01 octubre 2012

THE LANCET. Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a secondary analysis of a randomised controlled trial

Dr Renato D Lopes MD, Sana M Al-Khatib MD a, Prof Lars Wallentin MD b, Hongqiu Yang PhD a, Prof Jack Ansell MD c, M Cecilia Bahit MD d, Prof Raffaele De Caterina MD e, Prof Paul Dorian MD f, Prof J Donald Easton MD g, Prof Cetin Erol MD h, Justin A Ezekowitz MBBCh i, Prof Bernard J Gersh MB ChB j, Prof Christopher B Granger MD a, Prof Stefan H Hohnloser MD k, Prof John Horowitz MD l, Elaine M Hylek MD m, Prof John JV McMurray MD n, Puneet Mohan MD o, Prof Dragos Vinereanu MD p, John H Alexander MD a

Background: he Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial showed that apixaban is better than warfarin at prevention of stroke or systemic embolism, causes less bleeding, and results in lower mortality. We assessed in this trial s participants how results differed according to patients CHADS2, CHA2DS2VASc, and HAS-BLED scores, used to predict the risk of stroke and bleeding.

01 noviembre 2013

STROKE. Natural History of Small Unruptured Anterior Circulation Aneurysms

Erdem Güresir, MD, PhD; Hartmut Vatter, MD, PhD; Patrick Schuss, MD; Johannes Platz, MD; Jürgen Konczalla, MD; Richard Du Mesnil de Rochement, MD, PhD; Joachim Berkefeld, MD, PhD; Volker Seifert, MD, PhD

Background and Purpose—The natural history of small unruptured intracranial aneurysms of the anterior circulation in the European population is unclear. Therefore, the management of unruptured intracranial aneurysms <7 mm in the anterior circulation is controversial.

01 noviembre 2012

NEUROSURGERY. Cost Comparison of Endovascular Treatment of Anterior Circulation Aneurysms With the Pipeline Embolization Device and Stent-Assisted Coiling

Colby, Geoffrey P. MD, PhD*; Lin, Li-Mei MD*; Paul, Alexandra R. MD‡; Huang, Judy MD*; Tamargo, Rafael J. MD*; Coon, Alexander L. MD*

BACKGROUND: The Pipeline embolization device (PED) is a new endovascular option for wide-necked or fusiform anterior circulation aneurysms that were classically treated by coil embolization with adjunctive use of a stent. However, stent-coiling incurs significant equipment and implant costs.

01 noviembre 2013

THE LANCET. Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990—2010: findings from the Global Burden of Disease Study 2010

Rita V Krishnamurthi PhD a, Prof Valery L Feigin MD, Prof Mohammad H Forouzanfar MD b, George A Mensah MD c, Myles Connor MBBCh d e f g, Derrick A Bennett PhD h, Prof Andrew E Moran MD i, Prof Ralph L Sacco MD j, Laurie M Anderson PhD k, Thomas Truelsen MD l, Prof Martin O Donnell PhD n, Narayanaswamy Venketasubramanian MBBS o, Prof Suzanne Barker-Collo PhD p, Carlene M M Lawes MBChB q, Wenzhi Wang PhD r, Yukito Shinohara MD s, Emma Witt MSc a, Prof Majid Ezzati PhD m, Prof Mohsen Naghavi MD b, Prof Christopher Murray MD b, on behalf of the Global Burden of Diseases, Injuries, Risk Factors Study 2010 (GBD 2010) and the GBD Stroke Experts Group

Background: The burden of ischaemic and haemorrhagic stroke varies between regions and over time. With differences in prognosis, prevalence of risk factors, and treatment strategies, knowledge of stroke pathological type is important for targeted region-specific health-care planning for stroke and could inform priorities for type-specific prevention strategies. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990—2010.

01 noviembre 2013

NEUROSURGERY. Magnetic Resonance Imaging Assessment of Cerebral Arteriovenous Malformation Obliteration After Stereotactic Radiosurgery

O Connor, Timothy E. BS; Friedman, William A. MD

BACKGROUND: Stereotactic radiosurgery is ideal for treating small cerebral arteriovenous malformations (AVMs) that are surgically inaccessible. However, given the inherent delay of AVM obliteration and the potential for radiosurgical failure, detailed evaluation of the neurovascular architecture is necessary to monitor persistence of residual flow. Modern imaging systems such as magnetic resonance imaging (MRI) and angiography allow clinicians to assess transnidus flow after radiosurgical intervention.

01 noviembre 2013

STROKE. Carotid Plaque MRI and Stroke Risk. A Systematic Review and Meta-analysis

Ajay Gupta, MD; Hediyeh Baradaran, MD; Andrew D. Schweitzer, MD; Hooman Kamel, MD; Ankur Pandya, PhD; Diana Delgado, MLS; Allison Dunning, MS; Alvin I. Mushlin, MD, ScM; Pina C. Sanelli, MD, MPH

Background and Purpose—MRI characterization of carotid plaque has been studied recently as a potential tool to predict stroke caused by carotid atherosclerosis. We performed a systematic review and meta-analysis to summarize the association of MRI-determined intraplaque hemorrhage, lipid-rich necrotic core, and thinning/rupture of the fibrous cap with subsequent ischemic events.

01 noviembre 2013

EUROPEAN JOURNAL OF RADIOLOGY. Epidemiology and genetics of intracranial aneurysms

F. Caranci , F. Briganti , L. Cirillo , M. Leonardi , M. Muto

Abstract: Intracranial aneurysms are acquired lesions (5–10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences.

01 octubre 2013

THE LANCET. Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial

Prof Colin P Derdeyn MD, Prof Marc I Chimowitz MBChB b *, Michael J Lynn MS c, Prof David Fiorella MD d, Tanya N Turan MD b, L Scott Janis PhD e, Jean Montgomery RN c, Azhar Nizam MS c, Bethany F Lane RN c, Prof Helmi L Lutsep MD f, Stanley L Barnwell MD g, Michael F Waters MD h, Brian L Hoh MD i, J Maurice Hourihane MD k, Prof Elad I Levy MD j, Prof Andrei V Alexandrov MD l, Mark R Harrigan MD m, Prof David Chiu MD n, Richard P Klucznik MD o, Joni M Clark MD p, Prof Cameron G McDougall MD q, Mark D Johnson MD r, G Lee Pride MD s, John R Lynch MD t, Prof Osama O Zaidat MD u, Prof Zoran Rumboldt MD v, Prof Harry J Cloft MD w, for the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial Investigators

Background: Early results of the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis trial showed that, by 30 days, 33 (14·7%) of 224 patients in the stenting group and 13 (5·8%) of 227 patients in the medical group had died or had a stroke (percentages are product limit estimates), but provided insufficient data to establish whether stenting offered any longer-term benefit. Here we report the long-term outcome of patients in this trial.

01 noviembre 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Differences in Plaque Morphology and Correlation of Stenosis at the Carotid Artery Bifurcation and the Carotid Siphon

Luca Saba, Eytan Raz, Michele Anzidei, Marco Francone and Mario Piga

OBJECTIVE. The purpose of this study was to compare the type of plaque and the degree of stenosis in the carotid artery bifurcation and the carotid siphon to explore potential correlations between these parameters.

01 noviembre 2013

EUROPEAN JOURNAL OF RADIOLOGY. Angioarchitectural characteristics associated with initial hemorrhagic presentation in supratentorial brain arteriovenous malformations

Jianwei Pan , Lei Feng , Fernando Vinuela , Hongwei He , Zhongxue Wus , Renya Zhan

Objective: The difference in arterial supply, venous drainage, functional localization in supratentorial and infratentorial compartments may contribute to the conflicting results about risk factors for hemorrhage in published case series of brain arteriovenous malformation (bAVM). Further investigation focused on an individual brain compartment is thus necessary. This retrospective study aims to identify angioarchitectural characteristics associated with the initial hemorrhagic event of supratentorial bAVMs.

01 noviembre 2012

JAMA. Structural Brain Changes in Migraine

Inge H. Palm-Meinders, MD; Hille Koppen, MD; Gisela M. Terwindt, MD, PhD; Lenore J. Launer, PhD; Junya Konishi, MD; Juliette M. E. Moonen, BSc; Jacobus T. N. Bakkers, MD; Paul A. M. Hofman, MD, PhD; Baldur van Lew, MSc; Huub A. M. Middelkoop, PhD; Mark A. van Buchem, MD, PhD; Michel D. Ferrari, MD, PhD; Mark C. Kruit, MD, PhD

Context: A previous cross-sectional study showed an association of migraine with a higher prevalence of magnetic resonance imaging (MRI)–measured ischemic lesions in the brain.

01 octubre 2013

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Comparison of Intravascular Ultrasound with Conventional Venography for Detection of Extracranial Venous Abnormalities Indicative of Chronic Cerebrospinal Venous Insufficiency

Yuval Karmon, MD , Robert Zivadinov, MD, PhDemail address , Bianca Weinstock-Guttman, MD , Karen Marr, RVT, RDMS , Vesela Valnarov, MD, RVT, ARDMS, RPVI , Kresimir Dolic, MD , Cheryl L. Kennedy, LMSW, MPH , David Hojnacki, MD , Ellen M. Carl, MA , Jesper Hagemeier, MS , L. Nelson Hopkins, MD , Elad I. Levy, MD , Adnan H. Siddiqui, MD, PhD

Purpose: To investigate prevalence of extracranial abnormalities in azygos and internal jugular (IJ) veins using conventional venography and intravascular ultrasound (IVUS) in patients with multiple sclerosis (MS) being evaluated for chronic cerebrospinal venous insufficiency, a condition of vascular hemodynamic dysfunction.

01 octubre 2013

RADIOLOGY. Investigational Vertebroplasty Safety and Efficacy Trial (INVEST): Patient-reported Outcomes through 1 Year

Bryan A. Comstock, MS, Colleen M. Sitlani, PhD, Jeffrey G. Jarvik, MD, MPH, Patrick J. Heagerty, PhD, Judith A. Turner, PhD and David F. Kallmes, MD

Purpose: To evaluate 1-year outcomes of the Investigational Vertebroplasty Safety and Efficacy Trial (INVEST), a blinded, randomized, controlled trial to investigate the effectiveness of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures.

01 octubre 2013

RADIOLOGY. Natural History of Asymptomatic Unruptured Cerebral Aneurysms Evaluated at CT Angiography: Growth and Rupture Incidence and Correlation with Epidemiologic Risk Factors

J. Pablo Villablanca, MD, Gary R. Duckwiler, MD, Reza Jahan, MD, Satoshi Tateshima, MD, PhD, Neil A. Martin, MD, John Frazee, MD, Nestor R. Gonzalez, MD, James Sayre, PhD and Fernando V. Vinuela, MD

Purpose: To characterize the relationship between aneurysm size and epidemiologic risk factors with growth and rupture by using computed tomographic (CT) angiography.

01 octubre 2013

RADIOLOGY. Reperfusion Is a Stronger Predictor of Good Clinical Outcome than Recanalization in Ischemic Stroke

Armin Eilaghi, PhD, John Brooks, MD, Christopher d’Esterre, MSc, Liying Zhang, PhD, MD, Richard H. Swartz, MD, PhD, Ting-Yim Lee, PhD and Richard I. Aviv, MBChB

Purpose: To assess the predictive value of reperfusion indices, recanalization, and important baseline clinical and radiologic scores for good clinical outcome prediction.