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https://www.readbyqxmd.com/read/28095449/does-antiplatelet-therapy-during-bridging-thrombolysis-increase-rates-of-intracerebral-hemorrhage-in-stroke-patients
#1
Anne Broeg-Morvay, Pasquale Mordasini, Agnieszka Slezak, Kai Liesirova, Julia Meisterernst, Gerhard Schroth, Marcel Arnold, Simon Jung, Heinrich P Mattle, Jan Gralla, Urs Fischer
BACKGROUND: Symptomatic intracerebral hemorrhage (sICH) after bridging thrombolysis for acute ischemic stroke is a devastating complication. We aimed to assess whether the additional administration of aspirin during endovascular intervention increases bleeding rates. METHODS: We retrospectively compared bleeding complications and outcome in stroke patients who received bridging thrombolysis with (tPA+ASA) and without (tPA-ASA) aspirin during endovascular intervention between November 2008 and March 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28094166/carotid-stenting-prior-to-coronary-bypass-surgery-an-updated-systematic-review-and-meta-analysis
#2
REVIEW
K I Paraskevas, S Nduwayo, A N Saratzis, A R Naylor
OBJECTIVES: The aim was to determine 30-day outcomes in patients with concurrent carotid and cardiac disease who underwent carotid artery stenting (CAS) followed by coronary artery bypass grafting (CABG). METHODS: This was a systematic review with searches of PubMed/Medline, Embase, and Cochrane databases. "Same-day" procedures involved CAS + CABG being performed on the same day, and "staged" interventions involved at least 1 day's delay between undergoing CAS and then CABG...
January 13, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28092979/endovascular-treatment-of-hiv-associated-spontaneous-common-carotid-artery-pseudoaneurysm-in-a-case-of-miliary-and-cns-tuberculosis
#3
Rashmi Saraf, Amrita Narang, Mahesh Kardile, Prasad Udmale
HIV and tuberculosis infections are known to be associated with vasculopathy including occlusive disease and aneurysm formation. We report a case of 43-year-old male with miliary and central nervous system (CNS) tuberculosis; recently, diagnosed as HIV seropositive, on antiretroviral and antitubercular treatment presenting with painful neck swelling. He was found to have common carotid artery (CCA) pseudoaneurysm that was managed by endovascular stent grafting. HIV vasculopathy-related CCA pseudoaneurysm is a potentially life-threatening rare entity...
January 17, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28081270/outcome-and-treatment-effects-in-stroke-associated-with-acute-cervical-ica-occlusion
#4
Michael Gliem, John-Ih Lee, Aurica Barckhan, Bernd Turowski, Hans-Peter Hartung, Sebastian Jander
BACKGROUND: Endovascular therapy (EVT) with stent retrievers in addition to i.v. thrombolysis (IVT) has proven effective in acute stroke patients with middle cerebral artery (MCA, M1 segment) and distal internal carotid artery (ICA) occlusion. Limited data exist concerning acute cervical ICA occlusion, either alone or in combination with intracranial ICA occlusion (tandem occlusion). Therefore we analyzed outcome and treatment effects in stroke associated with cervical ICA occlusion, with specific focus on the impact of intracranial ICA or M1 patency...
2017: PloS One
https://www.readbyqxmd.com/read/28078914/appropriate-patient-selection-for-carotid-revascularization-procedures-is-urgently-needed
#5
Kosmas I Paraskevas, Frank J Veith, Dimitri P Mikhailidis, Christos D Liapis
The identification/selection of appropriate patient subgroups with asymptomatic carotid artery stenosis and the performance of prophylactic carotid endarterectomy (CEA)/carotid artery stenting (CAS) exclusively on these asymptomatic patient subgroups is currently one of the "hottest" topics in vascular surgery. It is now clear that offering CEA/CAS to asymptomatic carotid patients based only on the degree of carotid stenosis is unjustified and scientifically flawed. On the other hand, offering only best medical therapy to every asymptomatic patient, irrespective of certain high-risk criteria (such as the detection of microemboli by transcranial Doppler, intraplaque hemorrhage, silent embolic infarcts on brain computed tomography/magnetic resonance imaging, elevated biomarkers, family history), is equally wrong...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28076296/efficiency-test-of-current-carotid-embolic-protection-devices
#6
Anja Kurzhals, Jörn-Bo Matthies, Reimer Andresen, Christian Wissgott, Klaus-Peter Schmitz, Niels Grabow, Wolfram Schmidt
Embolic protection devices were developed to reduce the risk of stroke during carotid artery stenting. The aim of this study was to test the capture efficiency of five embolic protection devices under reproducible in vitro conditions. The setup consisted of silicone tubes representing the vessel modeling round and oval cross sections. Spherical polystyrene particles (150 μm, COOH-coating) were used to simulate the plaque. The particles were inserted in a clean water circuit and either captured by the device or collected in a glass filter...
January 11, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28062805/intravenous-thrombolysis-before-endovascular-therapy-for-large-vessel-strokes-can-lead-to-significantly-higher-hospital-costs-without-improving-outcomes
#7
Ansaar T Rai, SoHyun Boo, Chelsea Buseman, Amelia K Adcock, Abdul R Tarabishy, Maurice M Miller, Thomas D Roberts, Jennifer R Domico, Jeffrey S Carpenter
BACKGROUND: Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. PURPOSE: To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). METHODS: A single-center retrospective analysis was performed...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#8
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28057413/upper-extremity-blood-pressure-difference-in-patients-undergoing-carotid-revascularisation
#9
A Huibers, J Hendrikse, M M Brown, S A Pegge, M Arnold, F L Moll, L J Kapelle, G J de Borst
INTRODUCTION: Blood pressure (BP) regulation is important in patients with carotid artery atherosclerotic disease. Concomitant subclavian artery stenosis (SAS) might lead to an underestimation of the true systemic BP in the monitoring of these patients. This study aimed to assess the prevalence of the inter-arm BP difference in patients undergoing carotid intervention and its association with ipsilateral significant subclavian stenosis and clinical outcome. METHODS: Bilateral BP measurements and vascular imaging (CTA and MRA) of both subclavian arteries and the innominate artery were assessed in 182 symptomatic patients with carotid artery stenosis undergoing revascularisation in the International Carotid Stenting Study (ICSS)...
January 2, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28056759/should-we-be-concerned-about-the-inflammatory-response-to-endovascular-procedures
#10
Djordje Radak, Nenad Djukic, Slobodan Tanaskovic, Milan Obradovic, Desanka Cenic-Milosevic, Esma R Isenovic
Endovascular surgery represents a minimally invasive procedure for the treatment of occlusive and aneurysmal arterial disease. However, it is followed by inflammatory response, with a rise in specific inflammatory biomarkers, such as C-reactive protein, serum amyloid A and fibrinogen. Shear stress during balloon inflation and vascular injury represents triggering events for the inflammatory process, stimulating the production of proinflammatory molecules and activation of circulating monocytes. The current literature indicates that stent implantation induces more prominent inflammatory reaction...
January 5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28052665/graft-replacement-as-a-method-in-treatment-of-symptomatic-carotid-in-stent-restenosis
#11
Lazar B Davidovic, Igor B Koncar, Dusan M Kostic, Milos M Sladojevic, Dragan M Markovic
No abstract text is available yet for this article.
February 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28052661/rome-wasn-t-built-in-a-day-the-slow-but-steady-evolution-of-carotid-artery-stenting
#12
Bernhard Reimers, Giuseppe Ferrante, Giovanni Torsello
No abstract text is available yet for this article.
February 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#13
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#14
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043994/long-term-results-following-emergency-stent-graft-repair-for-traumatic-rupture-of-the-aortic-isthmus%C3%A2
#15
Cecile Martin, Frederic Thony, Mathieu Rodiere, Pierre Bouzat, Pierre Lavagne, Michel Durand, Olivier Chavanon
OBJECTIVES: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. METHOD: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28024850/volume-of-subclinical-embolic-infarct-correlates-to-long-term-cognitive-changes-after-carotid-revascularization
#16
Wei Zhou, Brittanie D Baughman, Salil Soman, Max Wintermark, Laura C Lazzeroni, Elizabeth Hitchner, Jyoti Bhat, Allyson Rosen
OBJECTIVE: Carotid intervention is safe and effective in stroke prevention in appropriately selected patients. Despite minimal neurologic complications, procedure-related subclinical microemboli are common and their cognitive effects are largely unknown. In this prospective longitudinal study, we sought to determine long-term cognitive effects of embolic infarcts. METHODS: The study recruited 119 patients including 46% symptomatic patients who underwent carotid revascularization...
December 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28018512/prevention-of-embolization-in-concomitant-endovascular-therapy-for-thoracic-and-abdominal-aneurysms-with-severely-atheromatous-aorta
#17
Tomohiro Takano, Shinya Takase, Akihito Kagoshima, Hitoshi Yokoyama
A 74-year-old man with multiple aortic aneurysms and shaggy aorta was simultaneously treated by conventional open repair for an abdominal aortic aneurysm and endoluminal stent grafting for a thoracic aortic aneurysm. We performed intermittent clamping of the visceral and carotid arteries under an extracorporeal circulation circuit without a blood flow pump, which lead to the avoidance of embolization in spite of the disadvantage of endoluminal stent grafting for atheromatous aorta.
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28017753/amplitude-of-tissue-oxygenation-index-change-predicts-cerebral-hyperperfusion-syndrome-during-carotid-artery-stenting
#18
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Yasushi Motoyama, Young Su Park, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
OBJECTIVE: Hyperperfusion syndrome (HPS) following carotid artery stenting (CAS) is a rare but serious complication. HPS is associated with preoperative hemodynamic impairment due to poor collateral flow and intraoperative cerebral ischemia. Filter-type embolic protection devices (EPDs) maintain anterograde carotid flow during CAS and somewhat prevent HPS. Early treatment of patients undergoing CAS and at risk for HPS is essential. Near-infrared spectroscopy (NIRS) allows non-invasive, real-time measurement of frontal lobe regional cerebral O2 saturation (TOI; tissue oxygenation index)...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28009236/increased-blood-cell-phosphatidylserine-exposure-and-circulating-microparticles-contribute-to-procoagulant-activity-after-carotid-artery-stenting
#19
Lu Zhao, Xiaoming Wu, Yu Si, Zhipeng Yao, Zengxiang Dong, Valerie A Novakovic, Li Guo, Dongxia Tong, He Chen, Yayan Bi, Junjie Kou, Huaizhang Shi, Ye Tian, Shaoshan Hu, Jin Zhou, Jialan Shi
OBJECTIVE Phosphatidylserine (PS) is a major component of the inner leaflet of membrane bilayers. During cell activation or apoptosis, PS is externalized to the outer membrane, providing an important physiological signal necessary for the release of the microparticles (MPs) that are generated through the budding of cellular membranes. MPs express PS and membrane antigens that reflect their cellular origin. PS exposure on the cell surface and the release of MPs provide binding sites for factor Xa and prothrombinase complexes that promote thrombin formation...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28004899/evidence-overview-benefit-of-cerebral-protection-devices-during-carotid-artery-stenting
#20
Jan A Vos
Embolic Protection Devices (EPD's) are often used during Carotid Angioplasty and Stenting (CAS) to reduce procedural cerebral emboli. This manuscript seeks to present an overview of evidence on EPD's during CAS. There are three categories of EPD's: Distal Occlusion (DO-EPD), Filter (F-EPD) and Proximal Occlusion (PO-EPD). DO and F-EPD's have the disadvantage that the device has to be advanced through the stenosis, without protection and that the device may damage the distal internal carotid artery (ICA). F-EPD's have the advantage of maintaining antegrade flow throughout the procedure...
December 22, 2016: Journal of Cardiovascular Surgery
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