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Cerebrovascular intervention

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https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#1
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28722196/safety-of-orbital-atherectomy-in-patients-with-left-ventricular-systolic-dysfunction
#2
Evan Shlofmitz, Perwaiz Meraj, Rajiv Jauhar, Sanjum S Sethi, Richard A Shlofmitz, Michael S Lee
OBJECTIVES: We evaluated the angiographic and clinical outcomes in patients with severely calcified lesions and systolic dysfunction who underwent orbital atherectomy (OA). We hypothesized that OA would provide similar outcomes in patients with systolic dysfunction compared with patients with preserved systolic function. BACKGROUND: Systolic dysfunction is associated with an increased risk of adverse clinical events after percutaneous coronary intervention (PCI)...
July 19, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28715552/large-perivascular-spaces-visible-on-magnetic-resonance-imaging-cerebral-small-vessel-disease-progression-and-risk-of-dementia-the-age-gene-environment-susceptibility-reykjavik-study
#3
Jie Ding, Sigurður Sigurðsson, Pálmi V Jónsson, Gudny Eiriksdottir, Andreas Charidimou, Oscar L Lopez, Mark A van Buchem, Vilmundur Guðnason, Lenore J Launer
Importance: With advancing age, an increased visibility of perivascular spaces (PVSs) on magnetic resonance imaging (MRI) is hypothesized to represent impaired drainage of interstitial fluid from the brain and may reflect underlying cerebral small vessel disease (SVD). However, whether large perivascular spaces (L-PVSs) (>3 mm in diameter) visible on MRI are associated with SVD and cognitive deterioration in older individuals is unknown. Objective: To examine whether L-PVSs are associated with the progression of the established MRI markers of SVD, cognitive decline, and increased risk of dementia...
July 17, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28711127/care-of-neurologic-conditions-in-an-observation-unit
#4
REVIEW
Matthew A Wheatley, Michael A Ross
As a group, neurologic conditions represent a substantial portion of emergency department (ED) visits. Cerebrovascular disease, headache, vertigo and seizures are all common reasons for patients to seek care in the ED. Patients being treated for each of these conditions are amenable to care in an ED observation unit (EDOU) if they require further diagnostic or therapeutic interventions beyond their ED stay. EDOUs are the ideal setting for patients who require advanced imaging such as MRIs, frequent neuro checks or specialist consultation in order to determine if they require admission or can be discharged home...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28706116/training-standards-in-neuroendovascular-surgery-program-accreditation-and-practitioner-certification
#5
REVIEW
Arthur L Day, Adnan H Siddiqui, Philip M Meyers, Tudor G Jovin, Colin P Derdeyn, Brian L Hoh, Howard Riina, Italo Linfante, Osama Zaidat, Aquilla Turk, Jay U Howington, J Mocco, Andrew J Ringer, Erol Veznedaroglu, Alexander A Khalessi, Elad I Levy, Henry Woo, Robert Harbaugh, Steven Giannotta
BACKGROUND AND PURPOSE: Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential...
July 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28702112/patient-preference-for-transradial-access-over-transfemoral-access-for-cerebrovascular-procedures
#6
Sudhakar R Satti, Ansar Z Vance, Sohil N Golwala, Tim Eden
PURPOSE: Shared decision-making, when physicians and patients collaborate and agree on health care decisions, is a key tenant of patient-centered care. Choice of access site for neurovascular procedures is rarely a shared decision point between physicians and patients. We present our initial evaluation of patient preference for radial over femoral access for cerebrovascular procedures. MATERIALS AND METHODS: IRB approved single-center, prospective, and consecutive survey of all patients undergoing transradial access for cerebrovascular imaging and intervention...
June 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28701487/differential-event-rates-and-independent-predictors-of-long-term-major-cardiovascular-events-and-death-in-5795-patients-with-unprotected-left-main-coronary-artery-disease-treated-with-stents-bypass-surgery-or-medication-insights-from-a-large-international-multicenter
#7
Se Hun Kang, Jung-Min Ahn, Cheol Hyun Lee, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. METHODS AND RESULTS: The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608)...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28698169/effectiveness-of-digital-medicines-to-improve-clinical-outcomes-in-patients-with-uncontrolled-hypertension-and-type-2-diabetes-prospective-open-label-cluster-randomized-pilot-clinical-trial
#8
Juan Frias, Naunihal Virdi, Praveen Raja, Yoona Kim, George Savage, Lars Osterberg
BACKGROUND: Hypertension and type 2 diabetes mellitus are major modifiable risk factors for cardiac, cerebrovascular, and kidney diseases. Reasons for poor disease control include nonadherence, lack of patient engagement, and therapeutic inertia. OBJECTIVE: The aim of this study was to assess the impact on clinic-measured blood pressure (BP) and glycated hemoglobin (HbA1c) using a digital medicine offering (DMO) that measures medication ingestion adherence, physical activity, and rest using digital medicines (medication taken with ingestible sensor), wearable sensor patches, and a mobile device app...
July 11, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28697774/the-impact-of-dpp-4-inhibitors-on-long-term-survival-among-diabetic-patients-after-first-acute-myocardial-infarction
#9
Mei-Tzu Wang, Sheng-Che Lin, Pei-Ling Tang, Wang-Ting Hung, Chin-Chang Cheng, Jin-Shiou Yang, Hong-Tai Chang, Chun-Peng Liu, Guang-Yuan Mar, Wei-Chun Huang
BACKGROUND: Previous studies regarding the cardioprotective effects of dipeptidyl peptidase 4 (DPP-4) inhibitors have not provided sufficient evidence of a relationship between DPP-4 inhibition and actual cardiovascular outcomes. This study aimed to evaluate the impact of DPP-4 inhibitors on the survival of diabetic patients after first acute myocardial infarction (AMI). METHODS: This was a nationwide, propensity score-matched, case-control study of 186,112 first AMI patients, 72,924 of whom had diabetes...
July 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28694612/cerebral-and-coronary-vasculature-in-disease-associations-and-dissociations-in-the-south-indian-population
#10
Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, G S Ravi
INTRODUCTION: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. PATIENTS AND METHODS: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28694198/survival-with-smog-and-smoke-precision-intervention
#11
Hua Linda Cai, Chen Wang
Despite continuous efforts of regional government agencies, air pollution remains a major threat to public health worldwide. In the January of 2017, a severe episode of smog similar to the London Fog in 1952, appeared in London. A longest episode of Chinese Haze also developed in Beijing, during which the PM2.5 (particular matter sized less than 2.5 micrometers) levels rose up to 500 μg/m(3). The European smog and the Chinese Haze are associated with large numbers of premature deaths each year, at 400,000 and 1...
July 7, 2017: Chest
https://www.readbyqxmd.com/read/28692459/comparative-determinants-of-5-year-cardiovascular-event-rates-in-patients-with-unprotected-left-main-coronary-artery-disease
#12
Cheol Hyun Lee, Jung-Min Ahn, Pil Hyung Lee, Minkyu Han, Se Hun Kang, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Diabetes mellitus (DM), low ejection fraction (EF), and the extent of coronary artery disease (CAD) have all been identified as predictors of cardiovascular events in multivessel disease, but their comparative contributions to future risk remain unclear in patients with unprotected left main coronary artery (ULMCA) disease. Through this study we aimed to categorize the risk for cardiovascular events in patients with ULMCA disease using simple clinical descriptors. PATIENTS AND METHODS: Our study included a total of 5975 patients with ULMCA disease from the Interventional Research Incorporation Society-Left MAIN Revascularization registry who were treated with percutaneous coronary intervention (n=2850), coronary artery bypass grafting (n=2337), or medical therapy alone (n=608)...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28686111/delayed-treatment-of-ruptured-brain-avms-is-it-ok-to-wait
#13
Jeffrey S Beecher, Kristopher Lyon, Vin Shen Ban, Awais Vance, Cameron M McDougall, Louis A Whitworth, Jonathan A White, Duke Samson, H Hunt Batjer, Babu G Welch
OBJECTIVE Despite a hemorrhagic presentation, many patients with arteriovenous malformations (AVMs) do not require emergency resection. The timing of definitive management is not standardized in the cerebrovascular community. This study was designed to evaluate the safety of delaying AVM treatment in clinically stable patients with a new hemorrhagic presentation. The authors examined the rate of rehemorrhage or neurological decline in a cohort of patients with ruptured brain AVMs during a period of time posthemorrhage...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28681620/the-burden-of-mood-disorder-cerebrovascular-disease-comorbidity-essential-neurobiology-psychopharmacology-and-physical-activity-interventions
#14
Michele Fornaro, Marco Solmi, Nicola Veronese, Domenico De Berardis, Elisabetta Filomena Buonaguro, Carmine Tomasetti, Giampaolo Perna, Antonio Preti, Mauro Giovanni Carta
Cardio-vascular diseases (CVDs) and CVD-related disorders (including cerebrovascular diseases; CBVDs) are a major public health concern as they represent the leading cause of mortality and morbidity in developed countries. Patients with CVDs and CBVDs co-morbid with mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD), suffer reduced quality-of-life and significant disability adjusted for years of life and mortality. The relationship between CVDs/CBVDs and mood disorders is likely to be bidirectional...
July 6, 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28679283/integrating-cardiovascular-diseases-hypertension-and-diabetes-with-hiv-services-a-systematic-review
#15
Victoria Haldane, Helena Legido-Quigley, Fiona Leh Hoon Chuah, Louise Sigfrid, Georgina Murphy, Suan Ee Ong, Francisco Cervero-Liceras, Nicola Watt, Dina Balabanova, Sue Hogarth, Will Maimaris, Kent Buse, Martin McKee, Peter Piot, Pablo Perel
Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people's chronic care needs, which present an opportunity to coordinate efforts and create synergies between programs to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes...
July 5, 2017: AIDS Care
https://www.readbyqxmd.com/read/28678658/description-of-a-multifaceted-intervention-programme-for-fatigue-after-acquired-brain-injury-a-pilot-study
#16
Jan Stubberud, Espen Edvardsen, Anne-Kristine Schanke, Anners Lerdal, Anita Kjeverud, Andreas Schillinger, Marianne Løvstad
The purpose of this pilot study was to describe and explore a group-based multifaceted intervention for patients with fatigue after acquired brain injury (ABI). We hypothesised that post-intervention changes would result in reduced fatigue, in addition to improved emotional health, sleep and attentional control. Eight subjects with traumatic brain injury (n = 3) and cerebrovascular insults (n = 5) were included. Inclusion was based upon the presence of fatigue complaints. The participants received 36 hours of intervention...
July 5, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28677160/risk-factors-for-the-incidence-of-delirium-in-cerebrovascular-patients-in-a-neurosurgery-intensive-care-unit-icu-a-prospective-study
#17
Jun Wang, Yuanyuan Ji, Ning Wang, Wenjin Chen, Yuehong Bao, Qinpu Qin, Qian Xiao, Shulan Li
AIMS AND OBJECTIVES: To explore the incidence of delirium in cerebrovascular patients admitted in our Neurosurgery Intensive Care Unit (NICU) and analyze the risk factors leading to delirium. BACKGROUND: Delirium is one of the most common mental disorders in general hospitals, but the incidence of different kinds of diseases and studies varies. Cerebrovascular patients in our NICU are high-risk groups for delirium; identifying risk factors for delirium and taking early interventions are crucial for patient prognosis...
July 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28674346/diagnosis-and-treatment-of-traumatic-cerebrovascular-injury-pitfalls-in-the-management-of-neurotrauma
#18
Hitoshi Kobata
Traumatic cerebrovascular injury (TCVI) is an uncommon clinical entity in traumatic brain injury (TBI), yet it may cause devastating brain injury with high morbidity and mortality. Early recognition and prioritized strategic treatment are of paramount importance. A total of 1966 TBI patients admitted between 1999 and 2015 in our tertiary critical care center were reviewed. Screening of TCVI was based on the Guidelines for the Management of Severe Head Injury in Japan. TCVI was confirmed in 33 (1.7%) patients; 29 blunt and 4 penetrating injuries...
June 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28671102/pentoxifylline-intervention-and-drug-action-in-scalping-forehead-flap-for-large-temporal-cutaneous-defects
#19
Jing An, Xingqi Chen, Yuhang Sun
Pentoxifylline is widely used in the treatment of cerebrovascular disease, at present, there are a variety of drugs in the clinical expansion of the role of the skin flap, by improving or promoting blood circulation, to ensure the survival of the flap. We designed scalping forehead flap to reconstruct large temporal cutaneous defects. This flap is reliable and can give us excellent postoperative result. This design has several advantages and is worth to be promoted. The scalping forehead flap we designed is reliable...
May 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28670721/age-is-not-a-bar-to-pci-insights-from-the-long-term-outcomes-from-off-site-pci-in-a-real-world-setting
#20
Robert T Gerber, Satpal S Arri, Mohamed O Mohamed, Gurpreet Dhillon, Alykhan Bandali, Idris Harding, Jeremy Gifford, Belinda Sandler, Ben Corbo, Eric McWilliams
OBJECTIVES: We sought to analyze the percutaneous coronary intervention (PCI) outcomes of very elderly patients (V. Eld. group, age >80 years) and compare their outcomes to a less elderly cohort (Eld. group, age 75-80 years) traditionally reported in the literature. BACKGROUND: Limited data exist on peri-procedural and long-term outcomes following PCI in the V. Eld. (age >80 years), with under-representation of this cohort in randomized controlled trials. These patients present with advanced complex coronary disease and multiple comorbidities...
July 2, 2017: Journal of Interventional Cardiology
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