01 julio 2016

JOURNAL OF NEUROSURGERY. Treatment of ruptured complex and large/giant ruptured cerebral aneurysms by acute coiling followed by staged flow diversion

Waleed Brinjikji, MD1, Mariangela Piano, MD4, Shanna Fang, MD2, Guglielmo Pero, MD4, David F. Kallmes, MD1,3, Luca Quilici, MD4, Luca Valvassori, MD4, Emilio Lozupone, MD5, Harry J. Cloft, MD, PhD1,3, Edoardo Boccardi, MD4, and Giuseppe Lanzino, MD1,3

OBJECT: Flow-diversion treatment has been shown to be associated with high rates of angiographic obliteration; however, the treatment is relatively contraindicated in the acute phase following subarachnoid hemorrhage (SAH) as these patients require periprocedural dual antiplatelet therapy. Acute coiling followed by flow diversion has emerged as an intriguing and feasible treatment option for ruptured complex and giant aneurysms. In this study the authors report outcomes and complications of patients with ruptured aneurysms undergoing coiling in the acute phase followed by planned delayed flow diversion.

01 julio 2016

JOURNAL OF NEUROSURGERY. Re-treatment rates after treatment with the Pipeline Embolization Device alone versus Pipeline and coil embolization of cerebral aneurysms: a single-center experience

Min S. Park, MD1, Michael Nanaszko, MD2, Matthew R. Sanborn, MD2, Karam Moon, MD2, Felipe C. Albuquerque, MD2, and Cameron G. McDougall, MD, FRCSC2

OBJECT: The optimal strategy for use of the Pipeline Embolization Device (PED, ev3 Neurovascular) has not been clearly defined. The authors examined re-treatment rates after treatment with PED alone versus PED and adjunctive coil embolization (PED/coil).

01 julio 2016

JOURNAL OF NEUROSURGERY. Management of arteriovenous malformations in the elderly: a single-center case series and analysis of outcomes

Aqueel H. Pabaney, MD, Kevin A. Reinard, MD, Max K. Kole, MD, Donald M. Seyfried, MD, and Ghaus M. Malik, MD

OBJECT: Treatment of brain arteriovenous malformations (bAVMs) in the elderly remains a challenge for cerebrovascular surgeons. In this study the authors reviewed the patient characteristics, treatments, angiographic results, and clinical outcomes in 28 patients over 65 years of age who were treated at Henry Ford Hospital between 1990 and 2014.

01 julio 2016

JOURNAL OF NEUROSURGERY. Intraarterial administration of norcantharidin attenuates ischemic stroke damage in rodents when given at the time of reperfusion: novel uses of endovascular capabilities

Imad S. Khan, MD1,2, Mitchell Odom, BS3, Moneeb Ehtesham, MD3, Daniel Colvin, PhD4, C. Chad Quarles, PhD4, BethAnn McLaughlin, PhD5, and Robert J. Singer, MD1,2

OBJECT: Matrix metalloprotease-9 (MMP-9) plays a critical role in infarct progression, blood-brain barrier (BBB) disruption, and vasogenic edema. While systemic administration of MMP-9 inhibitors has shown neuroprotective promise in ischemic stroke, there has been little effort to incorporate these drugs into endovascular modalities. By modifying the rodent middle cerebral artery occlusion (MCAO) model to allow local intraarterial delivery of drugs, one has the ability to mimic endovascular delivery of therapeutics. Using this model, the authors sought to maximize the protective potential of MMP-9 inhibition by intraarterial administration of an MMP-9 inhibitor, norcantharidin (NCTD).

01 abril 2016

EUROPEAN JOURNAL OF NEUROLOGY. Frequency and temporal profile of recanalization after cerebral vein and sinus thrombosis

C. Herweh1, M. Griebe2, C. Geisbüsch3, K. Szabo2, E. Neumaier-Probst4, M. G. Hennerici2, M. Bendszus1, P. A. Ringleb3 andS. Nagel3,*

Background and purpose: The temporal course of recanalization and its association with clinical outcome were analysed in our patients with cerebral sinus and/or venous thrombosis (CSVT) and follow-up magnetic resonance imaging (MRI).

01 febrero 2016

EUROPEAN JOURNAL OF NEUROLOGY. A collaborative system for endovascular treatment of acute ischaemic stroke: the Madrid Stroke Network experience

M. Alonso de Leciñana1,†,*, B. Fuentes2,†, Á. Ximénez-Carrillo3,†, J. Vivancos3, J. Masjuan1, A. Gil-Nuñez4, P. Martínez-Sánchez2, G. Zapata-Wainberg3, A. Cruz-Culebras1, A. García-Pastor4, F. Díaz-Otero4, E. Fandiño1, R. Frutos1, J.-L. Caniego3, J.-C. Méndez1, A. Fernández-Prieto2, E. Bárcena-Ruiz3, E. Díez-Tejedor2 andon behalf of the Madrid Stroke Network

Background and purpose: The complexity and expense of endovascular treatment (EVT) for acute ischaemic stroke (AIS) can present difficulties in bringing this approach closer to the patients. A collaborative node was implemented involving three stroke centres (SCs) within the Madrid Stroke Network to provide round-the-clock access to EVT for AIS.

26 marzo 2016

THE LANCET. A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAP-HF): a multicentre, open-label, single-arm, phase 1 trial

Prof Gerd Hasenfuß, MD, Prof Chris Hayward, MD, Dan Burkhoff, MD, Frank E Silvestry, MD, Scott McKenzie, MD, Finn Gustafsson, MD, Filip Malek, MD, Jan Van der Heyden, MD, Prof Irene Lang, MD, Prof Mark C Petrie, MD, Prof John G F Cleland, MD, Prof Martin Leon, MD, Prof David M Kaye, MD on behalf of the REDUCE LAP-HF study investigators†

Background: Heart failure with preserved ejection fraction (HFPEF) is a common, globally recognised, form of heart failure for which no treatment has yet been shown to improve symptoms or prognosis. The pathophysiology of HFPEF is complex but characterised by increased left atrial pressure, especially during exertion, which might be a key therapeutic target. The rationale for the present study was that a mechanical approach to reducing left atrial pressure might be effective in HFPEF.

26 marzo 2016

THE LANCET. Unidirectional left-to-right interatrial shunting for treatment of patients with heart failure with reduced ejection fraction: a safety and proof-of-principle cohort study

Maria Del Trigo, MD, Sebastien Bergeron, MD, Mathieu Bernier, MD, Ignacio J Amat-Santos, MD, Rishi Puri, PhD, Francisco Campelo-Parada, MD, Omar Abdul-Jawad Altisent, MD, Ander Regueiro, MD, Neal Eigler, MD, Erez Rozenfeld, Prof Philippe Pibarot, PhD, Prof William T Abraham, MD, Dr Josep Rodés-Cabau, MD

Background: In patients with heart failure, interventions to reduce elevated left atrial pressure improve symptoms and reduce the risk of hospital admission. We aimed to assess the safety and potential efficacy of therapeutic left-to-right interatrial shunting in patients with heart failure with reduced ejection fraction.

26 marzo 2016

THE LANCET. 1-year outcomes with the Absorb bioresorbable scaffold in patients with coronary artery disease: a patient-level, pooled meta-analysis

Prof Gregg W Stone, MD, Prof Runlin Gao, MD, Takeshi Kimura, MD, Dean J Kereiakes, MD, Prof Stephen G Ellis, MD, Yoshinobu Onuma, PhD, Wai-Fung Cheong, PhD, Jennifer Jones-McMeans, PhD, Xiaolu Su, MS, Zhen Zhang, PhD, Prof Patrick W Serruys, PhD

Background: Compared with metallic drug-eluting stents, bioresorbable vascular scaffolds (BVS) offer the potential to improve long-term outcomes of percutaneous coronary intervention. Whether or not these devices are as safe and effective as drug-eluting stents within the first year after implantation is unknown.

12 marzo 2016

THE LANCET. Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial

Nicolai Tegn, MD, Prof Michael Abdelnoor, PhD, Lars Aaberge, MD, Knut Endresen, MD, Prof Pål Smith, MD, Prof Svend Aakhus, MD, Erik Gjertsen, MD, Ola Dahl-Hofseth, MD, Prof Anette Hylen Ranhoff, MD, Prof Lars Gullestad, MD, Dr Bjørn Bendz, MD for the After Eighty study investigators

Background: Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris are frequent causes of hospital admission in the elderly. However, clinical trials targeting this population are scarce, and these patients are less likely to receive treatment according to guidelines. We aimed to investigate whether this population would benefit from an early invasive strategy versus a conservative strategy.

23 febrero 2016

STROKE. Clinical Sciences. Patient- and Aneurysm-Specific Risk Factors for Intracranial Aneurysm Growth. A Systematic Review and Meta-Analysis

Daan Backes, MD; Gabriel J.E. Rinkel, MD, FRCPE; Kamil G. Laban, MD; Ale Algra, MD, PhD; Mervyn D.I. Vergouwen, MD, PhD

Background and Purpose: Follow-up imaging is often performed in intracranial aneurysms that are not treated. We performed a systematic review and meta-analysis on patient- and aneurysm-specific risk factors for aneurysm growth.

25 febrero 2016

STROKE. Clinical Sciences. Cerebrovascular Disease. in Rheumatic Diseases A Systematic Review and Meta-Analysis

Stewart J. Wiseman, BSc; Stuart H. Ralston, FRCP; Joanna M. Wardlaw, FRCR

Background and Purpose: Some rheumatic diseases are associated with stroke. Less is known about associations with stroke subtypes or stroke risk by age. We quantified the association between stroke, its subtypes, and rheumatic diseases and identified when stroke risk is greatest.

03 marzo 2016

STROKE. Clinical Sciences. Stroke and Embolic Events in Hypertrophic Cardiomyopathy. Risk Stratification in Patients Without Atrial Fibrillation

Shintaro Haruki, MD, PhD; Yuichiro Minami, MD, PhD; Nobuhisa Hagiwara, MD, PhD

Background and Purpose: Stroke and systemic embolic events are known to occur as complications of hypertrophic cardiomyopathy (HCM), and these complications are more common in patients with accompanying atrial fibrillation (AF). The diagnosis of AF is sometimes difficult, however, and it is possible that subclinical asymptomatic paroxysmal episodes or a first episode of AF in patients without previously documented AF may lead to embolic events. We investigated the prevalence of embolic events in patients with HCM and evaluated risk factors for these events in patients without documented AF.

23 febrero 2016

STROKE. Brief Report. Early Endovascular Treatment in Intravenous Tissue Plasminogen Activator–Ineligible Patients

Letícia C. Rebello, MD; Diogo C. Haussen, MD; Jonathan A. Grossberg, MD; Samir Belagaje, MD; Andrey Lima, MD; Aaron Anderson, MD; Michael R. Frankel, MD; Raul G. Nogueira, MD

Background and Purpose: Intravenous tissue-type plasminogen activator (tPA) treatment in acute stroke has many exclusion criteria. We aimed to assess the safety and efficacy of endovascular therapy (ET) in intravenous (IV) tPA-ineligible patients.

01 marzo 2016

STROKE. Brief Report. Safety of Endovascular Thrombectomy in Patients Receiving Non–Vitamin K Antagonist Oral Anticoagulants

Jan C. Purrucker, MD; Marcel Wolf, MD; Kirsten Haas, PhD; Timolaos Rizos, MD; Shujah Khan; Rainer Dziewas, MD; Christoph Kleinschnitz, MD; Andreas Binder, MD; Klaus Gröschel, MD; Michael G. Hennerici, MD; Kyriakos Lobotesis, MD; Sven Poli, MD; Günter Seidel, MD; Tobias Neumann-Haefelin, MD; Peter A. Ringleb, MD; Peter U. Heuschmann, MD; Roland Veltkamp, MD

Background and Purpose: Prospective data on the safety of endovascular thrombectomy in acute stroke patients on non–vitamin K antagonist oral anticoagulants are lacking.