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ESTUDIOS


01 agosto 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Carotid Atherosclerotic Plaque Progression and Change in Plaque Composition Over Time: A 5-Year Follow-Up Study Using Serial CT Angiography

M.J. van Gils, D. Vukadinovic, A.C. van Dijk, D.W.J. Dippel, W.J. Niessen and A. van der Lugt

BACKGROUND AND PURPOSE: Serial in vivo imaging of atherosclerosis is important for understanding plaque progression and is potentially useful in predicting cardiovascular events and monitoring treatment efficacy. This prospective study aims to quantify temporal changes in carotid atherosclerotic plaque volume and plaque composition using MDCTA.

01 agosto 2012

NEURORADIOLOGY. Dissecting aneurysms of the vertebral artery—angiographic patterns at the dissecting site on balloon test occlusion

Yutaka Kai, Jun-ichiro Hamada, Motohiro Morioka, Yuki Ohmori, Masaki Watanabe, Teruyuki Hirano, Takayuki Kawano, Shigetoshi Yano, Jun-ichi Kuratsu

Introduction: At present, the risk of future hemorrhage or ischemic insult from vertebral artery (VA) dissection cannot be estimated from available imaging data. We investigated the relationship between symptoms and the angiographic patterns of the dissecting site on balloon test occlusion (BTO) to develop guidelines for clinical decision-making.

01 julio 2013

JOURNAL OF NEUROSURGERY. The Barrow Ruptured Aneurysm Trial: 3-year results

Robert F. Spetzler, M.D., Cameron G. McDougall, M.D., Felipe C. Albuquerque, M.D., Joseph M. Zabramski, M.D., Nancy K. Hills, Ph.D., Shahram Partovi, M.D., Peter Nakaji, M.D. and Robert C. Wallace, M.D.

Object: The authors report the 3-year results of the Barrow Ruptured Aneurysm Trial (BRAT). The objective of this ongoing randomized trial is to compare the safety and efficacy of microsurgical clip occlusion and endovascular coil embolization for the treatment of acutely ruptured cerebral aneurysms and to compare functional outcomes based on clinical and angiographic data. The 1-year results have been previously reported.

01 junio 2012

STROKE. The Cost-Effectiveness of Primary Stroke Centers for Acute Stroke Care

Gregory F. Guzauskas, MSPH; Denise M. Boudreau, PhD; Kathleen F. Villa, MS; Steven R. Levine, MD; David L. Veenstra, PharmD, PhD

Background and Purpose—Primary stroke centers (PSC) have demonstrated improved survival in patients with acute ischemic stroke (AIS). The objective of this study was to evaluate the cost-effectiveness of treating AIS patients in a PSC compared with a nonPSC hospital setting.

01 junio 2012

STROKE. Risk of Intracerebral Hemorrhage in Patients With Cerebral Microbleeds Undergoing Endovascular Intervention

Yannie O.Y. Soo, MD; Deyond Y.W. Siu, MD; Jill Abrigo, MD; Simon Yu, MD; Nick Ng, MSc; Anil T. Ahuja, MD; Lawrence K.S. Wong, MD; Thomas W. Leung, MD

Background and Purpose—Cerebral microbleeds (CMBs) on MRI gradient echo images are hemosiderin deposits, which may predict intracerebral hemorrhage (ICH). The risk of ICH in patients with CMBs could be exacerbated by the use of antithrombotics. The purpose of our study is to prospectively evaluate the risk of ICH in patients with ischemic stroke who receive dual antiplatelet therapy for endovascular intervention.

01 julio 1012

RADIOLOGY. Nontraumatic Subarachnoid Hemorrhage Management: Evaluation with Reduced Iodine Volume at CT Angiography

Domitille Millon, MD, Anne Laure Derelle, MD, Patrick Omoumi, MD, Marie Tisserand, MD, Emmanuelle Schmitt, MD, Sylvain Foscolo, MD, René Anxionnat, MD, PhD and Serge Bracard, MD

Purpose: To evaluate the technical quality and the diagnostic performance of a protocol with use of low volumes of contrast medium (25 mL) at 64-detector spiral computed tomography (CT) in the diagnosis and management of adult, nontraumatic subarachnoid hemorrhage (SAH).

01 julio 2012

RADIOLOGY. Spontaneous Symptomatic Intracranial Vertebrobasilar Dissection: Initial and Follow-up Imaging Findings

Sung Soo Ahn, MD, Byung Moon Kim, MD, PhD, Sang Hyun Suh, MD, PhD, Dong Joon Kim, MD, PhD, Dong Ik Kim, MD, PhD, Yong Sam Shin, MD, PhD, Sam Youl Ha, MD and Young Sub Kwon, MD

Purpose: To evaluate initial radiologic findings of symptomatic intracranial vertebrobasilar dissections (VBDs) as well as the results at follow-up imaging of dissections that are conservatively managed.

01 julio 2013

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Flow diverter as a rescue therapy for a complicated basilar angioplasty

Murat Velioğlu, Ersin Öztürk, Güner Sönmez, Tansel Kendirli, Hakan Mutlu, Çınar Başekim

Intracranial atherosclerotic disease is a major cause of ischemic stroke. Stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis was terminated prematurely due to a high stroke and death rate in patients randomized for intracranial stent placement. However, for some patients, angioplasty and/or stent placement remains the best approach. Flow diverters (FDs) are designed to produce a hemodynamic flow diversion by constituting a laminar flow pattern in the parent artery and are mainly used in non-ruptured complex wide-neck aneurysms as well as in ruptured aneurysms. Herein, we present a case where an FD was used in a complicated angioplasty for basilar artery atherosclerosis. A 72-year-old female patient was admitted to our hospital with left side weakness and vertigo. Her diffusion magnetic resonance imaging and magnetic resonance angiography showed right-sided pontine and left-sided occipital acute infarcts with left-sided pontine and right-sided occipital chronic infarcted areas and preocclusive mid-basilar stenosis. The patient was under supervised medical treatment. Despite chronic brain stem and occipital infarcts her modified Rankin Scale was 2. Diagnostic angiography showed no posterior communicating arteries and no pial-pial collaterals and a critical mid-basilar artery stenosis. We decided to perform intracranial angioplasty to increase the perfusion of posterior circulation and reduce the risk of additional embolic infarcts. Angioplasty was complicated with dissection and vessel perforation. We used an FD for rescue therapy to avoid rebleeding. The patient was discharged with good clinical and angiographic results.

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.

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