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https://www.readbyqxmd.com/read/29345594/should-stemi-patients-receive-opiate-analgesia-the-morphine-paradox
#1
Mohamed Farag, Nikolaos Spinthakis, Manivannan Srinivasan, Diana Adrienne Gorog
BACKGROUND: The very significant benefit of P2Y12 receptor inhibitor administration in patients with ST-elevation myocardial infarction (STEMI), in reducing future ischaemic events and stent thrombosis, is undisputed. Morphine analgesia is very frequently co-administered to these patients for pain relief, along with antiplatelet therapy, at the time of presentation, and prior to reperfusion with primary percutaneous coronary intervention. METHODS: Research and online content related to opiates use in STEMI was reviewed...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29339323/mechanical-thrombectomy-of-acute-middle-cerebral-artery-occlusion-using-trans-anterior-communicating-artery-approach
#2
Krishna Amuluru, Charles E Romero, Logan Pyle, Mohammad El-Ghanem, Fawaz Al-Mufti
BACKGROUND: A cross-circulation technique involves gaining access to a cerebral vessel through a patent anterior or posterior communicating artery. This technique may be utilized in patients with emergent large vessel occlusions and an unfavorable direct route to the occlusion. While few previous reports have demonstrated successful cross-circulation technique for treatment of emergent large vessel occlusions, we present the first two cases of trans-anterior communicating artery stent-retriever thrombectomy...
January 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29338037/stentless-vs-stented-bioprosthesis-for-aortic-valve-replacement-a-case-matched-comparison-of-long-term-follow-up-and-subgroup-analysis-of-patients-with-native-valve-endocarditis
#3
Andreas Schaefer, Jannis Dickow, Gerhard Schoen, Sumi Westhofen, Lisa Kloss, Tarik Al-Saydali, Hermann Reichenspurner, Sebastian A Philipp, Christian Detter
BACKGROUND: Current retrospective evidence suggests similar clinical and superior hemodynamic outcomes of the Sorin Freedom Solo stentless aortic valve (SFS) (LivaNova PLC, London, UK) compared to the Carpentier Edwards Perimount stented aortic valve (CEP) (Edwards Lifesciences Inc., Irvine, California, USA). To date, no reports exist describing case-matched long-term outcomes and analysis for treatment of native valve endocarditis (NVE). METHODS: From 2004 through 2014, 77 consecutive patients (study group, 59...
2018: PloS One
https://www.readbyqxmd.com/read/29337211/extraperitoneal-para-aortic-lymphadenectomy-by-robot-assisted-laparoscopy
#4
Ana Gomes da Costa, Yves Borghesi, Delphine Hudry, Julie Faes, Lucie Bresson, Fabrice Narducci, Eric Leblanc
STUDY OBJECTIVE: The aim of this study was to evaluate the outcomes of extraperitoneal para-aortic lymphadenectomy by robot-assisted laparoscopy. DESIGN: A retrospective study (Canadian Task Force classification III). SETTING: An academic institution. PATIENTS: Twenty-three consecutive patients with gynecologic cancer who presented for para-aortic lymphadenectomy between March 2016 and May 2017 were reviewed retrospectively...
January 11, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29329474/immediate-retrieval-of-a-maldeployed-lumen-apposing-metal-stent-from-a-walled-off-cavity
#5
Nabeel Azeem, Martin L Freeman, Stuart K Amateau
No abstract text is available yet for this article.
January 12, 2018: Endoscopy
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
#6
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/29324372/dislocation-of-a-cerebral-protection-device-component-during-carotid-stenting-a-case-report-of-favorable-outcome-from-conservative-management-after-failure-of-retrieval
#7
Ilaria Tocco-Tussardi, Caterina Kulyk, Vincenzo Vindigni, Giampiero Avruscio
INTRODUCTION: Cerebral-protection devices (CPDs) are a well-established system for reduction of embolic risk in carotid artery angioplasty and stenting (CAS). Although rare, adverse events with CPDs are unpredictable and can be associated with serious outcomes and iatrogenic sequelae. PRESENTATION OF CASE: We describe the unique case of dislocation of a FilterWire EX™ filter loop during right CAS. On trying to recapture the CPD filter at the end of the procedure, the filter loop suddenly detached from the guidewire and dislocated to the proximal middle cerebral artery...
December 28, 2017: International Journal of Surgery Case Reports
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
#8
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/29314555/lost-and-found-coronary-stent-retrieval-and-review-of-literature
#9
Shahbaz A Malik, Emmanouil S Brilakis, Vincent Pompili, Yiannis S Chatzizisis
A 61-year-old man with a history of percutaneous coronary intervention (PCI) of the mid right coronary artery (RCA) with a drug eluting stent (DES), presented with non-ST segment elevation myocardial infarction. Coronary angiography demonstrated complex disease of the distal RCA as well as in-stent stenosis of the previously placed mid RCA stent. The patient underwent bifurcation PCI of the distal RCA followed by attempted intervention with a DES on the mid RCA lesion. The stent could not cross the lesion and eventually became dissociated from its delivery system...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29303452/different-learning-curves-between-stent-retrieval-and-a-direct-aspiration-first-pass-technique-for-acute-ischemic-stroke
#10
Hidehisa Nishi, Akira Ishii, Ichiro Nakahara, Shoji Matsumoto, Nobutake Sadamasa, Yasutoshi Kai, Ryota Ishibashi, Michio Yamamoto, Satoshi Morita, Izumi Nagata
OBJECTIVE The clinical outcomes of a direct aspiration first-pass technique (ADAPT) and stent retriever (SR) have been reported to be similar in several observational studies. In this study, procedural and clinical outcomes with ADAPT and SR for the treatment of acute ischemic stroke with large artery occlusion were compared in different time periods. METHODS In each specific time period, SR and ADAPT were used as the first-line treatment approach for acute ischemic stroke patients with large artery occlusion at the authors' institution...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29296999/safety-and-efficacy-of-a-3-dimensional-stent-retriever-with-aspiration-based-thrombectomy-vs-aspiration-based-thrombectomy-alone-in-acute-ischemic-stroke-intervention-a-randomized-clinical-trial
#11
Raul G Nogueira, Donald Frei, Jawad F Kirmani, Osama Zaidat, Demetrius Lopes, Aquilla S Turk, Donald Heck, Brian Mason, Diogo C Haussen, Elad I Levy, Siddhart Mehta, Marc Lazzaro, Michael Chen, Arnd Dörfler, Albert J Yoo, Colin P Derdeyn, Lee Schwamm, David Langer, Adnan Siddiqui
Importance: The treatment effects of individual mechanical thrombectomy devices in large-vessel acute ischemic stroke (AIS) remain unclear. Objective: To determine whether the novel 3-dimensional (3-D) stent retriever used in conjunction with an aspiration-based mechanical thrombectomy device (Penumbra System; Penumbra) is noninferior to aspiration-based thrombectomy alone in AIS. Design, Setting, and Participants: This randomized, noninferiority clinical trial enrolled patients at 25 North American centers from May 19, 2012, through November 19, 2015, with follow-up for 90 days...
January 2, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29284735/contact-aspiration-versus-stent-retriever-in-patients-with-acute-ischemic-stroke-with-m2-occlusion-in-the-aster-randomized-trial-contact-aspiration-versus-stent-retriever-for-successful-revascularization
#12
Benjamin Gory, Bertrand Lapergue, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
BACKGROUND AND PURPOSE: Middle cerebral artery M2-segment occlusions represent an important subgroup of patients with acute stroke with large-vessel occlusion. The safety of mechanical thrombectomy, especially contact aspiration (CA), in such distal intracranial occlusions is still under debate. We compared reperfusion, adverse events, neurological recovery, and functional outcome of patients with isolated M2 occlusions according to the first-line strategy mechanical thrombectomy devices (CA versus stent retriever [SR])...
December 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29250025/procedure-related-complication-of-willis-covered-stent-in-the-treatment-of-blood-blister-like-aneurysm-stent-detachment-from-dilating-balloon
#13
Yuxiang Zhang, Yupeng Zhang, Fei Liang, Chuhan Jiang
The use of Willis covered stent (WCS) for intracranial aneurysms has increased based on the promising results of previous studies about its safety and effectiveness. With the accumulation of cases, reports about peri-procedural complications are emerging. In our department, 25 patients were treated with WCS during December 2015 to March 2017. We here reported an unexpected technical complication occurred in the treatment with the WCS for a blood blister-like aneurysm (BBA). During the procedure, the distal end of the stents detached from the dilating balloon partially or as a whole...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#14
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29248122/pathology-of-graft-and-stent-graft-infections-lessons-learned-from-examination-of-explant-materials
#15
REVIEW
Anne Lejay, Antoine Monnot, Yannick Georg, Benjamin Colvard, Fabien Thaveau, Bernard Geny, Nabil Chakfé
Due to the aging population, the number of patients treated with aortic grafts or endografts continues to increase. Although infection after these procedures is uncommon, aortic graft infection is a life-threatening condition, and refinement of management guidelines based on implant pathophysiology is appropriate. In the early 1990s, our European collaborative retrieval program, European Group for Research on Prostheses Applied for Vascular Surgery (GEPROVAS) was commissioned to analyze the degenerative phenomenon occurring on explanted grafts or endografts...
June 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29246906/comparison-of-the-efficacy-and-safety-of-thrombectomy-devices-in-acute-stroke-a-network-meta-analysis-of-randomized-trials
#16
Hamidreza Saber, Gary B Rajah, Riyad Y Kherallah, Ashutosh P Jadhav, Sandra Narayanan
INTRODUCTION: Mechanical thrombectomy (MT) is increasingly used for large-vessel occlusions (LVO), but randomized clinical trial (RCT) level data with regard to differences in clinical outcomes of MT devices are limited. We conducted a network meta-analysis (NMA) that enables comparison of modern MT devices (Trevo, Solitaire, Aspiration) and strategies (stent retriever vs aspiration) across trials. METHODS: Relevant RCTs were identified by a systematic review. The efficacy outcome was 90-day functional independence (modified Rankin Scale (mRS) score 0-2)...
December 15, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29244133/contact-aspiration-or-stent-retrieval-thrombectomy-for-acute-ischemic-stroke-due-to-large-vessel-occlusion
#17
Robert M Starke, David J McCarthy, Ricardo J Komotar, E Sander Connolly
No abstract text is available yet for this article.
January 1, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29239803/ultrasound-guided-ureteroscopy-in-children-safety-and-success
#18
Jeffrey C Morrison, Jason P Van Batavia, Kassa Darge, Christopher J Long, Aseem R Shukla, Arun K Srinivasan
INTRODUCTION: Ureteroscopy has been shown to be a highly efficacious and safe modality for the treatment of pediatric urolithiasis. However, conventional ureteroscopy relies on fluoroscopy for intraoperative guidance, exposing both patient and operating room personnel to ionizing radiation. Pediatric urolithiasis patients are at a particularly increased risk from this radiation exposure. The use of ultrasound in place of fluoroscopy for intraoperative guidance has emerged as one modification that can reduce radiation exposure during ureteroscopy...
October 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29238099/8-f-balloon-guide-catheter-for-embolization-of-anterior-circulation-aneurysms-an-institutional-experience-in-152-patients
#19
Tomotaka Ohshima, Chinmaya Dash, Andrey Belayev, Taiki Yamamoto, Shunsaku Goto, Yoko Kato
The use of 8-F balloon guide catheter (BGC) for proximal flow control was previously shown to prevent distal embolic complications during mechanical clot retrieval in patients with acute ischemic stroke. In this retrospective study, the utility of 8-F BGCs for proximal flow control during endovascular coiling of anterior circulation aneurysms was investigated. Patients who underwent endovascular coiling for anterior circulation aneurysms between August 2013 and December 2016 were retrospectively analyzed. Among a total of 152 patients included in this series, 64 patients presented with aneurysmal rupture, whereas the aneurysms were detected incidentally or due to mass effects in the remaining patients...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29236163/evaluation-of-pain-perception-associated-with-use-of-the-magnetic-end-ureteric-double-j-stent-for-short-term-ureteric-stenting
#20
S Sevcenco, K Eredics, L Lusuardi, Hans Christoph Klingler
PURPOSE: To investigate the morbidity, complication rate, and pain perception during removal of a novel ureteric stent with a magnetic end using a-traumatic retrieval catheter. METHODS: Between November 2013 and July 2015, 151 consecutive patients who underwent semirigid ureterorenoscopy (URS) for stone removal were prospectively enrolled. Stent removal was performed under local anesthesia using a special magnetic-end stent remover 1 week following URS. At follow-up, we obtained patients' medical history, urine culture result, renal ultrasonogram, and visual analog scale (VAS) score regarding stent irritation (VAS 1) and pain during removal (VAS 2)...
December 13, 2017: World Journal of Urology
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