Background and Purpose—The joint effect of risk factors on the risk of aneurysmal SAH (aSAH) has been studied sparsely.
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.
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.
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.
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).
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.
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.
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.
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
Spontaneous or nontraumatic intracerebral hemorrhage (ICH) is an important cause of mortality and morbidity worldwide.1 Management of patients presenting with spontaneous ICH includes medical therapy and, if indicated, surgical intervention.1,2 Acute reduction of elevated blood pressure is an important component of the initial medical management of such patients. This can be justified by the fact that elevated blood pressure in the setting of ICH may lead to hematoma expansion and is therefore associated with poor clinical outcome.3-5 A question that remains unanswered, however, is whether an early and rapid reduction in systolic blood pressure (SBP) could worsen outcome by causing ischemia in perihematoma brain tissue.6,7 To study this important issue, Butcher et al conducted a prospective randomized clinical trial in which 75 patients presenting with spontaneous ICH were randomized into two different target treatment groups.8,9 The study focused on evaluating the perihematoma relative cerebral blood flow (CBF) and the clinical outcome associated with each target treatment. The results were published in the March 2013 issue of Stroke.8
BACKGROUND: Stent-assisted coiling (SAC) and balloon-assisted coiling (BAC) are 2 well-established techniques for the treatment of complex and wide-necked intracranial aneurysms. Most clinicians are reluctant to perform SAC in the setting of subarachnoid hemorrhage because of the need for dual antiplatelet therapy.
BACKGROUND: Treatment of unruptured intracranial aneurysms (UIAs) involves endovascular coiling or aneurysm clipping. While many studies have compared these treatment modalities with respect to various clinical outcomes, few studies have investigated the economic costs associated with each procedure.
Purpose: To report subgroup analyses of an updated systematic review on endovascular treatment of intracranial unruptured aneurysms (UAs); to compare types of embolic agents, adjunct techniques, and newer devices; and to identify potential risk factors for poor outcomes.
BACKGROUND AND PURPOSE: The carotid bulb is innervated by the sinus nerve of Hering, a branch of the glossopharyngeal nerve, derived from the third pharyngeal arch. The aim of this study was to determine the frequency, predictors, and outcome of the carotid BR after carotid stent placement according to the location of the plaque lesion.
BACKGROUND AND PURPOSE: Recanalization is the important outcome measure for acute stroke therapy. Several methods of recanalization assessment are used in clinical practice, but few studies have addressed their reliability. We, therefore, sought to assess interobserver reliability of the diagnosis of intracranial artery recanalization following intervention by using TIMI criteria.
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