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https://www.readbyqxmd.com/read/28225471/neuroanesthesiology-update
#1
Jeffrey J Pasternak, William L Lanier
We reviewed manuscripts published in 2016 that are related to the care of neurosurgical patients or the perioperative care of patients with neurological diseases. We address the broad categories of general neurosurgery and neuroanesthesiology, anesthetic neurotoxicity and neuroprotection, stroke, traumatic brain injury, and nervous system monitoring.
February 20, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28225286/-closure-of-the-left-atrial-appendage-by-means-of-the-atriclip-system
#2
Aleš Mokráček, Vojtěch Kurfirst, Alan Bulava, Jiří Haniš
INTRODUCTION: Atrial fibrillation (AFib) is related to a high risk of stroke. The main role in etiopathogenesis is played by the left atrial appendage (LAA). As many as 95 % of thrombi in nonvalvular atrial fibrillation are located in the appendage. Prevention of stroke then consists in permanent anticoagulation which, however, has its limits and risks. An alternative method is the left atrial appendage occlusion. In our report, we would like to present a new possibility of the closure using the epicardial system AtriClip (AtriCure)...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28217291/paradigms-and-mechanisms-of-inhalational-anesthetics-mediated-neuroprotection-against-cerebral-ischemic-stroke
#3
REVIEW
Hailian Wang, Peiying Li, Na Xu, Ling Zhu, Mengfei Cai, Weifeng Yu, Yanqin Gao
Cerebral ischemic stroke is a leading cause of serious long-term disability and cognitive dysfunction. The high mortality and disability of cerebral ischemic stroke is urging the health providers, including anesthesiologists and other perioperative professioners, to seek effective protective strategies, which are extremely limited, especially for those perioperative patients. Intriguingly, several commonly used inhalational anesthetics are recently suggested to possess neuroprotective effects against cerebral ischemia...
October 2016: Medical Gas Research
https://www.readbyqxmd.com/read/28216366/implications-of-concomitant-hypogastric-artery-embolization-with-endovascular-repair-of-infrarenal-abdominal-aortic-aneurysms
#4
Behzad S Farivar, Richa Kalsi, Charles B Drucker, Carly B Goldstein, Rajabrata Sarkar, Shahab Toursavadkohi
OBJECTIVE: Hypogastric artery embolization (HAE) is associated with significant risk of ischemic complications. We assessed the impact of HAE on 30-day outcomes of endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2014 to identify and to compare clinical features, operative details, and 30-day outcomes of EVAR with those of concomitant HAE with EVAR (HAE + EVAR)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28214642/short-term-results-of-carotid-endarterectomy-and-stenting-after-the-introduction-of-carotid-magnetic-resonance-imaging-a-single-institutional-retrospective-study
#5
Ryu Fukumitsu, Kazumichi Yoshida, Yoshitaka Kurosaki, Koichi Torihashi, Nobutake Sadamasa, Masaomi Koyanagi, Osamu Narumi, Tsukasa Sato, Masaki Chin, Akira Handa, Sen Yamagata, Susumu Miyamoto
OBJECTIVE: While carotid artery stenting (CAS) has been gaining popularity as an alternative to carotid endarterectomy (CEA), the perioperative stroke rate following contemporary CAS remains significantly higher than that in CEA. The purpose of this study was to assess perioperative (within 30-day) therapeutic results in patients with carotid stenosis (CS) after the introduction of preoperative carotid magnetic resonance plaque evaluation in a single center offering both CEA and CAS. METHODS: Based on prospectively collected data for patients with CS who were scheduled for carotid revascularization, retrospective analysis was conducted of 295 consecutive CS patients...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28203558/cerebral-monitoring-during-carotid-endarterectomy-by-transcranial-doppler-ultrasonography
#6
Woo-Sung Yun
PURPOSE: To evaluate the efficacy and safety of cerebral monitoring by transcranial Doppler ultrasonography (TCD) for the detection of cerebral ischemia during carotid endarterectomy (CEA). METHODS: From August 2004 to December 2013, 159 CEAs were performed in a tertiary hospital. All procedures were performed under general anesthesia. Intraoperative TCD was routinely used to detect cerebral ischemia. Of the 159 patients, 102 patients were included in this study, excluding 27 patients who had a poor transtemporal isonation window and 30 patients who used additional cerebral monitoring systems such as electroencephalography or somatosensory evoked potentials...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#7
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28202829/-treatment-strategy-and-results-of-carotid-endarterectomy-in-chronic-renal-failure-patients
#8
Takeo Murahashi, Kenji Kamiyama, Toshiaki Osato, Toshiichi Watanabe, Tatsuya Ogino, Hironori Sugio, Hideki Endo, Kazuki Takahira, Koichiro Shindo, Shuhei Takahashi, Hirohiko Nakamura
INTRODUCTION: The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. METHODS: The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#9
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28185702/impact-of-total-arterial-revascularization-on-long-term-survival-a-systematic-review-and-meta-analysis-of-130-305-patients
#10
Bobby Yanagawa, Subodh Verma, Amine Mazine, Derrick Y Tam, Peter Jüni, John D Puskas, Shamini Murugavel, Jan O Friedrich
OBJECTIVES: This meta-analysis compares total arterial revascularization (TAR) versus conventional coronary artery bypass and additionally to two arterial grafts. METHODS: We searched MEDLINE and EMBASE Databases from 1996-to-2016 for studies comparing TAR versus non-TAR for multi-vessel surgical revascularization. Data were extracted by 2 independent investigators. Meta-analysis used random effects, which incorporates heterogeneity. RESULTS: There were 4 smaller shorter follow-up randomized controlled trials (RCTs), plus 15 matched/adjusted and 6 unmatched/unadjusted larger longer follow-up observational studies that met inclusion criteria (N=130...
February 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28167634/management-of-patients-on-non-vitamin-k-antagonist-oral-anticoagulants-in-the-acute-care-and-periprocedural-setting-a-scientific-statement-from-the-american-heart-association
#11
Amish N Raval, Joaquin E Cigarroa, Mina K Chung, Larry J Diaz-Sandoval, Deborah Diercks, Jonathan P Piccini, Hee Soo Jung, Jeffrey B Washam, Babu G Welch, Allyson R Zazulia, Sean P Collins
Non-vitamin K oral anticoagulants (NOACs) are now widely used as alternatives to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism. In clinical practice, there is still widespread uncertainty on how to manage patients on NOACs who bleed or who are at risk for bleeding. Clinical trial data related to NOAC reversal for bleeding and perioperative management are sparse, and recommendations are largely derived from expert opinion. Knowledge of time of last ingestion of the NOAC and renal function is critical to managing these patients given that laboratory measurement is challenging because of the lack of commercially available assays in the United States...
February 6, 2017: Circulation
https://www.readbyqxmd.com/read/28156447/practice-patterns-and-outcomes-of-rivaroxaban-usage-in-patients-with-cancer
#12
Ali Zalpour, Juhee Song, Marsha N Richardson, Tony Lam, Josiah Halm, SWamique Yusuf, Shuwei Gao
: 194 Background: Patients with cancer have an increased risk of venous thromboembolism (VTE) and frequently require anticoagulation. In addition, many patients with cancer also have comorbidities such as atrial fibrillation (AF) and are on stroke prevention. Rivaroxaban (RV) is an oral (factor Xa inhibitor) used in these scenarios; however, there is little experience utilizing this agent in patients with cancer. Our aim is to describe practice patterns and outcomes of RV usage in patients with cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28145446/migraine-migraine-is-associated-with-increased-risk-of-perioperative-ischaemic-stroke
#13
Heather Wood
No abstract text is available yet for this article.
February 1, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28142887/the-effect-of-increasing-operator-experience-on-procedure-related-characteristics-in-patients-undergoing-carotid-artery-stenting
#14
George Kouvelos, Andreas Koutsoumpelis, Eleni Arnaoutoglou, Christos Nassis, Vasilios Bouris, Michalis Peroulis, George Papadopoulos, Miltiadis Matsagkas
Objectives To evaluate the efficacy and safety of carotid artery stenting for the treatment of severe carotid artery disease in our department and to investigate the effect of increasing operator experience on perioperative and procedure-related characteristics. Methods From January 2007 to February 2015 200 patients underwent 207 endovascular procedures for carotid artery stenosis. Of all, 113 arteries (56.5%) were symptomatic. Significant changes across time were calculated with the use of Change Point analysis using bootstrap and mean squared error estimates...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28127789/transcranial-doppler-monitoring-in-carotid-endarterectomy-a-systematic-review-and-meta-analysis
#15
Reshmi Udesh, Piruthiviraj Natarajan, Karthy Thiagarajan, Lawrence R Wechsler, Donald J Crammond, Jeffrey R Balzer, Parthasarathy D Thirumala
OBJECTIVES: To evaluate the efficacy of intraoperative transcranial Doppler monitoring in predicting perioperative strokes after carotid endarterectomy (CEA). METHODS: An electronic search of PubMed, Embase, and Web of Science databases was conducted for studies on transcranial Doppler monitoring in CEA published from January 1970 through September 2015. All titles and abstracts were independently screened on the basis of predetermined inclusion criteria, which included randomized clinical trials and prospective or retrospective cohort reviews, patients who underwent CEA with intraoperative transcranial Doppler monitoring (either middle cerebral artery velocity [MCAV] or cerebral microembolic signals [MES]) and postoperative neurologic assessments up to 30 days after the surgery, and studies including an abstract, published in English on adult humans 18 years and older with a sample size of 50 or greater...
January 27, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28127515/effects-of-preoperative-statin-use-on-perioperative-outcomes-of-carotid-endarterectomy
#16
Enzo Ballotta, Antonio Toniato, Filippo Farina, Claudio Baracchini
OBJECTIVES: Several studies have shown the beneficial role of statins in reducing the risk of major perioperative complications and death associated with noncardiac vascular surgery, but few have focused on their effects in the event of carotid endarterectomy (CEA). This study analyzes the effects of preoperative statin use on perioperative outcomes in patients undergoing CEA. MATERIALS AND METHODS: Data from all consecutive patients who underwent primary CEA for symptomatic and asymptomatic carotid disease between 2002 and 2014 at a single institution were prospectively stored in a vascular surgery registry, recording risk factors, medication, and indication for surgery...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28122491/mild-volume-acute-normovolemic-hemodilution-is-associated-with-lower-intraoperative-transfusion-and-postoperative-pulmonary-infection-in-patients-undergoing-cardiac-surgery-a-retrospective-propensity-matching-study
#17
Zhen-Feng Zhou, Xiu-Ping Jia, Kai Sun, Feng-Jiang Zhang, Li-Na Yu, Tian Xing, Min Yan
BACKGROUND: Perioperative allogenic transfusion is required in almost 50% of patients undergoing cardiac surgery and is associated with higher risk of mortality and morbidity (Xue et al., Lancet 387:1905, 2016; Ferraris et al., Ann Thorac Surg 91:944-82, 2011). Acute normovolemic hemodilution (ANH) is recommended as a potential strategy during cardiac surgery, but the blood conservation effect and the degree of ANH was still controversial. There is also an increasing concern about the improved outcomes associated with ANH...
January 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28118262/permanent-atrial-fibrillation-and-2-year-clinical-outcomes-in-patients-with-a-left-ventricular-assist-device-implant
#18
Cenk Oezpeker, Armin Zittermann, Thomas Pühler, Stephan Ensminger, Jan F Gummert, Michiel Morshuis
Atrial fibrillation (AF) may increase the risk of thromboembolic complications in patients with left ventricular assist devices (LVADs). In a single-center study we investigated 205 patients with sinus rhythm (SR group) and 117 patients with AF (AF group). Our main read outs were 2-year overall survival (primary endpoint), perioperative right heart failure and 2-year freedom from stroke, pump thrombosis, and gastrointestinal bleeding (secondary endpoints). Oral anticoagulation was performed with phenprocomoun (INR target range: 2...
January 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28112798/multidisciplinary-perioperative-protocol-in-patients-undergoing-acute-high-risk-abdominal-surgery
#19
L T Tengberg, M Bay-Nielsen, T Bisgaard, M Cihoric, M L Lauritsen, N B Foss
BACKGROUND: Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery. METHODS: The AHA study was a prospective single-centre controlled study in consecutive patients undergoing AHA surgery, defined as major abdominal pathology requiring emergency laparotomy or laparoscopy including reoperations after elective gastrointestinal surgery...
March 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28108838/clinical-impact-of-preoperative-brain-mr-angiography-and-mr-imaging-in-candidates-for-liver-transplantation-a-propensity-score-matching-study-in-a-single-institution
#20
Mi Sun Chung, Ho Sung Kim, Young-Suk Lim, Sang-Beom Jeon, Seon-Ok Kim, Hwa Jung Kim, Shin Hwang, Seung Chai Jung, Choong Gon Choi, Sang Joon Kim
OBJECTIVES: To investigate the prevalence of cerebrovascular stenosis and white matter lesions on preoperative magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) in liver transplantation candidates. METHODS: This retrospective study included 1,460 consecutive patients with liver cirrhosis (LC) who underwent MRA with/without brain MRI for pretransplantation evaluation. These patients were matched with 5,331 controls using propensity scores, and the prevalences of significant cerebrovascular stenosis and white matter lesions were compared...
January 20, 2017: European Radiology
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