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ESTUDIOS


09 noviembre 2011

INTERNATIONAL JOURNAL OF STROKE. Thrombolytic therapy for acute ischemic stroke after recent transient ischemic attack

María Alonso de Leciñana, Blanca Fuentes, Jaime Masjuan, Patricia Simal, Fernando Díaz-Otero, Gemma Reig, Exuperio Díez-Tejedor, Antonio Gil-Nuñez, Jose Vivancos, and Jose-Antonio Egido

Safety and efficacy of intravenous thrombolysis in stroke patients with recent transient ischemic attack are hotly debated. Patients suffering transient ischemic attack may present with diffusion-weighted imaging lesions, and although normal computed tomography would not preclude thrombolysis, the concern is that they may be at higher risk for hemorrhage postthrombolysis treatment. Prior ipsilateral transient ischemic attack might provide protection due to ischemic preconditioning. We assessed post-thrombolysis outcomes in stroke patients who had prior transient ischemic attack. © 2011 The Authors. International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, April 2012, 213–218.

21 octubre 2011

INTERNATIONAL JOURNAL OF STROKE. Benefits of intravenous thrombolysis in acute ischemic stroke related to extra cranial internal carotid dissection. Dream or reality?

Blanca Fuentes, Jaime Masjuan, María Alonso de Leciñana, Patricia Simal, José Egido, Fernando Díaz-Otero, Antonio Gil-Nuñez4, Patricia Martínez-Sánchez, Exuperio Díez-Tejedor, and Madrid Stroke Network

Small clinical series have reported the safety of intravenous thrombolysis in ischemic stroke related to extracranial internal carotid dissection. However, no studies specifically analyzing the effects on stroke outcome are available. Aims Our goal was to evaluate whether patients with ischemic stroke related to extracranial internal carotid dissection obtain any benefit from intravenous thrombolysis. Copyright © 2011 The Authors. International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, January 2012, 7–13.

20 octubre 2011

INTERNATIONAL JOURNAL OF STROKE. Preceding intravenous thrombolysis facilitates endovascular mechanical recanalization in large intracranial artery occlusion

Thomas Pfefferkorn, Markus Holtmannspötter, Maximilian Patzig, Hartmut Brückmann, Caroline Ottomeyer, Christian Opherk, Martin Dichgans, and Gunther Fesl

Acute occlusions of the large intracranial arteries are relatively resistant to intravenous thrombolysis. Therefore, multimodal approaches combining intravenous thrombolysis with endovascular mechanical recanalization are increasingly being applied. In this setting, intravenous thrombolysis may facilitate subsequent mechanical thrombectomy. To test this hypothesis, we analyzed the influence of intravenous thrombolysis on net intervention time in subsequent endovascular mechanical recanalization. Methods In this retrospective single-center analysis,wecompared net intervention time with and without preceding intravenous thrombolysis in patients treated by endovascular mechanical recanalization between 01/2003 and 06/2010. The net intervention timewas defined as the interval between the onset of endovascular thrombus manipulation and successful vessel recanalization. Copyright © 2011 The Authors. 14 International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, January 2012, 14–18.

24 noviembre 2011

INTERNATIONAL JOURNAL OF STROKE. Cerebral small vessel disease: a review of clinical, radiological, and histopathological phenotypes

Chris Moran, Thanh G. Phan, and Velandai K. Srikanth

Cerebral small vessel disease is difficult to directly visualize in vivo. Therefore, we rely on radiological phenotypes as surrogate markers of disease. The principal phenotypes of clinical interest are small, deep brain infarcts, cerebral white matter lesions, deep brain haemorrhages, and cerebral microbleeds. The causes or mechanisms underlying these phenotypes are understood in varying degrees of detail. This review aims to summarize recent knowledge regarding these phenotypes and place it in context with classical clinicopathological observations to provide mechanistic, clinical, and therapeutic insights into small vessel disease. Copyright © 2011 The Authors. International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, January 2012, 36–46.

28 abril 2011

STROKE. Frequency of Increased Blood Pressure Levels During Systemic Thrombolysis and Risk of Intracerebral Hemorrhage

Lars Kellert, MD; Andrea Rocco, PhD; Marek Sykora, PhD; Werner Hacke, PhD; Peter A. Ringleb, MD

Background and Purpose—Significantly increased blood pressure (BP) is common in patients receiving intravenous thrombolysis (IVT). We aimed to investigate frequency of pre- and post-treatment elevated BP and its relation to intracerebral hemorrhage (ICH) and symptomatic ICH (sICH), respectively. Stroke. 2011; 42: 1702-1706 Published online before print April 28, 2011. Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 0039-2499. Online ISSN: 1524-4628

12 enero 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Safety of Protected Carotid Artery Stenting in Patients with Severe Carotid Artery Stenosis and Carotid Intraplaque Hemorrhage

W. Yoon, S.K. Kim, M.S. Park, H.J. Chae and H.K. Kang

BACKGROUND AND PURPOSE: Carotid IPH can be detected with MR imaging. The aim of this study was to determine the safety of CAS using an emboli protection device in patients with severe carotid artery stenosis and MR imaging–depicted carotid IPH. Published online before print January 12, 2012, doi: 10.3174/ajnr.A2911. Copyright © 2012 American Society of Neuroradiology

01 septiembre 2011

NEUROSURGERY. Incidence of Seizures or Epilepsy After Clipping or Coiling of Ruptured and Unruptured Cerebral Aneurysms in the Nationwide Inpatient Sample Database: 2002-2007

Hoh, Brian L MD; Nathoo, Sunina BS; Chi, Yueh-Yun PhD; Mocco, J MD, MS; Barker, Fred G II MD

BACKGROUND: It is not clear whether treatment modality (clipping or coiling) affects the risk of seizures after treatment for cerebral aneurysms. OBJECTIVE: To determine whether there is an increased risk of seizures after clipping vs coiling. Neurosurgery: September 2011 - Volume 69 - Issue 3 - pp 644-650 doi: 10.1227/NEU.0b013e31821bc46d. Copyright © by the Congress of Neurological Surgeons

14 julio 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Use of the Outreach Distal Access Catheter for Microcatheter Stabilization during Intracranial Arteriovenous Malformation Embolization

M.J. Binning, P. Yashar, D. Orion, E.F. Hauck, E.I. Levy, L.N. Hopkins and A.H. Siddiqui

SUMMARY: The Outreach DAC is an intermediate-sized catheter designed for use with the Merci clot retriever in acute stroke. We investigated its utility as an adjunctive device during AVM pedicle embolization. In the author s opinion, the DAC provided additional guide-catheter and microcatheter support, improved selective angiographic visualization of AVM angioarchitecture, aided microcatheter removal from its embedded position in the AVM Onyx cast, and enhanced local microcatheter control and safety, compared with embolization with the guide and microcatheter alone. Copyright © 2011 American Society of Neuroradiology

09 febrero 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Proteomic Analysis of Aneurysm Healing Mechanism after Coil Embolization: Comparison of Dense Packing with Loose Packing

R. Kadirvel, Y.H. Ding, D. Dai, D.A. Lewis and D.F. Kallmes

BACKGROUND AND PURPOSE: In clinical practice, durability of occlusion following coil embolization is superior in densely packed, compared with loosely packed, aneurysms. In a rabbit model, we probed, by using proteomics tools, the biologic mechanisms associated with densely packed and completely occluded aneurysms, compared with loosely packed and incompletely occluded aneurysms, to explore the biologic mechanisms of intra-aneurysmal healing following embolization. Published online before print February 9, 2012, doi: 10.3174/ajnr.A2940. Copyright © 2012 American Society of Neuroradiology

31 marzo 2011

CVIR. Flow Changes after Endovascular Treatment of a Wide-Neck Anterior Communicating Artery Aneurysm by using X-configured Kissing Stents (Cross-Kissing Stents) Technique

Kamil Zelenˇa´k • Jana Zelenˇa´kova´ • Ju´ lius DeRiggo • Egon Kurcˇa • Jaroslav Boudny´ • Hubert Polacek

Endovascular treatment for a wide-neck anterior communicating artery (AcomA) aneurysm remains technically challenging. Stent-assisted embolization has been proposed as an alternative of treatment of complex aneurysms. The X-configuration double-stent-assisted technique was used to achieve successful coiling of wideneck AcomA aneurysm. Implanted stent can alter intraarterial flow. Follow-up angiograms 4 months later showed flow changes due to used X-technique of stents implantation and filling of the anterior cerebral artery from the opposite internal carotid artery. Cardiovasc Intervent Radiol (2011) 34:1308–1311. Copyright The Author(s) 2011. This article is published with open access at Springerlink.com

28 abril 2011

STROKE. Transfer Delay Is a Major Factor Limiting the Use of Intra-Arterial Treatment in Acute Ischemic Stroke

Shyam Prabhakaran, MD, MS; Edward Ward, MD, MPH; Sayona John, MD; Demetrius K. Lopes, MD; Michael Chen, MD; Richard E. Temes, MD, MS; Yousef Mohammad, MD, MS; Vivien H. Lee, MD; Thomas P. Bleck, MD

Background and Purpose—The development of comprehensive stroke centers within hub-and-spoke stroke networks offers the opportunity to increase the proportion of acute ischemic stroke patients treated with intra-arterial therapies (IAT). Interhospital transfer delays will be critical in evaluating the success of this strategy. Stroke. 2011; 42: 1626-1630 Published online before print April 28, 2011. Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 0039-2499. Online ISSN: 1524-4628.

07 septiembre 2011

THE NEW ENGLAND JOURNAL OF MEDICINE. Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis

Marc I. Chimowitz, M.B., Ch.B., Michael J. Lynn, M.S., Colin P. Derdeyn, M.D., Tanya N. Turan, M.D., David Fiorella, M.D., Ph.D., Bethany F. Lane, R.N., L. Scott Janis, Ph.D., Helmi L. Lutsep, M.D., Stanley L. Barnwell, M.D., Ph.D., Michael F. Waters, M.D., Ph.D., Brian L. Hoh, M.D., J. Maurice Hourihane, M.D., Elad I. Levy, M.D., Andrei V. Alexandrov, M.D., Mark R. Harrigan, M.D., David Chiu, M.D., Richard P. Klucznik, M.D., Joni M. Clark, M.D., Cameron G. McDougall, M.D., Mark D. Johnson, M.D., G. Lee Pride, Jr., M.D., Michel T. Torbey, M.D., M.P.H., Osama O. Zaidat, M.D., Zoran Rumboldt, M.D., and Harry J. Cloft, M.D., Ph.D., for the SAMMPRIS Trial Investigators*

Atherosclerotic intracranial arterial stenosis is an important cause of stroke that is increasingly being treated with percutaneous transluminal angioplasty and stenting (PTAS) to prevent recurrent stroke. However, PTAS has not been compared with medical management in a randomized trial. This article (10.1056/NEJMoa1105335) was published on September 7, 2011, at NEJM .org. N Engl J Med 2011;365:993-1003. Copyright © 2011 Massachusetts Medical Society.

27 enero 2012

JACC. The PROFI Study (Prevention of Cerebral Embolization by Proximal Balloon Occlusion Compared to Filter Protection During Carotid Artery Stenting)

Klaudija Bijuklic, MD, Andreas Wandler, MD, Fadia Hazizi, MD, Joachim Schofer, MD, PHD Hamburg, Germany

The objective of this study was to compare the cerebral embolic load of filter-protected versus proximal balloon– protected carotid artery stenting (CAS). Journal of the American College of Cardiology Vol. 59, No. x, 2012 © 2012 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc.

21 abril 2011

STROKE. Cost Effectiveness of Warfarin Versus Aspirin in Patients Older Than 75 Years With Atrial Fibrillation

Sue Jowett, PhD; Stirling Bryan, PhD; Jonathan Mant, MD; Kate Fletcher, BA; Andrea Roalfe, MSc; David Fitzmaurice, MD; Gregory Y.H. Lip, MD; F.D. Richard Hobbs, FMedSci

Background and Purpose—Oral anticoagulants are effective at reducing stroke compared with aspirin in atrial fibrillation patients older than 75 years. Although the benefits of reduced stroke risk outweigh the risks of bleeding, the cost effectiveness of warfarin in this patient population has not yet been established. Stroke. 2011; 42: 1717-1721 Published online before print April 21, 2011. Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 0039-2499. Online ISSN: 1524-4628.

16 enero 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Endovascular Treatment of Ruptured Brain AVMs in the Acute Phase of Hemorrhage

W.J. van Rooij, S. Jacobs, M. Sluzewski, G.N. Beute and B. van der Pol

BACKGROUND AND PURPOSE: Patients with ruptured brain AVMs are at considerable risk of repeat hemorrhage, particularly when associated intranidal or flow-related aneurysms are present. There is controversy about the timing of diagnosis and treatment of patients with hemorrhagic stroke. We present our results of endovascular treatment of ruptured AVMs in the acute phase. Published online before print January 26, 2012, doi: 10.3174/ajnr.A2995. Copyright © 2012 American Society of Neuroradiology

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