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Cerebrovascular intervention

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https://www.readbyqxmd.com/read/27914488/safety-of-6-month-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndromes-rationale-and-design-of-the-smart-angioplasty-research-team-safety-of-6-month-duration-of-dual-antiplatelet-therapy-after
#1
Joo Myung Lee, Deok-Kyu Cho, Joo-Yong Hahn, Young Bin Song, Taek Kyu Park, Ju-Hyeon Oh, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) is a fundamental treatment that optimizes clinical outcomes after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). Although current international guidelines recommend DAPT for at least 12 months after implantation of a drug-eluting stent in patients with ACS, these recommendations are not based on randomized controlled trials dedicated to ACS population. STUDY DESIGN: The SMART-DATE trial is a prospective, multicenter, randomized, and open-label study to demonstrate the noninferiority of 6-month DAPT compared with 12 months or longer DAPT in patients with ACS undergoing percutaneous coronary intervention...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27907893/factors-impacting-complication-rates-for-catheter-ablation-of-atrial-fibrillation-from-2003-to-2015
#2
Eunice Yang, Esra Gucuk Ipek, Muhammad Balouch, Yuliya Mints, Jonathan Chrispin, Joseph E Marine, Ronald D Berger, Hiroshi Ashikaga, Jack Rickard, Hugh Calkins, Saman Nazarian, David D Spragg
AIMS: Complications from catheter ablation for atrial fibrillation (AF) are well described. Changing aspects of AF ablation including patient populations referred, institutional experience, and emerging catheter and pharmacological options may impact complication rates. We assessed procedural complication trends in AF ablation patients from 2003-2015 to identify what factors affect adverse event rates. METHODS AND RESULTS: We evaluated consecutively enrolled patients undergoing initial AF ablation from 2003 through 2015...
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27906755/optimal-blood-pressure-target-in-stroke-prevention
#3
Alexandra Yannoutsos, Céline Dreyfuss Tubiana, Michel E Safar, Jacques Blacher
PURPOSE OF REVIEW: A generalized single blood pressure (BP) goal may appear not suitable to achieve an optimal stroke prevention at the individual level. The aim of the present review is to consider the clinical relevance of individualized BP goal according to patient's age, comorbidities and established cerebrovascular disease. RECENT FINDINGS: Observational and interventional data support heterogeneity in target organ prevention in that lower BP values than recommended by hypertension guidelines are associated with further stroke risk reduction...
November 30, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27904973/platelet-reactivity-and-clinical-outcomes-in-patients-using-cyp3a4-metabolized-statins-with-clopidogrel-in-percutaneous-coronary-intervention
#4
Jin Sup Park, Kwang Soo Cha, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Taek Jong Hong, Hyo Soo Kim
Statins are primarily metabolized by cytochrome P450 3A4 (CYP3A4), which reduces clopidogrel to its active metabolite. Recent studies suggest that CYP3A4-metabolized statins attenuate clopidogrel's anti-aggregatory effect on platelets. We aimed to assess the impact of concomitant CYP3A4-metabolized statin and clopidogrel use on antiplatelet activity and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). We enrolled 1187 patients from the HOST-ASSURE trial with platelet reactivity unit (PRU) values at both baseline and 1 month...
November 30, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27899937/predictive-value-of-syntax-score-ii-for-clinical-outcomes-in-octogenarian-undergoing-percutaneous-coronary-intervention
#5
Evan Kurniawan, Feng-Hua Ding, Qi Zhang, Zhen-Kun Yang, Jian Hu, Wei-Feng Shen, Rui-Yan Zhang
OBJECTIVE: To evaluate the predictive value of SYNTAX Score II (SS-II) for percutaneous coronary intervention (PCI) in octogenarian (≥ 80 years old) undergoing PCI. METHODS & RESULTS: Data from three consecutive years of octogenarian undergoing PCI from Ruijin Hospital (Shanghai, China) was retrospectively collected (n = 308). Follow up clinical data at one year including all cause mortality, cardiac mortality and main adverse cardiovascular and cerebrovascular events (MACCE) were collected...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27897111/aggressive-antioxidant-reductive-stress-impairs-brain-endothelial-cell-angiogenesis-and-blood-brain-barrier-function
#6
Shireen Mentor, David Fisher
Oxidative stress in the brain microvasculature is a common characteristic in models of cerebrovascular disease. Considering the effects of reactive oxygen species activity in vascular-derived insults, it is naturally prudent to hypothesize those interventions inhibiting reactive oxygen species activity, such as antioxidant supplementation, may be beneficial for cerebrovascular disease. Hyper doses of antioxidant supplements, and foods with high antioxidant concentrations, are commonly used as an ongoing remedial and 'over-the-counter' treatments for most seasonal ailments...
November 29, 2016: Current Neurovascular Research
https://www.readbyqxmd.com/read/27895242/availability-of-endovascular-therapies-for-cerebrovascular-disease-at-primary-stroke-centers
#7
Mark J Alberts, Jean Range, William Spencer, Vicki Cantwell, M J Hampel
BACKGROUND: Endovascular therapies (EVTs) are useful for treating cerebrovascular disease. There are few data about the availability of such services at primary stroke centers (PSCs). Our hypothesis was that some of these services may be available at some PSCs. METHODS: We conducted an internet-based survey of hospitals certified as PSCs by the Joint Commission. The survey inquired about EVTs such as intra-arterial (IA) lytics, IA mechanical clot removal, coiling of aneurysms, and cervical arterial stenting, physician training, coverage models, hospital type, and outcomes...
November 28, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27894260/high-platelet-reactivity-affects-the-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention
#8
Jun-Jie Zhang, Xiao-Fei Gao, Zhen Ge, Nai-Liang Tian, Zhi-Zhong Liu, Song Lin, Fei Ye, Shao-Liang Chen
BACKGROUND: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation. METHODS: All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27884459/balance-evaluation-techniques-and-physical-therapy-in-post-stroke-patients-a-literature-review
#9
REVIEW
Eglė Lendraitienė, Agnė Tamošauskaitė, Daiva Petruševičienė, Raimondas Savickas
A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions...
November 17, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27884354/computing-methods-for-composite-clinical%C3%A2-endpoints-in-unprotected-left-main-coronary-artery-revascularization-a-post-hoc-analysis-of-the-delta-registry
#10
Davide Capodanno, Giuseppe Gargiulo, Sergio Buccheri, Alaide Chieffo, Emanuele Meliga, Azeem Latib, Seung-Jung Park, Yoshinobu Onuma, Piera Capranzano, Marco Valgimigli, Inga Narbute, Raj R Makkar, Igor F Palacios, Young-Hak Kim, Pawel E Buszman, Tarun Chakravarty, Imad Sheiban, Roxana Mehran, Christoph Naber, Ronan Margey, Arvind Agnihotri, Sebastiano Marra, Martin B Leon, Jeffrey W Moses, Jean Fajadet, Thierry Lefèvre, Marie-Claude Morice, Andrejs Erglis, Ottavio Alfieri, Patrick W Serruys, Antonio Colombo, Corrado Tamburino
OBJECTIVES: The study sought to investigate the impact of different computing methods for composite endpoints other than time-to-event (TTE) statistics in a large, multicenter registry of unprotected left main coronary artery (ULMCA) disease. BACKGROUND: TTE statistics for composite outcome measures used in ULMCA studies consider only the first event, and all the contributory outcomes are handled as if of equal importance. METHODS: The TTE, Andersen-Gill, win ratio (WR), competing risk, and weighted composite endpoint (WCE) computing methods were applied to ULMCA patients revascularized by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) at 14 international centers...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27881850/relationship-between-asymptomatic-intra-cranial-lesions-and-brachial-ankle-pulse-wave-velocity-in-coronary-artery-disease-patients-without-stroke
#11
Noriaki Tabata, Daisuke Sueta, Takayoshi Yamashita, Daisuke Utsunomiya, Yuichiro Arima, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto
Little is known about the significance of asymptomatic intra-cranial lesions (ICL) identified by brain MRI in coronary artery disease (CAD) patients. Silent cerebral lesions are suggested to be associated with arterial stiffness in healthy subjects. We investigated whether subclinical ICL are associated with arterial stiffness and the prognosis in CAD patients without medical history of cerebrovascular diseases. We recruited CAD patients who required percutaneous coronary intervention (PCI), did not meet exclusion criteria, and agreed with MRI before PCI...
November 24, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27873347/infantile-hemangioma-with-minimal-or-arrested-growth-further-observations-on-clinical-and-histopathologic-findings-of-this-unique-but-underrecognized-entity
#12
Ellen Hui Ma, Susan J Robertson, Chung W Chow, Philip S Bekhor
BACKGROUND: Infantile hemangioma (IH) with minimal or arrested growth (IH-MAG) is becoming increasingly recognized in the literature. It is important to be aware of their existence, because the correct diagnosis is essential for prognostication and treatment and, in the case of facial segmental lesions, the direction of further investigations if PHACE (posterior fossa abnormalities and other structural brain abnormalities; hemangioma(s) of the cervical facial region; arterial cerebrovascular anomalies; cardiac defects, aortic coarctation, and other aortic abnormalities; eye anomalies) syndrome or Sturge-Weber syndrome is suspected...
November 22, 2016: Pediatric Dermatology
https://www.readbyqxmd.com/read/27866026/survival-and-cardiovascular-events-after-coarctation-repair-in-long-term-follow-up-coafu-predictive-value-of-clinical-variables
#13
P Bambul Heck, J Pabst von Ohain, H Kaemmerer, P Ewert, A Hager
OBJECTIVE: Long-term sequelae and events after coarctation repair are well described. However, the predictive value of variables from clinical follow-up investigation for late events and survival has rarely been investigated. METHODS: All patients who participated in the prospective cross-sectional COALA Study in 2000 with a structural clinical investigation including blood pressure measurement and symptom-limited exercise test were contacted for reevaluation of survival, current clinical status and major cardiovascular events...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27862875/cost-awareness-decreases-total-percutaneous-coronary-intervention-procedural-cost-the-shopping-show-how-options-in-price-for-procedures-can-be-influenced-greatly-trial
#14
Elad Asher, John Mansour, Adam Wheeler, Daniel Kendrick, Michael Cunningham, Sahil Parikh, David Zidar, Todd Harford, Daniel I Simon, Vikram S Kashyap
OBJECTIVES: We initiated the SHOPPING Trial (Show How Options in Price for Procedures can be InflueNced Greatly) to see if percutaneous coronary intervention (PCI) procedures can be performed at a lower cost in a single institution. BACKGROUND: Procedural practice variability is associated with inefficiency and increased cost. We hypothesized that announcing costs for all supplies during a catheterization procedure and reporting individual operator cost relative to peers would spur cost reduction without affecting clinical outcomes...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27857051/elevation-of-the-acth-cortisol-ratio-in-female-opioid-dependent-patients-a-biomarker-of-aging-and-correlate-of-metabolic-and-immune-activation
#15
(no author information available yet)
BACKGROUND: Whilst the hypothalamic-pituitary-adrenal (HPA) Axis is a major stress axis, and is necessarily perturbed in opioid dependency, and stress is a major contributor to aging mechanisms, the HPA axis has not been studied in opioid dependency in an age-dependent manner. OBJECTIVE: Hypothesis - Differences in age dependent levels of HPA components. DESIGN: Cross-sectional comparison of general medical and opioid dependent patients (ODP, GMP)...
September 18, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27855470/14-year-results-of-bilateral-versus-single-internal-thoracic-artery-grafts-for-left-sided-myocardial-revascularization-in-young-diabetic-patients
#16
Brigitte Gansera, Alem Delalic, Edgar Eszlari, Walter Eichinger
Objectives Despite encouraging late outcomes, the use of bilateral internal thoracic artery (BITA) grafting for myocardial revascularization in diabetic patients remains controversial because of an increased risk of sternal wound complications. In the present study, early- and long-term outcomes of the use of left-sided BITA versus single internal thoracic artery (SITA) grafting in young (< 65 years of age) diabetic patients were reviewed retrospectively. Methods A total of 250 propensity score pair-matched diabetic patients, operated on between February 2000 and December 2011, receiving either BITA (n = 125) or SITA (n = 125) grafting were analyzed retrospectively...
November 17, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27853372/post-stroke-dyskinesias
#17
REVIEW
Mohammad Obadah Nakawah, Eugene C Lai
Strokes, whether ischemic or hemorrhagic, are among the most common causes of secondary movement disorders in elderly patients. Stroke-related (vascular) movement disorders, however, are uncommon complications of this relatively common disease. The spectrum of post-stroke movement disorders is broad and includes both hypo- and hyperkinetic syndromes. Post-stroke dyskinesias are involuntary hyperkinetic movements arising from cerebrovascular insults and often present with mixed phenotypes of hyperkinesia which can sometimes be difficult to classify...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27845873/periprocedural-myocardial-injury-after-recanalization-of-single-chronic-coronary-occlusion-a-propensity-score-analysis-comparing-long-term-clinical-outcomes
#18
Milosz Jaguszewski, Natasza Gilis-Malinowska, Juan Luis Gutierrez-Chico, Michal Chmielecki, Pawel Skarzynski, Slawomir Burakowski, Piotr Drewla, Radoslaw Targonski, Lukasz Lewicki, Witold Dubaniewicz, Marcin Fijalkowski, Marcin Gruchala, Dariusz Ciecwierz
BACKGROUND: Rates and importance of periprocedural myocardial injury (PMI) after crossing coronary chronic total occlusions (CTOs) is not well understood. This study sought to investigate long-term clinical implications of PMI in patients undergoing percutaneous coronary intervention (PCI) for single CTO utilizing antegrade technique. METHODS: Out of 11,957 patients undergoing non-urgent PCI, a total of 1110 patients with symptomatic angina and single CTO were treated by antegrade PCI and observed for up to 10 years...
November 15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27842962/haze-public-health-and-mitigation-measures-in-china-a-review-of-the-current-evidence-for-further-policy-response
#19
Jinghong Gao, Alistair Woodward, Sotiris Vardoulakis, Sari Kovats, Paul Wilkinson, Liping Li, Lei Xu, Jing Li, Jun Yang, Jing Li, Lina Cao, Xiaobo Liu, Haixia Wu, Qiyong Liu
With rapid economic development, China has been plagued by choking air pollution in recent years, and the frequent occurrence of haze episodes has caused widespread public concern. The purpose of this study is to describe the sources and formation of haze, summarize the mitigation measures in force, review the relationship between haze pollution and public health, and to discuss the challenges, potential research directions and policy options. Haze pollution has both natural and man-made causes, though it is anthropogenic sources that are the major contributors...
November 11, 2016: Science of the Total Environment
https://www.readbyqxmd.com/read/27834778/hippocampus-and-basal-forebrain-volumetry-for-dementia-and-mild-cognitive-impairment-diagnosis-could-it-be-useful-in-primary-care
#20
Stefan J Teipel, Felix Keller, Jochen R Thyrian, Urs Strohmaier, Attila Altiner, Wolfgang Hoffmann, Ingo Kilimann
BACKGROUND: Once a patient or a knowledgeable informant has noticed decline in memory or other cognitive functions, initiation of early dementia assessment is recommended. Hippocampus and cholinergic basal forebrain (BF) volumetry supports the detection of prodromal and early stages of Alzheimer's disease (AD) dementia in highly selected patient populations. OBJECTIVE: To compare effect size and diagnostic accuracy of hippocampus and BF volumetry between patients recruited in highly specialized versus primary care and to assess the effect of white matter lesions as a proxy for cerebrovascular comorbidity on diagnostic accuracy...
November 9, 2016: Journal of Alzheimer's Disease: JAD
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