numerous studies have indicated that cerebral IPostC can suppress the inflammatory reaction in ischemia reperfusion injury, improve cerebral circulation, reduce infarct volume, and promote both neurogenesis and angiogenesis...
March 8, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28284343/sphk1-mediates-neuroinflammation-and-neuronal-injury-via-traf2-nf-%C3%AE%C2%BAb-pathways-in-activated-microglia-in-cerebral-ischemia-reperfusion
#13
Danying Su, Yuefeng Cheng, Shi Li, Dawei Dai, Wei Zhang, Manhua Lv
Sphingosine kinase 1 (Sphk1), a key enzyme responsible for phosphorylating sphingosine into sphingosine1-phosphate (S1P), plays an important role in mediating post-stroke neuroinflammation. However, the pathway and mechanism of the Sphk1-mediated inflammatory response remains unknown. In this study, we found that suppression of Sphk1 decreased IL17 production and relieved neuronal damage induced by microglia in cerebral ischemia reperfusion (IR) or in an in vitro oxygen-glucose deprivation reperfusion (OGDR) system...
April 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28283469/timely-reperfusion-in-stroke-and-myocardial-infarction-is-not-correlated-an-opportunity-for-better-coordination-of-acute-care
#14
Kori Sauser Zachrison, Deborah A Levine, Gregg C Fonarow, Deepak L Bhatt, Margueritte Cox, Phillip Schulte, Eric E Smith, Robert E Suter, Ying Xian, Lee H Schwamm
BACKGROUND: Timely reperfusion is critical in acute ischemic stroke (AIS) and ST-segment-elevation myocardial infarction (STEMI). The degree to which hospital performance is correlated on emergent STEMI and AIS care is unknown. Primary objective of this study was to determine whether there was a positive correlation between hospital performance on door-to-balloon (D2B) time for STEMI and door-to-needle (DTN) time for AIS, with and without controlling for patient and hospital differences...
March 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28282606/protection-against-cerebral-infarction-by-withaferin-a-involves-inhibition-of-neuronal-apoptosis-activation-of-pi3k-akt-signaling-pathway-and-reduced-intimal-hyperplasia-via-inhibition-of-vsmc-migration-and-matrix-metalloproteinases
#15
Qi-Zhi Zhang, Yu-Dong Guo, Hao-Mei Li, Rui-Zheng Wang, Shou-Gang Guo, Yi-Feng Du
PURPOSE: Stroke is a major public health concern with high rates of morbidity and mortality worldwide. Cerebral ischemia and infarction are commonly associated with stroke. Currently used medications, though effective, are also associated with adverse effects. Development of effective neuroprotective agents with fewer side effects would be of clinical value. We evaluated the effects of Withaferin A (WA), a steroidal lactone derived from the plant Withania somnifera, on experimentally induced cerebral infarction...
March 7, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28277459/diffusion-and-perfusion-mr-imaging-in-acute-stroke-clinical-utility-and-potential-limitations-for-treatment-selection
#16
Mathew Bateman, Lee-Anne Slater, Thabele Leslie-Mazwi, Claus Z Simonsen, Stephen Stuckey, Ronil V Chandra
Magnetic resonance (MR) diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) offer unique insight into acute ischemic stroke pathophysiology. These techniques may offer the ability to apply pathophysiology to accurately individualize acute stroke reperfusion treatment, including extending the opportunity of reperfusion treatment to well beyond the current time-based treatment windows.This review examines the use of DWI and PWI in the major stroke trials, their current clinical utility, and potential limitations for reperfusion treatment selection...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28277455/ischemic-stroke-treatment-trials-neuroimaging-advancements-and-implications
#17
Vivek P Patel, Jeremy J Heit
There have been significant advancements in the treatment of acute ischemic stroke in the last 2 decades. Recent trials have placed a significant emphasis on minimizing the time from symptom onset to stroke treatment by reperfusion therapies, which decreases the cerebral infarct volume and improves clinical outcomes. These clinical advances have paralleled and been aided by advances in neuroimaging. However, controversy remains regarding how much time should be spent on neuroimaging evaluation versus expediting patient treatment...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28275651/platelet-microparticles-a-biomarker-for-recanalization-in-rtpa-treated-ischemic-stroke-patients
#18
Andrew Bivard, Lisa F Lincz, Jane Maquire, Mark Parsons, Christopher Levi
OBJECTIVES: Identification of a biomarker for acute recanalization could have significant clinical impact. METHODS: We prospectively collected baseline, 24-h, and 90-day clinical and imaging data from consecutive ischemic stroke patients who fulfilled standard clinical eligibility criteria for treatment with intravenous recombinant tissue plasminogen activator (rtPA). Computed tomography angiography was acquired at 24 h and assessed using the thrombolysis is myocardial infarction (TIMI) scale with a score of 2b/3 indicating recanalization...
March 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28273719/depletion-of-microglia-exacerbates-postischemic-inflammation-and-brain-injury
#19
Wei-Na Jin, Samuel Xiang-Yu Shi, Zhiguo Li, Minshu Li, Kristofer Wood, Rayna J Gonzales, Qiang Liu
Brain ischemia elicits microglial activation and microglia survival depend on signaling through colony-stimulating factor 1 receptor (CSF1R). Although depletion of microglia has been linked to worse stroke outcomes, it remains unclear to what extent and by what mechanisms activated microglia influence ischemia-induced inflammation and injury in the brain. Using a mouse model of transient focal cerebral ischemia and reperfusion, we demonstrated that depletion of microglia via administration of the dual CSF1R/c-Kit inhibitor PLX3397 exacerbates neurodeficits and brain infarction...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28271328/intraprocedural-thrombus-fragmentation-during-interventional-stroke-treatment-a-comparison-of-direct-thrombus-aspiration-and-stent-retriever-thrombectomy
#20
Christian Maegerlein, Sascha Prothmann, Kristin Elizabeth Lucia, Claus Zimmer, Benjamin Friedrich, Johannes Kaesmacher
PURPOSE: The aim of this study was to compare the rates of intraprocedural thrombus fragmentation between the exclusive thrombus aspiration technique (ADAPT) and the use of stent retrievers. MATERIALS AND METHODS: Cases with successful recanalization of the primary occlusion site (POS) with either of the techniques were analyzed (n = 36 ADAPT, n = 61 stent retriever). The primary endpoint was the evaluation of intraprocedural thrombus fragmentation before applying additional maneuvers to enhance reperfusion success...
March 7, 2017: Cardiovascular and Interventional Radiology
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