01 julio 2012

RADIOLOGY. Neither Subendplate Cement Deposition nor Cement Leakage into the Disk Space during Vertebroplasty Significantly Affects Patient Outcomes

Ankaj Khosla, BS, Felix E. Diehn, MD, Arash Ehteshami Rad, BS and David F. Kallmes, MD

Purpose: To determine the impact of cement placement immediately adjacent to and through the endplate during percutaneous vertebroplasty on postprocedural pain and subsequent fracture rate.

01 julio 2012

STROKE. Traditional Cardiovascular Risk Factors Explain the Minority of the Variability in Carotid Plaque

Frank Kuo, BS; Hannah Gardener, ScD; Chuanhui Dong, PhD; Digna Cabral, BS, RDMS; David Della-Morte, MD, PhD; Susan H. Blanton, PhD; Mitchell S.V. Elkind, MD, MS; Ralph L. Sacco, MD, MS; Tatjana Rundek, MD, PhD

Background and Purpose—Subclinical atherosclerotic plaque is an important marker of increased vascular risk. Identifying factors underlying the variability in burden of atherosclerotic carotid plaque unexplained by traditional vascular risk factors may help target novel preventive strategies.

01 julio 2012

STROKE. Total and High-Density Lipoprotein Cholesterol and Stroke Risk

Yurong Zhang, MD, PhD*; Jaakko Tuomilehto, MD, PhD; Pekka Jousilahti, MD, PhD; Yujie Wang, MSc; Riitta Antikainen, MD, PhD; Gang Hu, MD, PhD*

Background and Purpose—The association of total and high-density lipoprotein (HDL) cholesterol with stroke risk is unclear, especially regarding hemorrhagic stroke.

01 julio 2012

STROKE. Relationship Between Angiographic Vasospasm and Regional Hypoperfusion in Aneurysmal Subarachnoid Hemorrhage

Rajat Dhar, MD; Michael T. Scalfani, MSCI; Spiros Blackburn, MD; Allyson R. Zazulia, MD; Tom Videen, PhD; Michael Diringer, MD

Background and Purpose—Angiographic vasospasm frequently complicates subarachnoid hemorrhage and has been implicated in the development of delayed cerebral ischemia. Whether large-vessel narrowing adequately accounts for the critical reductions in regional cerebral blood flow underlying ischemia is unclear. We sought to clarify the relationship between angiographic vasospasm and regional hypoperfusion.

01 julio 2012

STROKE. Leukoaraiosis Predicts Parenchymal Hematoma After Mechanical Thrombectomy in Acute Ischemic Stroke

Zhong-Song Shi, MD; Yince Loh, MD; David S. Liebeskind, MD; Jeffrey L. Saver, MD; Nestor R. Gonzalez, MD; Satoshi Tateshima, MD; Reza Jahan, MD; Lei Feng, MD; Paul M. Vespa, MD; Sidney Starkman, MD; Noriko Salamon, MD; J. Pablo Villablance, MD; Latisha K. Ali, MD; Bruce Ovbiagele, MD; Doojin Kim, MD; Fernando Viñuela, MD; Gary R. Duckwiler, MD

Background and Purpose—The purpose of this study was to determine whether leukoaraiosis (LA) predicts hemorrhagic transformation and poor outcome in patients with acute ischemic stroke treated by mechanical thrombectomy.

01 julio 2012

STROKE. Intracranial Carotid Artery Atherosclerosis. Prevalence and Risk Factors in the General Population

Daniel Bos, MD; Maggee J.M. van der Rijk, MSc; Tychon E.A. Geeraedts, MD; Albert Hofman, MD, PhD; Gabriel P. Krestin, MD, PhD; Jacqueline C.M. Witteman, PhD; Aad van der Lugt, MD, PhD; M. Arfan Ikram, MD, PhD; Meike W. Vernooij, MD, PhD

Background and Purpose—Intracranial atherosclerosis is worldwide one of the leading causes of stroke. However, surprisingly little is known about its prevalence and risk factors in a community-dwelling population of white descent. In this study, we determined the prevalence and investigated risk factors of intracranial internal carotid artery calcification (ICAC) as a marker of intracranial atherosclerosis.

01 julio 2012

STROKE. Joint Effect of Modifiable Risk Factors on the Risk of Aneurysmal Subarachnoid Hemorrhage. A Cohort Study

Haakon Lindekleiv, MD, PhD; Marie S. Sandvei, MD, PhD; Pål R. Romundstad, PhD; Tom Wilsgaard, PhD; Inger Njølstad, MD, PhD; Tor Ingebrigtsen, MD, PhD; Anne Vik, MD, PhD*; Ellisiv B. Mathiesen, MD, PhD*

Background and Purpose—The joint effect of risk factors on the risk of aneurysmal SAH (aSAH) has been studied sparsely.

01 julio 2012

STROKE. The Course of Unilateral Intracranial Arteriopathy in Young Adults With Arterial Ischemic Stroke

Marcel M.M. Bulder, MD; Kees P.J. Braun, MD; Jan Willem Leeuwis, MD; Rob T.H. Lo, MD; Onno van Nieuwenhuizen, MD; L. Jaap Kappelle, MD; Catharina J.M. Klijn, MD

Background and Purpose—Unilateral intracranial focal nonprogressive arteriopathy is often found in children with arterial ischemic stroke. We aimed to investigate the course of unilateral intracranial arteriopathy in young adults.

01 junio 2013

JACC. Association of the Recovery of Objective Abnormal Cerebral Perfusion With Neurocognitive Improvement After Carotid Revascularization

Ching-Chang Huang, MD; Ying-Hsien Chen, MD; Mao-Shin Lin, MD; Cheng-Hsin Lin, MD; Hung-Yuan Li, MD, PhD; Ming-Jang Chiu, MD, PhD; Chi-Chao Chao, MD; Yen-Wen Wu, MD, PhD; Ya-Fang Chen, MD; Jen-Kuang Lee, MD; Ming-Jiuh Wang, MD, PhD; Ming-Fong Chen, MD, PhD; Hsien-Li Kao, MD

Objectives: This study sought to report the effect of carotid artery stenting (CS) on neurocognitive function (NCF) in patients with severe carotid artery occlusive disease, depending on baseline brain perfusion status.

01 junio 2013

JACC. Asymptomatic Carotid Stenosis: The Not-So-Silent Disease. Changing Perspectives From Thromboembolism to Cognition

Adnan H. Siddiqui, MD, PhD; L. Nelson Hopkins, MD

More than 100,000 carotid revascularization procedures are performed annually in the United States, primarily for asymptomatic stenosis to improve flow and provide protection from thromboembolic events to the ipsilateral hemisphere. Indications for asymptomatic carotid stenosis revascularization stem from ACAS (Asymptomatic Carotid Atherosclerosis Study) and ACST (Asymptomatic Carotid Surgery Trial) (1,). In ACST, there was a reduction in cerebral ischemic events from 11.8% in patients treated with aspirin alone to 6.4% in those undergoing endarterectomy for ≥60% carotid stenosis over 5 years. Despite the benefit for revascularization of carotid stenosis of at least 60% in ACAS and ACST, most subsequent trials have established a higher standard for asymptomatic disease with inclusion criteria established at 80% carotid stenosis.

20 mayo 2013

JACC. Renal Impairment and Ischemic Stroke Risk Assessment in Patients With Atrial Fibrillation. The Loire Valley Atrial Fibrillation Project

Objectives: This study sought to determine the risk of ischemic stroke (IS)/thromboembolism (TE) associated with renal impairment and its incremental predictive value over established risk stratification scores (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke [CHADS2] and congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke, vascular disease, age 65 to 74 years, sex category (female) [CHA2DS2-VASc]) in patients with atrial fibrillation (AF).

01 junio 2012

CIRCULATION. Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and a History of Stroke or Transient Ischemic Attack

Stefan K. James, MD, PhD; Robert F. Storey, MD, DM; Nardev S. Khurmi, MD; Steen Husted, MD, DSc; Matyas Keltai, MD, PhD; Kenneth W. Mahaffey, MD; Juan Maya, MD, MS; Joao Morais, MD; Renato D. Lopes, MD, PhD; Jose C. Nicolau, MD, PhD; Prem Pais, MD; Dimitar Raev, MD, ScD; Jose L. Lopez-Sendon, MD, PhD; Susanna R. Stevens, MS; Richard C. Becker, MD for the PLATO Study Group

Background—Patients with acute coronary syndromes and history of stroke or transient ischemic attack (TIA) have an increased rate of recurrent cardiac events and intracranial hemorrhages.

01 mayo 2013

NEUROSURGERY. The Durability of Carotid Endarterectomy: Long-term Results for Restenosis and Stroke

Babu, Maya A. MD; Meissner, Irene MD; Meyer, Fredric B. MD

BACKGROUND: Carotid endarterectomy is a low-risk treatment for carotid occlusive disease. Recent clinical trials have suggested that carotid angioplasty may be a viable alternative. One important issue that has not been evaluated is the long-term recurrent stenosis rate after either intervention.

01 mayo 2013

NEUROSURGERY. Mechanisms of Stroke After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial

Derdeyn, Colin P. MD; Fiorella, David MD, PhD; Lynn, Michael J. MS; Rumboldt, Zoran MD; Cloft, Harry J. MD, PhD; Gibson, Daniel MD; Turan, Tanya N. MD; Lane, Bethany F. RN; Janis, L. Scott PhD; Chimowitz, Marc I. MB, ChB; for the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial Investigators

BACKGROUND: Enrollment in the Stenting and Aggressive Medical Management for the Prevention of stroke in Intracranial Stenosis (SAMMPRIS) trial was halted owing to higher-than-expected 30-day stroke rates in the stenting arm. Improvement in periprocedural stroke rates from angioplasty and stenting for intracranial atherosclerotic disease (ICAD) requires an understanding of the mechanisms of these events.

01 mayo 2013

NEUROSURGERY. Endovascular Therapy in Acute Ischemic Stroke

Starke, Robert M.; Komotar, Ricardo J.; Connolly, E. Sander

Large vessel thrombosis accounts for a significant proportion of morbidity and mortality in the setting of acute ischemic stroke.1,2 Despite many trials, only limited therapies have been approved for ischemic stroke including care at a stroke center, use of aspirin to decrease further clot formation, and revascularization within 4.5 with recombinant tissue plasminogen activator (t-PA). Specific endovascular therapies has also been approved, but with significant controversy.3