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ESTUDIOS


31 julio 2013

CIRCULATION. Stroke. Subclinical Left Ventricular Dysfunction and Silent Cerebrovascular Disease

Cesare Russo, MD; Zhezhen Jin, PhD; Shunichi Homma, MD; Mitchell S.V. Elkind, MD, MS; Tatjana Rundek, MD, PhD; Mitsuhiro Yoshita, MD, PhD; Charles DeCarli, MD; Clinton B. Wright, MD, MS; Ralph L. Sacco, MD, MS, FAHA; Marco R. Di Tullio, MD

Background: Silent brain infarcts (SBIs) and white matter hyperintensities are subclinical cerebrovascular lesions associated with incident stroke and cognitive decline. Left ventricular ejection fraction (LVEF) is a predictor of stroke in patients with heart failure, but its association with subclinical brain disease in the general population is unknown. Left ventricular global longitudinal strain (GLS) can detect subclinical cardiac dysfunction even when LVEF is normal. We investigated the relationship of LVEF and GLS with subclinical brain disease in a community-based cohort.

01 septiembre 2013

JACC. Meta-Analysis and Systematic Review of the Predictive Value of Carotid Plaque Hemorrhage on Cerebrovascular Events by Magnetic Resonance Imaging

Tobias Saam, MD∗; Holger Hetterich, MD∗; Verena Hoffmann, PhD†; Chun Yuan, MD‡; Martin Dichgans, MD§; Holger Poppert, MD‖; Thomas Koeppel, MD¶; Ulrich Hoffmann, MD#; Maximilian F. Reiser, MD∗; Fabian Bamberg, MD, MPH∗

Objectives: This study sought to conduct a systematic review and meta-analysis to determine precise estimates of the predictive value of carotid intraplaque hemorrhage (IPH) as determined by magnetic resonance imaging (MRI) for cerebrovascular events.

01 septiembre 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Neurovascular Rescue for Thrombus-Related Embolic Stroke During Transcatheter Aortic Valve Implantation

Pablo Salinas, MD∗; Raul Moreno, MD, PhD∗; Remedios Frutos, MD†; Jose Luis Lopez-Sendon, MD, PhD∗

An 88-year-old woman with critical aortic stenosis was scheduled for transfemoral transcatheter aortic valve implantation (TAVI). She received pre-procedural aspirin plus clopidogrel, and 100 IU/kg of unfractionated heparin during the procedure. The procedure was uneventful, and the balloon-expandable valve was successfully deployed. After deflating the balloon, an echo-dense mobile mass was seen in the left ventricular outflow tract, probably attached to the intraventricular portion of the guidewire. This mass was not present after valvuloplasty, so torn leaflets from the native valve were unlikely. Activated clotting time was 270 s. When the balloon catheter and guidewire were withdrawn, the mass disappeared.

25 julio 2013

STROKE. Brief Report. Morphological and Functional Assessment of Carotid Plaques Have Similar Predictive Accuracy for Coronary Artery Disease

Konstantinos Toutouzas, MD; Georgios Benetos, MD; Maria Drakopoulou, MD; Archontoula Michelongona, MD; Charalampia Nikolaou, MD; Constantina Masoura, MD; Konstantinos Stathogiannis, MD; Constantina Aggeli, MD; Eleftherios Tsiamis, MD; Elias Siores, BSc, MSc, PhD; Christodoulos Stefanadis, MD

Background and Purpose: Microwave radiometry allows noninvasive in vivo measuring of internal temperature of tissues reflecting inflammation. In the present study, we evaluated the predictive accuracy of this method for the diagnosis of coronary artery disease (CAD).

11 junio 2013

STROKE. Clinical Sciences. Impact of Diffusion-Weighted Imaging Lesion Volume on the Success of Endovascular Reperfusion Therapy

Jean-Marc Olivot, MD, PhD; Pascal J. Mosimann, MD; Julien Labreuche, BST; Manabu Inoue, MD; Elena Meseguer, MD; Jean-Philippe Desilles, MD; Aymeric Rouchaud, MD; Isabelle F. Klein, MD, PhD; Matus Straka, MD, PhD; Roland Bammer, MD, PhD; Michael Mlynash, MD, MS; Pierre Amarenco, MD; Gregory W. Albers, MD; Mikael Mazighi, MD, PhD

Background and Purpose: Diffusion-weighted imaging (DWI) lesion volume is associated with poor outcome after thrombolysis, and it is unclear whether endovascular therapies are beneficial for large DWI lesion. Our aim was to assess the impact of pretreatment DWI lesion volume on outcomes after endovascular therapy, with a special emphasis on patients with complete recanalization.

28 mayo 2013

STROKE. Clinical Sciences. Alberta Stroke Program Early CT Scale Evaluation of Multimodal Computed Tomography in Predicting Clinical Outcomes of Stroke Patients Treated With Aspiration Thrombectomy

Marios-Nikos Psychogios, MD; Peter Schramm, MD, PhD; Andreas Maximilian Frölich, MD; Kai Kallenberg, MD; Katrin Wasser, MD; Lars Reinhardt, MS; Andreas S. Kreusch, MS; Klaus Jung, PhD; Michael Knauth, MD, PhD

Background and Purpose: Patient selection is crucial in the endovascular treatment of acute ischemic stroke patients. Baseline computed tomographic (CT) images, evaluated with the Alberta Stroke Program Early CT Scale (ASPECTS), are considered significant predictors of outcome. In this study, we evaluated CT images and perfusion parameters, analyzed with ASPECTS, as final outcome predictors after endovascular stroke treatment.

30 mayo 2013

STROKE. Clinical Sciences. Comparison of Flow Diversion and Coiling in Large Unruptured Intracranial Saccular Aneurysms

Nohra Chalouhi, MD; Stavropoula Tjoumakaris, MD; Robert M. Starke, MD; L. Fernando Gonzalez, MD; Ciro Randazzo, MD; David Hasan, MD; Jeffrey F. McMahon, BS; Saurabh Singhal, MD; Lea A. Moukarzel, BA; Aaron S. Dumont, MD; Robert Rosenwasser, MD; Pascal Jabbour, MD

Background and Purpose: Flow diversion has emerged as an important tool for the management of intracranial aneurysms. The purpose of this study was to compare flow diversion and traditional embolization strategies in terms of safety, efficacy, and clinical outcomes in patients with unruptured, large saccular aneurysms (≥10 mm).

07 mayo 2014

SPRINGER. Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales

Marcin Sawicki1, R. Bohatyrewicz2, K. Safranow3, A. Walecka1, J. Walecki4, O. Rowinski5, J. Solek-Pastuszka2, Z. Czajkowski6, M. Guzinski7, M. Burzynska8 and J. Wojczal9

Introduction: The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD.

05 septiembre 2013

AMERICAN JOURNAL OF NEURORADIOLOGY. MRA Versus DSA for Follow-Up of Coiled Intracranial Aneurysms: A Meta-Analysis

M.J. van Amerongen, H.D. Boogaarts, J. de Vries, A.L.M. Verbeek, F.J.A. Meijer, M. Prokop and R.H.M.A. Bartels

Summary: MR angiography is proposed as a safer and less expensive alternative to the reference standard, DSA, in the follow-up of intracranial aneurysms treated with endovascular coil occlusion. We performed a systematic review and meta-analysis to evaluate the accuracy of TOF-MRA and contrast-enhanced MRA in detecting residual flow in the follow-up of coiled intracranial aneurysms. Literature was reviewed through the PubMed, Cochrane, and EMBASE data bases. In comparison with DSA, the sensitivity of TOF-MRA was 86% (95% CI: 82–89%), with a specificity of 84% (95% CI: 81–88%), for the detection of any recurrent flow. For contrast-enhanced MRA, the sensitivity and specificity were 86% (95% CI: 82–89%) and 89% (95% CI: 85–92%), respectively. Both TOF-MRA and contrast-enhanced MRA are shown to be highly accurate for detection of any recanalization in intracranial aneurysms treated with endovascular coil occlusion.

19 junio 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. Patients Prone to Recurrence after Endovascular Treatment: Periprocedural Results of the PRET Randomized Trial on Large and Recurrent Aneurysms

J. Raymond,b, R. Klink, M. Chagnon, S.L. Barnwell, A.J. Evans, J. Mocco, B.L. Hoh, A.S. Turk, R.D. Turner, H. Desal, D. Fiorella, S. Bracard, A. Weill, F. Guilbert and D. Roy on behalf of the PRET Collaborative Group

Background and Purpose: Some patients with large or recurrent aneurysms may be at increased risk of recurrence postcoiling. The Patients Prone to Recurrence after Endovascular Treatment (PRET) trial was designed to assess whether hydrogel coils were superior to platinum coils in these high-risk patients. This article reports periprocedural safety and operator-assessed angiographic results from the PRET trial.

24 abril 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. An In Vivo, MRI-Integrated Real-Time Model of Active Contrast Extravasation in Acute Intracerebral Hemorrhage

R.I. Aviv, T. Huynh, Y. Huang, D. Ramsay, P. Van Slyke, D. Dumont, P. Asmah, R. Alkins, R. Liu and K. Hynynen

Background and Purpose: The “spot sign” or contrast extravasation is strongly associated with hematoma formation and growth. An animal model of contrast extravasation is important to test existing and novel therapeutic interventions to inform present and future clinical studies. The purpose of this study was to create an animal model of contrast extravasation in acute intracerebral hemorrhage.

01 septiembre 2014

NEUROSURGERY. Solitaire AB Stent-Assisted Coiling of Wide-Necked Intracranial Aneurysms: Mid-term Results From the SOLARE Study

Gory, Benjamin MD, MSc*; Klisch, Joachim MD, PhD‡; Bonafé, Alain MD, PhD§; Mounayer, Charbel MD, PhD¶; Beaujeux, Remy MD‖; Moret, Jacques MD#; Lubicz, Boris MD, PhD**; Riva, Roberto MD*; Turjman, Francis MD, PhD*

Background: Endovascular treatment of intracranial aneurysms can be technically difficult when the neck is wide. The Solitaire AB stent (Covidien, Irvine, California), the only fully retrieved stent, assists in the coiling of wide-neck intracranial aneurysms.

01 agosto 2014

NEUROSURGERY. Characteristics of Posterior Cerebral Artery Aneurysms: An Angiographic Analysis of 93 Aneurysms in 81 Patients

Goehre, Felix MD*,‡; Jahromi, Behnam Rezai MB‡; Hernesniemi, Juha MD, PhD‡; Elsharkawy, Ahmed MD§; Kivisaari, Riku MD, PhD‡; von und zu Fraunberg, Mikael MD, PhD¶; Jääskeläinen, Juha MD, PhD¶; Lehto, Hanna MD‡; Lehecka, Martin MD, PhD‡

Background: Posterior cerebral artery (PCA) aneurysms are rare lesions. Because of their low incidence, the individual or institutional experience is usually limited.

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