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ABSTRACT


22 enero 2015

STROKE. Clinical Sciences. Genetic Overlap Between Diagnostic Subtypes of Ischemic Stroke

Elizabeth G. Holliday, PhD; Matthew Traylor, PhD; Rainer Malik, PhD; Steve Bevan, PhD; Guido Falcone, MD; Jemma C. Hopewell, PhD; Yu-Ching Cheng, PhD; Ioana Cotlarciuc, PhD; Joshua C. Bis, PhD; Eric Boerwinkle, PhD; Giorgio B. Boncoraglio, MD; Robert Clarke, MD; John W. Cole, MD; Myriam Fornage, PhD; Karen L. Furie, MD; M. Arfan Ikram, MD, PhD; Jim Jannes, MBBS; Steven J. Kittner, MD; Lisa F. Lincz, PhD; Jane M. Maguire, PhD; James F. Meschia, MD; Thomas H. Mosley, PhD; Mike A. Nalls, PhD; Christopher Oldmeadow, PhD; Eugenio A. Parati, MD; Bruce M. Psaty, MD, PhD; Peter M. Rothwell, FRCP; Sudha Seshadri, MD; Rodney J. Scott, PhD; Pankaj Sharma, FRCP; Cathie Sudlow, FRCPE; Kerri L. Wiggins, MS; Bradford B. Worrall, MD, MSc; Jonathan Rosand, MD; Braxton D. Mitchell, PhD; Martin Dichgans, MD; Hugh S. Markus, DM; Christopher Levi, MBBS; John Attia, MD, PhD*; Naomi R. Wray, PhD*; on behalf of the Australian Stroke Genetics Collaborative, the Wellcome Trust Case Control Consortium 2, and the International Stroke Genetics Consortium

Background and Purpose: Despite moderate heritability, the phenotypic heterogeneity of ischemic stroke has hampered gene discovery, motivating analyses of diagnostic subtypes with reduced sample sizes. We assessed evidence for a shared genetic basis among the 3 major subtypes: large artery atherosclerosis (LAA), cardioembolism, and small vessel disease (SVD), to inform potential cross-subtype analyses.

05 febrero 2015

STROKE. Clinical Sciences. Relevance of Blood–Brain Barrier Disruption After Endovascular Treatment of Ischemic Stroke. Dual-Energy Computed Tomographic Study

Arturo Renú, MD; Sergio Amaro, MD; Carlos Laredo, MSc; Luis San Román, MD; Laura Llull, MD; Antonio Lopez, MD; Xabier Urra, MD; Jordi Blasco, MD; Laura Oleaga, MD; Ángel Chamorro, MD

Background and Purpose: Computed tomographic (CT) high attenuation (HA) areas after endovascular therapy for acute ischemic stroke are a common finding indicative of blood–brain barrier disruption. Dual-energy CT allows an accurate differentiation between HA areas related to contrast staining (CS) or to brain hemorrhage (BH). We sought to evaluate the prognostic significance of the presence of CS and BH after endovascular therapy.

03 febrero 2015

STROKE. Clinical Sciences. Distance to Thrombus in Acute Middle Cerebral Artery Occlusion

Benjamin Friedrich, MD*; Matthias Gawlitza, MD; Stefan Schob, MD; Carsten Hobohm, MD; Mariana Raviolo, MD; Karl-Titus Hoffmann, MD; Donald Lobsien, MD*

Background and Purpose: In patients with acute middle cerebral artery (MCA) stroke, therapeutic decisions are influenced by the location of the occlusion. This study aimed to analyze clinical outcomes in patients with acute ischemic MCA stroke treated with systemic intravenous thrombolysis (IVT) using recombinant tissue plasminogen activator, according to the location of the occlusion.

27 enero 2015

STROKE. Clinical Sciences. Isolated MCA Disease in Patients Without Significant Atherosclerotic Risk Factors

Sung-Ho Ahn, MD; Jookyung Lee, MD; Yeon-Jung Kim, MD; Sun U. Kwon, MD, PhD; Deokhee Lee, MD, PhD; Seung-Chai Jung, MD, PhD; Dong-Wha Kang, MD, PhD; Jong S. Kim, MD, PhD

Background and Purpose: Diagnosis of intracranial artery atherosclerosis remains often uncertain. The high-resolution magnetic resonance imaging (HR-MRI) enables vessel wall assessment for more precise diagnoses. The aim of the present study was to investigate the etiologies of middle cerebral artery steno-occlusive disease in young adult patients with few atherosclerotic risk factors using HR-MRI.

22 enero 2015

STROKE. Clinical Sciences. Effect of Patching on Reducing Restenosis in the Carotid Revascularization Endarterectomy Versus Stenting Trial

Mahmoud Malas, MD, MHS; Natalia O. Glebova, MD, PhD; Susan E. Hughes, BSN; Jenifer H. Voeks, PhD; Umair Qazi, MD, MPH; Wesley S. Moore, MD; Brajesh K. Lal, MD; George Howard, DrPH; Rafael Llinas, MD; Thomas G. Brott, MD

Background and Purpose: The purpose is to determine whether patching during carotid endarterectomy (CEA) affects the perioperative and long-term risks of restenosis, stroke, death, and myocardial infarction as compared with primary closure.

05 febrero 2015

STROKE. Topical Reviews. Techniques for Endovascular Treatment of Acute Ischemic Stroke

Laurent Pierot, MD, PhD; Sébastien Soize, MD; Azzedine Benaissa, MD; Ajay K. Wakhloo, MD, PhD

Early recanalization of occluded vessels in acute ischemic stroke (AIS) either by intravenous thrombolysis or endovascular revascularization has been shown to be associated with improved clinical outcome and reduced mortality.1 Initial works on endovascular treatment (EVT) of AIS was published in the 1980s.2,3 Since then, the endovascular techniques for AIS treatment have tremendously improved, advancing from intra-arterial administration of thrombolytic drugs to first-generation mechanical thrombectomy devices (Merci clot retriever and Penumbra clot aspiration) and more recently to second-generation mechanical thrombectomy devices (stent-retrievers; Figure 1). Introduction of various tools and techniques in EVT for AIS will, for obvious reasons, affect the efficacy and safety.

01 marzo 2015

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Occlusion of Small Arteries in the Neuroendovascular and Head and Neck Territory—Initial Experiences with a Microvascular Plug

Justus F. Kleine, Dr Med , Sascha Prothmann, Dr Med , Tobias Boeckh-Behrens, Dr Med

The microvascular plug (MVP, UNO; Reverse Medical Corp, Irvine, California) is designed for occlusion of small vessels that are accessible only by microcatheters. This report describes eight neuroendovascular cases, including aneurysms and acute or imminent hemorrhage, treated with 10 microvascular plug devices. Instantaneous flow arrest was observed in all but two cases, in which the device was undersized, requiring supplementary coiling or microvascular plug replacement, respectively. Persistent occlusion was confirmed on follow-up examinations. There was one adverse event, which involved inadvertent device detachment after repeated resheathing. The microvascular plug appears to be suitable for the designated purpose. Further studies need to evaluate safety and confirm long-term durability of the results.

01 febrero 2015

RADIOLOGY. Carotid Artery Stenosis: Cost-effectiveness of Assessment of Cerebrovascular Reserve to Guide Treatment of Asymptomatic Patients

Ankur Pandya, PhD, Ajay Gupta, MD, Hooman Kamel, MD, Babak B. Navi, MD, Pina C. Sanelli, MD, MPH, Bruce R. Schackman, PhD

To project and compare the lifetime health benefits, health care costs, and incremental cost-effectiveness of a decision rule based on assessment of cerebrovascular reserve (CVR) compared with medical therapy and immediate revascularization in asymptomatic patients with carotid artery stenosis for prevention of stroke.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Predictors of Carotid Occlusion Intolerance During Proximal Protected Carotid Artery Stenting

Giuseppe Giugliano, MD∗; Eugenio Stabile, MD, PhD†; Giancarlo Biamino, MD∗; Giampaolo Petroni, MD∗; Anna Sannino, MD†; Linda Brevetti, MD†; Armando Pucciarelli, MD∗; Grigore Popusoi, MD∗; Tullio Tesorio, MD∗; Angelo Cioppa, MD∗; Linda Cota, MD∗; Luigi Salemme, MD∗; Antonio Sorropago, BS†; Angelo Ausania, MD∗; Giovanni Della Pietra, MD∗; Arturo Fontanelli, MD∗; Bruno Trimarco, MD†; Giovanni Esposito, MD, PhD†; Paolo Rubino, MD∗

Objectives: The aim of this study was to identify predictors of occlusion intolerance (OI) developing during proximal protected carotid artery stenting (CAS).

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Experience and Outcomes With Carotid Artery Stenting. An Analysis of the CHOICE Study (Carotid Stenting for High Surgical-Risk Patients; Evaluating Outcomes Through the Collection of Clinical Evidence)

Mehdi H. Shishehbor, DO, MPH, PhD∗; Sridhar Venkatachalam, MD∗; William A. Gray, MD†; Christopher Metzger, MD‡; Brajesh K. Lal, MD§; Lei Peng, MSc‖; Hend L. Omran, BA‖; Eugene H. Blackstone, MD∗

Objectives: This study sought to examine operator experience measured by time-related variables on outcomes with protected carotid artery stenting (CAS).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Cerebral Embolic Lesions Detected With Diffusion-Weighted Magnetic Resonance Imaging Following Carotid Artery Stenting. A Meta-Analysis of 8 Studies Comparing Filter Cerebral Protection and Proximal Balloon Occlusion

Eugenio Stabile, MD, PhD; Anna Sannino, MD; Gabriele Giacomo Schiattarella, MD; Giuseppe Gargiulo, MD; Evelina Toscano, MD; Linda Brevetti, MD; Fernando Scudiero, MD; Giuseppe Giugliano, MD; Cinzia Perrino, MD, PhD; Bruno Trimarco, MD; Giovanni Esposito, MD, PhD

Objectives: The aim of this meta-analysis was to evaluate and compare the efficacy of the 2 different neuroprotection systems in preventing embolization during carotid artery stenting (CAS), as detected by diffusion-weighted magnetic resonance imaging (DW-MRI).

09 septiembre 2014

SPRINGER. Presence of anterior temporal artery associates with good outcome in acute atherosclerotic M1-middle cerebral artery occlusion

Dezhi Liu, Yongkun Li, Zhaorong Shi, Stephen M. Davis, Ka Sing Wong, Thomas W. Leung, Bernard Yan, Yunyun Xiong, Wen Sun, Gelin Xu

Introduction: We aim to investigate the correlation between presence of anterior temporal artery (ATA), the first major branch of middle cerebral artery (MCA), on conventional angiography and clinical outcome in patients with acute atherosclerotic M1-MCA occlusion.

04 septiembre 2014

SPRINGER. Thromboembolic events associated with single balloon-, double balloon-, and stent-assisted coil embolization of asymptomatic unruptured cerebral aneurysms: evaluation with diffusion-weighted MR imaging

Tomoji Takigawa, Kensuke Suzuki, Yoshiki Sugiura, Ryotaro Suzuki, Issei Takano, Nobuyuki Shimizu, Yoshihiro Tanaka, Akio Hyodo

Introduction: The introduction of the balloon remodeling and stent-assisted technique has revolutionized the approach to coil embolization for wide-neck aneurysms. The purpose of this study was to determine the frequency of thromboembolic events associated with single balloon-assisted, double balloon-assisted, and stent-assisted coil embolization for asymptomatic unruptured aneurysms.

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