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https://www.readbyqxmd.com/read/27903481/hybrid-repair-of-complex-left-subclavian-artery-injury-with-partial-transection-and-complete-thrombosis-in-an-unstable-patient-following-blunt-trauma
#1
Ilitch Diaz-Gutierrez, Muhammad A Rana, Barkat Ali, John M Marek, Mark Langsfeld
Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27856952/clinical-outcomes-of-posterior-versus-anterior-circulation-infarction-with-low-national-institutes-of-health-stroke-scale-scores
#2
Joon-Tae Kim, Man-Seok Park, Kang-Ho Choi, Beom Joon Kim, Moon-Ku Han, Tai Hwan Park, Sang-Soon Park, Kyung Bok Lee, Byung-Chul Lee, Kyung-Ho Yu, Mi Sun Oh, Jae Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Jun Lee, Soo Joo Lee, Youngchai Ko, Jae Guk Kim, Jong-Moo Park, Kyusik Kang, Yong-Jin Cho, Keun-Sik Hong, Jay Chol Choi, Dong-Eog Kim, Wi-Sun Ryu, Dong-Ick Shin, Min-Ju Yeo, Wook-Joo Kim, Juneyoung Lee, Ji Sung Lee, Hee-Joon Bae, Jeffrey L Saver, Ki-Hyun Cho
BACKGROUND AND PURPOSE: We compared baseline characteristics and outcomes at 3 months between patients with minor anterior circulation infarction (ACI) versus minor posterior circulation infarction (PCI), including the influence of large vessel disease on outcomes. METHODS: This study is an analysis of a prospective multicenter registry database in South Korea. Eligibility criteria were patients with ischemic stroke admitted within 7 days of stroke onset, lesions in either anterior or posterior circulation, and National Institutes of Health Stroke Scale score of ≤4 at baseline...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27854084/impacts-of-cigarette-smoking-and-basilar-artery-flow-on-1-year-recovery-in-3-month-survivors-of-intracranial-vertebrobasilar-artery-dissection-related-ischemic-stroke
#3
Chih-Ping Chung, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Yung-Yang Lin
OBJECTIVE: Intracranial vertebrobasilar artery dissection (iVBD) is an important etiology for posterior circulation ischemic stroke (PCS); however, its long-term functional outcome has been seldom reported. The present study aimed to elucidate the functional outcomes and the predictors of poor functional recovery at 1-year after iVBD-caused PCS. METHODS: Patients with iVBD-caused PCS who had been recruited in the Stroke Registry of Taipei Veterans General Hospital between January 1, 2012 to February 28, 2014 were included...
September 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27852380/-clinical-analysis-of-endovascular-strategies-in-the-treatment-of-vertebrobasilar-dissecting-aneurysms
#4
Y Z Zang, Z G Wang, C W Wang, Y Zhang, X Ding, X F Wang
Objective: To evaluate the efficacy and safety of endovascular strategies for vertebrobasilar dissecting aneurysm (VBDA) and analyze advantages and disadvantages of different endovascular methods for the treatment of VBDA through long-term follow-up. Methods: Retrospectively analyzing was used for the clinical information of 45 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department from January 2007 to December 2015. The treatment modalities were classified into reconstructive surgery and destructive surgery that were based on parent artery preservation...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27836994/treatment-of-posterior-circulation-non-saccular-aneurysms-with-flow-diverters-a-single-center-experience-and-review-of-56-patients
#5
REVIEW
P Bhogal, M Aguilar Pérez, O Ganslandt, H Bäzner, H Henkes, S Fischer
BACKGROUND AND PURPOSE: Non-saccular aneurysms of the posterior fossa are an uncommon pathology with no clear treatment strategy. The use of flow-diverting stents (FDS) has had mixed results. We sought to evaluate our experience of FDS for the treatment of this pathology. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated only with flow diversion for an unruptured non-saccular aneurysm of the posterior circulation between February 2009 and April 2016...
November 11, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27831484/dynamic-respiratory-tortuosity-of-the-vertebral-artery-ostium
#6
Xiaobin Tang, Feng Tang, Chang Hu, Qian Wang, Whitney Long, Lei Li
PURPOSE: To determine the prevalence of dynamic respiratory tortuosity (DRT) of the vertebral artery ostium (VAO) as well as to evaluate its correlation with in-stent restenosis (ISR) and stent fracture. METHODS: From March 2012 to June 2015, 178 consecutive patients (mean age 65.2±5.8 years; 124 men) with symptoms of atherosclerotic vertebrobasilar ischemia underwent angiography prior to stent implantation in the vertebral, subclavian, and/or carotid arteries...
November 9, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27801397/-tactics-of-surgical-treatment-of-patients-with-unruptured-asymptomatic-cerebral-aneurysms
#7
A S Kheireddin, Sh Sh Eliava, S B Yakovlev, Yu M Filatov, A N Kaftanov, O B Belousova, I A Sazonov, S R Arustamyan, K G Mikeladze, E Yu Bukharin, P S Dorokhov
AIM: To clarify the indications for surgical treatment and the principles for choosing a surgical technique for patients with unruptured asymptomatic aneurysms (UAAs) based on the results of direct and endovasal operations performed at the Burdenko Neurosurgical Institute and on the literature data. MATERIAL AND METHODS: The study included 694 UAA patients (481 females (69.3%) and 213 males (30.7%)) operated on at the Burdenko Neurosurgical Institute from 1997 to 2013...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27801396/-results-of-deconstructive-endovascular-surgery-in-treatment-of-large-and-giant-intracranial-aneurysms
#8
S R Arustamyan, S B Yakovlev, A R Shakhnovich, I V Krasnoperov, O B Sazonova, A V Bocharov, E Yu Bukharin, O B Belousova, A N Kaftanov
AIM: To clarify the indications for deconstructive endovascular surgery in patients with large and giant intracranial aneurysms and to evaluate short-term and long-term postoperative outcomes. MATERIAL AND METHODS: The study was based on a retrospective analysis of the treatment results in 50 patients with large (15-25 mm) and giant (more than 25 mm) intracranial aneurysms, aged from 18 to 75 years, who were treated at the Burdenko Neurosurgical Institute in 2002-2014...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27799374/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#9
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798854/temporary-vertebral-artery-occlusion-after-c3-fracture-dislocation-injury-and-spontaneous-resolution-following-reduction-and-instrumented-fusion-case-report-and-literature-review
#10
REVIEW
Kurt Yaeger, Justin Mascitelli, Christopher Kellner, Zachary Hickman, J Mocco, Konstantinos Margetis
Vertebral artery injuries as a result of blunt trauma can result in vertebrobasilar strokes. Typical treatment of such an injury includes early anticoagulation to prevent cerebral ischemic events due to vessel occlusion or embolism. We present a case of cervical fracture-dislocation injury and compression/occlusion of the right vertebral artery, which spontaneously resolved following surgical reduction and fusion. Postoperative cerebral angiography showed no evidence of vertebral artery stenosis, and systemic anticoagulation was discontinued...
October 18, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798325/dynact-angiography-for-the-diagnosis-of-bilateral-bow-hunter-s-syndrome
#11
Tony Lu, Ponraj Chinnadurai, Javier E Anaya-Ayala, Orlando M Diaz
We herein present a rare case of bilateral positional vertebrobasilar insufficiency secondary to mechanical obstruction of the V2 segment of the vertebral artery in a 71-year-old patient presenting with vertigo, occipital headache, tremors and respiratory irregularities. Two-dimensional digital subtraction angiography is the traditional diagnostic imaging standard but does not capture any peri-vascular bony or soft tissue abnormalities that are important to understand the three-dimensional pathophysiology. Intra-procedural cone-beam computed tomography (CT) is an increasingly used diagnostic adjunct, available in most modern angiographic suites that allows for the three-dimensional visualization of the vasculature as well as CT-like soft tissue visualization of its surrounding anatomy...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27797875/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#12
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27772791/evaluating-the-morphological-changes-of-intracranial-arteries-and-whole-brain-perfusion-in-undetermined-isolated-vertigo
#13
Wenxian Li, Youzhen Feng, Weibiao Lu, Xie Xie, Zhilin Xiong, Zhen Jing, Xiangran Cai, Li'an Huang
PURPOSE: To determine the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo (UIV) patients using 320-detector row computed tomography (CT). METHODS: A total of 150 patients who underwent CT angiography (CTA) and CT perfusion (CTP) imaging were divided into UIV group and benign paroxysmal positional vertigo (BPPV) group. Sixty individuals with sex- and age-matched without vertigo and cerebral diseases served as the control...
November 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27770193/variation-of-some-arteries-of-the-vertebrobasilar-system-case-report
#14
Borisav Stojanović, Ljiljana Vasović, Slobodan Vlajković, Milena Trandafilović, Marija Mladenović
A specificity of the vertebrobasilar system (VBS) is a convergent junction of paired vertebral arteries (VAs) in the basilar artery (BA) usually at the level of bulbopontine sulcus on the ventral side of the rhombencephalon. We revealed multiple VBS variations (a high junction of both VAs, absence of posterior inferior cerebellar arteries, short and ectatic BA, hypoplasia and initial duplication of the left anterior inferior cerebellar artery, and bilateral common trunks of the posterior cerebral and superior cerebellar arteries) in a 52-year-old male that routinely autopsied at the Institute of Forensic Medicine...
October 21, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27767394/resolution-of-intractable-retching-following-mobilization-of-a-dolichoectatic-vertebral-artery-case-report-of-a-unique-brainstem-cranial-nerve-compression-syndrome
#15
Scott Seaman, Paul Nelson, Jacob Alexander, Andrew Swift, James Fick
The authors present the case of a 53-year-old man who was referred with disabling retching provoked by left arm abduction. At the time of his initial evaluation, a cervical MRI study was available for review and revealed an anatomical variation of the ipsilateral juxtamedullary vertebrobasilar junction. After brain imaging revealed contact of the medulla by a dolichoectatic vertebral artery at the dorsal root entry zone of the glossopharyngeal and vagus nerves, the patient was successfully treated by microvascular decompression of the brainstem and cranial nerves...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27766499/arteries-and-veins-of-the-cerebellum
#16
Matthieu Delion, Mickael Dinomais, Philippe Mercier
Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA)...
October 20, 2016: Cerebellum
https://www.readbyqxmd.com/read/27762120/sudden-simultaneous-cerebellar-infarction-in-the-territories-of-the-medial-division-of-posterior-inferior-cerebellar-arteries
#17
K Mugundhan, Rajesh Shankar Iyer
Strokes involving posterior inferior cerebellar arteries (PICA) are rare and usually unilateral. They can involve either the lateral division or the medial division of PICA. Sudden simultaneous cerebellar infarctions in the medial PICA territories are extremely rare. We report one such patient who presented with acute bilateral cerebellar infarctions in the medial PICA territories. She was a diabetic and had features of diffuse atherosclerotic vertebrobasilar disease. We discuss the anatomical peculiarities of PICA and its blood supply along with the clinical features differentiating the medial and lateral PICA infarctions...
August 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27753972/os-11-05-superior-cervical-ganglionectomy-scgx-reduces-sympathetic-innervation-of-vertebrobasilar-arteries-but-does-not-affect-cerebrovascular-remodelling-in-the-adult-spontaneously-hypertensive-rat-shr
#18
Dawid Walas, Eva Von Roloff, Julian Paton
OBJECTIVE: Our hypothesis is that hypoperfusion of the brainstem is due to elevated vertebrobasilar artery resistance, triggers hypertension. We asked: is there a functional relationship between the sympathetic innervation to the vertebrobasilar system and its remodelling in the SHR? DESIGN AND METHOD: SHRs (11-12 weeks old) received either sham surgery or bilateral SCGx. Animals recovered for 14 days, were then perfused-fixed with 4% PFA and the vertebrobasilar arteries examined using both immunohistofluorecent staining of sympathetic (anti-DβH) and parasympathetic (anti-VAChT) fibres, and by cross sectional examination of vertebral and basilar arteries...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27743924/endovascular-treatment-of-the-subclavian-artery-steno-occlusive-disease
#19
Andrey Karpenko, Vladimir Starodubtsev, Pavel Ignatenko, Alexander Gostev
OBJECTIVE: The aim of our study was to compare immediate and long-term results of endovascular interventions for the treatment of steno-occlusive disease of subclavian arteries (SAs) depending on the length of lesion. MATERIALS AND METHODS: Between 2010 and 2013, we performed 245 endovascular procedures to treat patients with atherosclerotic steno-occlusive disease of SAs. All patients were examined and subdivided according to the received results into 2 groups: 125 patients with stenosis of SA were included in the first group and 120 patients with occlusion of SA were included in the second group...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27716015/rotational-vertebrobasilar-insufficiency-due-to-compression-of-a-persistent-first-intersegmental-vertebral-artery-variant-case-report
#20
Vivek P Buch, Peter J Madsen, Kerry A Vaughan, Paul F Koch, David K Kung, Ali K Ozturk
Rotational vertebrobasilar insufficiency, or bow hunter's syndrome, is a rare cause of posterior circulation ischemia, which, following rotation of the head, results in episodic vertigo, dizziness, nystagmus, or syncope. While typically caused by dynamic occlusion of the vertebral artery in its V2 and V3 segments, the authors here describe a patient with dynamic occlusion of the vertebral artery secondary to a persistent first intersegmental artery, a rare variant course of the vertebral artery. In this case the vertebral artery coursed under rather than over the posterior arch of the C-1...
October 7, 2016: Journal of Neurosurgery. Spine
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