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Cerebral embolism

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https://www.readbyqxmd.com/read/28917562/an-updated-meta-analysis-of-novel-oral-anticoagulants-versus-vitamin-k-antagonists-for-uninterrupted-anticoagulation-in-atrial-fibrillation-catheter-ablation
#1
Rhanderson Cardoso, Leonardo Knijnik, Aditya Bhonsale, Guilherme Nasi, Manuel Rivera, Vanessa Blumer, Hugh Calkins
BACKGROUND: Catheter ablation is recommended as a first or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation for patients undergoing AF ablation. OBJECTIVE: We aimed to perform an updated meta-analysis of novel oral anticoagulants (NOACs) vs. vitamin K antagonists (VKAs) as uninterrupted anticoagulation for patients undergoing AF ablation. METHODS: Databases and conference abstracts were searched...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28917515/cerebral-embolic-protection-during-transfemoral-aortic-valve-replacement-significantly-reduces-death-and-stroke-compared-with-unprotected-procedures
#2
Julia Seeger, Birgid Gonska, Markus Otto, Wolfgang Rottbauer, Jochen Wöhrle
OBJECTIVES: The aim of this study was to evaluate the impact of cerebral embolic protection on stroke-free survival in patients undergoing transfemoral aortic valve replacement (TAVR). BACKGROUND: Imaging data on cerebral embolic protection devices have demonstrated a significant reduction in number and volume of cerebral lesions. METHODS: A total of 802 consecutive patients were enrolled. The Sentinel cerebral embolic protection device (Claret Medical Inc...
September 7, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28916665/integrin-%C3%AE-4-overexpression-on-rat-mesenchymal-stem-cells-enhances-transmigration-and-reduces-cerebral-embolism-after-intracarotid-injection
#3
Li-Li Cui, Franziska Nitzsche, Evgeny Pryazhnikov, Marina Tibeykina, Laura Tolppanen, Jussi Rytkönen, Tuulia Huhtala, Jing-Wei Mu, Leonard Khiroug, Johannes Boltze, Jukka Jolkkonen
BACKGROUND AND PURPOSE: Very late antigen-4 (integrin α4β1)/vascular cell adhesion molecule-1 mediates leukocyte trafficking and transendothelial migration after stroke. Mesenchymal stem cells (MSCs) typically express integrin β1 but insufficient ITGA4 (integrin α4), which limits their homing after intravascular transplantation. We tested whether ITGA4 overexpression on MSCs increases cerebral homing after intracarotid transplantation and reduces MSC-borne cerebral embolism. METHODS: Rat MSCs were lentivirally transduced to overexpress ITGA4...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28914868/-combination-treatment-of-cerebral-arteriovenous-malformations-using-endovascular-and-microsurgical-techniques
#4
D M Galaktionov, A V Dubovoy, V S Kiselev, A O Sosnov, K S Ovsyannikov, A M Perfil'ev, A V Cherepanov
MATERIAL AND METHODS: The study included 40 patients with cerebral AVMs. In the study group, 14 (35%) patients underwent microsurgical resection without preliminary embolization (1st group), and 26 (65%) patients underwent combined treatment (endovascular embolization and microsurgical intervention, 2nd group). The first group included patients with S&M grade I-III AVMs, and the second group included patients with S&M grade II-V AVMs. Treatment outcomes were evaluated with allowance for completeness of AVM resection, operative blood loss, duration of surgery, changes in clinical and neurological impairments according to the modified Rankin scale, and rate of neurological and surgical complications...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28906352/clinical-and-angiographic-outcomes-following-endovascular-treatment-of-very-small-3%C3%A2-mm-or-smaller-intracranial-aneurysm-a-single-center-experience
#5
Yongsheng Liu, Feng Wang, Xiaochen Fu, Yongjian Liu, Guodong Zhang, Ke Xu
Treatments for very small (3 mm or smaller) intracranial aneurysms (VSAs) remain controversial. The aim of this study was to evaluate the efficacy of endovascular treatment for VSAs and to evaluate clinical risk factors associated with complications.This retrospective study enrolled 82 VSA patients who underwent coil embolization in our institution. Angiographic outcomes were assessed according to the Meyers classification. The clinical results were evaluated using the modified Rankin scale (mRS) immediately after coiling, at discharge, and during follow-up...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906205/preventing-cognitive-decline-and-dementia-from-cerebral-small-vessel-disease-the-laci-1-trial-protocol-and-statistical-analysis-plan-of-a-phase-iia-dose-escalation-trial-testing-tolerability-safety-and-effect-on-intermediary-endpoints-of-isosorbide-mononitrate
#6
Gordon W Blair, Jason P Appleton, Zhe Kang Law, Fergus Doubal, Katie Flaherty, Richard Dooley, Kirsten Shuler, Carla Richardson, Iona Hamilton, Yulu Shi, Michael Stringer, Julia Boyd, Michael J Thrippleton, Nikola Sprigg, Philip M Bath, Joanna M Wardlaw
Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms of action to support their testing to prevent stroke recurrence, cognitive impairment, or radiological progression after lacunar stroke. Aim LACI-1 will assess the tolerability, safety, and efficacy, by dose, of isosorbide mononitrate and cilostazol, alone and in combination, in patients with ischemic lacunar stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28904796/endovascular-management-of-symptomatic-cerebral-aneurysm-thromboembolism-due-to-pre-aneurysmal-arterial-stenosis
#7
Torin Karsonovich, Ajeet Gordhan
BACKGROUND: Pre-aneurysmal internal carotid steno-occlusive disease resulting in cerebral intra-aneurysmal thrombosis and subsequent embolic infarction has not been previously described. CONCLUSION: Antithrombotic treatment for dissolution of the thrombus and pre-aneurysmal stent angioplasty followed by Pipeline embolization flow diverter placement through the aneurysm is a safe and feasible management option.
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28904468/gyriform-infarction-in-cerebral-air-embolism-imaging-mimicker-of-status-epilepticus
#8
Konark Malhotra, Appaji Rayi
Cerebral air embolism (CAE) is a potentially fatal iatrogenic complication related to common procedures including central venous catheter (CVC) removal. We report an interesting case of CAE related to CVC removal that was further complicated with status epilepticus. Neuroimaging of CAE and status epilepticus could pose diagnostic dilemmas and require consideration of wide diagnostic differentials. We discuss the clinical presentation, mechanism, and diagnostic approach, especially neuroimaging to differentiate various etiologies in CAE patients...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28902823/-comparing-the-risks-for-the-development-of-perioperative-complications-in-carotid-endarterectomy-and-carotid-angioplasty
#9
R A Vinogradov, K A Lashevich, V S Pykhteev
The article is a literature review presenting a comparative analysis of 30-day risks of mortality and complications after carotid endarterectomy and carotid angioplasty with stenting. The risks studied were as follows: myocardial infarction, stroke, transitory ischaemic attacks, bradycardia, hypotension, postoperative haematomas, and damages to the craniocerebral nerves. The authors analysed a series of recently published foreign studies and meta-analyses dedicated to the problem concerned. The obtained findings revealed that carotid endarterectomy turned out to be associated with a higher perioperative risk for the development of myocardial infarction, postoperative haematomas and damages to the craniocerebral nerves, whereas carotid angioplasty with stenting appeared to be associated with an increased risk for the development of stroke, bradycardia and hypotension within the first 30 postoperative days...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28898867/cerebral-fat-embolism-clinical-presentation-diagnostic-steps-and-long-term-follow-up
#10
Juliane Dunkel, Christian Roth, Frank Erbguth, Wenke Dietrich, Monika Hügens-Penzel, Andreas Ferbert
OBJECTIVE: Symptomatic cerebral fat embolism (CFE) is a rare complication that occurs after a traumatic injury or orthopaedic surgery and is diagnostically challenging. No data is currently available concerning long-term follow-up. METHODS: We identified from medical records 9 patients with CFE and revised the clinical signs and the diagnostic process. We then analysed long-term follow-up data, targeting clinical course after discharge, neurological impairment, and current quality of life, using the Barthel index and the modified Rankin Scale...
September 12, 2017: European Neurology
https://www.readbyqxmd.com/read/28895285/complete-filter-based-cerebral-embolic-protection-with-transcatheter-aortic-valve-replacement
#11
Lennart Van Gils, Herbert Kroon, Joost Daemen, Claire Ren, Anne-Marie Maugenest, Marguerite Schipper, Peter P De Jaegere, Nicolas M Van Mieghem
OBJECTIVES: To evaluate the value of left vertebral artery filter protection in addition to the current filter-based embolic protection technology to achieve complete cerebral protection during TAVR. BACKGROUND: The occurrence of cerebrovascular events after transcatheter aortic valve replacement (TAVR) has fueled concern for its potential application in younger patients with longer life expectancy. Transcatheter cerebral embolic protection (TCEP) devices may limit periprocedural cerebrovascular events by preventing macro and micro-embolization to the brain...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28893127/successful-presurgical-endovascular-management-of-venous-sinus-thrombosis-associated-with-high-grade-cerebral-arteriovenous-malformation-a-case-report
#12
Yoshinari Osada, Hidenori Endo, Kenichi Sato, Yasushi Matsumoto, Toshiki Endo, Miki Fujimura, Teiji Tominaga
We report a case of a 39-year-old man presenting with a high-grade left parieto-occipital arteriovenous malformation (AVM) complicated by superior sagittal sinus (SSS) stenosis, seven years after the first presentation. Magnetic resonance imaging revealed a newly developed perilesional edema. Venous sinus stenosis acutely progressed to occlusion and induced multiple intracerebral hemorrhages. An emergent balloon venoplasty of the SSS successfully recanalized the thrombosed sinus. Further, multistage transarterial nidus embolization was performed followed by surgical resection, resulting in a complete eradication of the large AVM...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28890009/impact-of-onyx%C3%A2-embolization-on-radiosurgical-management-of-cerebral-avm-treatment-and-outcome
#13
Ido Strauss, Oz Haim, Daniel Umansky, Benjamin W Corn, Vladimir Frolov, Natan Shtraus, Shimon Maimon, Andrew A Kanner
BACKGROUND: Stereotactic radiosurgery (SRS) is a well-established treatment modality for cerebral arterio-venous malformations (AVMs). The main limiting factor in the radiosurgical treatment of AVMs is the volume of the nidus with high-grade lesions often requiring combined treatment to reduce the SRS target volume. To overcome this limitation, we have been using a combined treatment approach consisting of endovascular embolization with ONYX followed by SRS. OBJECTIVE: To evaluate our clinical experience for safety and feasibility of this multimodality treatment approach...
September 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28887238/emergent-carotid-stent-removal-after-carotid-stent-thrombosis-surgical-technique
#14
Konstantinos G Moulakakis, Andreas Lazaris
OBJECTIVE: To present the technique for emergent removal of the thrombosed stent in acute carotid stent thrombosis in patients undergoing carotid artery angioplasty-stenting (CAS) BACKGROUND: Acute carotid stent thrombosis in patients undergoing CAS is a relatively rare and potentially devastating complication influencing significantly the quality of life. With the increasing use of stenting in clinical practice, it is expected to represent a more often encountered complication for physicians performing CAS...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885101/association-between-the-maximal-distance-of-atrial-septal-protrusion-and-cryptogenic-stroke
#15
Keisuke Tokunaga, Masahiro Yasaka, Takahiro Kuwashiro, Seiji Gotoh, Asako Nakamura, Go Takaguchi, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Yasushi Okada
Background and purpose Previous studies have suggested that atrial septal aneurysm is a potential risk factor for cerebral embolism. However, the association between the level of atrial septal protrusion and cerebral embolism is still unclear. The purpose of the present study was to assess the association between the maximal distance of atrial septal protrusion and cryptogenic stroke. Methods A total of 588 consecutive acute ischemic stroke patients (70 ± 11 (mean ± SD) years, 401 men) who underwent transesophageal echocardiography were enrolled...
December 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28882716/remote-thoracic-myelopathy-from-a-spinal-dural-arteriovenous-fistula-at-the-cranio-cervical-junction-case-report-and-review-of-literature
#16
Michael J Lang, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
BACKGROUND: The cranio-cervical junction is a rare location for spinal dural arteriovenous fistulas (dAVF). Typically, fistulas at this location present with findings related to intracranial cortical venous reflux or with cervical myelopathy. We present a case of cranio-cervical junction dAVF with isolated clinical and radiographic findings of thoracolumbar myelopathy. CASE DESCRIPTION: A 54 year-old male presented with subacute onset of lower extremity weakness, paresthesias and gait dysfunction...
September 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882392/fundus-autofluorescence-in-retinal-artery-occlusion-a-more-precise-diagnosis
#17
J-L Bacquet, M Sarov-Rivière, C Denier, G Querques, B Riou, L Bonin, E Barreau, M Labetoulle, A Rousseau
IMPORTANCE: Retinal artery occlusion (RAO) is a medical emergency associated with a high risk of cerebral vascular accident and other cardiovascular events. Among patients with non-arteritic RAO, a retinal embolus is observed in approximately 40% of cases. Fundus examination and retinography are not reliable to predict the nature of the emboli. OBSERVATIONS: We report three consecutive cases of central and branch RAO that were investigated with fundus autofluorescence, fluorescein angiography and color retinal photographs...
September 4, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28881114/intra-arterial-and-intravenous-tirofiban-infusion-for-thromboembolism-during-endovascular-coil-embolization-of-cerebral-aneurysm
#18
Sang Heum Kim, Tae Gon Kim, Min Ho Kong
OBJECTIVE: Thromboembolism is the one of the most serious complications that can occur during endovascular coil embolization of cerebral aneurysm. We report on the effectiveness and safety of intra-arterial/intravenous (IA/IV) glycoprotein IIb/IIIa inhibitor (tirofiban) infusion for treating thromboembolism during endovascular coil embolization of cerebral aneurysm. METHODS: We performed a retrospective analysis of 242 patients with ruptured or unruptured cerebral aneurysms (n=264) who underwent endovascular coil embolization from January 2011 to June 2014...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28879803/practice-patterns-of-retrievable-inferior-vena-cava-filters-and-predictors-of-filter-retrieval-in-patients-with-pulmonary-embolism
#19
Jieun Kang, Heung-Kyu Ko, Ji Hoon Shin, Gi-Young Ko, Kyung-Wook Jo, Jin Won Huh, Yeon-Mok Oh, Sang-Do Lee, Jae Seung Lee
Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016...
September 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28877718/aortic-atheroma-as-a-source-of-stroke-assessment-of-embolization-risk-using-3d-cmr-in-stroke-patients-and-controls
#20
Thomas Wehrum, Iulius Dragonu, Christoph Strecker, Florian Schuchardt, Anja Hennemuth, Johann Drexl, Thomas Reinhard, Daniel Böhringer, Werner Vach, Jürgen Hennig, Andreas Harloff
BACKGROUND: It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. METHODS: One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways...
September 6, 2017: Journal of Cardiovascular Magnetic Resonance
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