Using Imaging to Select for Late Window Endovascular Therapy Using Imaging to Select for Late Window Endovascular Therapy

After acute stroke, MRI and computed tomography perfusion may be useful for selecting appropriate candidates for late window thrombectomy.Stroke
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Neurology & Neurosurgery Journal Article Source Type: news

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CONCLUSION: FDCTA, reconstructed from VP-FDCT data, allows reliable detection of ICA or MCA M1 segment occlusion comparable to CTA and may provide information concerning the clot extent with sufficient image quality. PMID: 30862169 [PubMed - as supplied by publisher]
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research
Conclusions: CTP penumbra did not identify patients who would benefit from endovascular treatment when patients were selected with non-contrast CT ASPECTS ≥7. There is no correlation of CTP penumbra with good outcomes or mortality. Larger prospective trials are warranted to justify the use of CTP within 6 h of symptom onset.Intervent Neurol 2019;8:116 –122
Source: Interventional Neurology - Category: Neurology Source Type: research
To determine the clinical outcome of patients undergoing emergent large vessel thrombectomy within 6 hours and ASPECTS>6 but with large core infarct volumes on pre-procedural CT perfusion imaging (CBF70cc). Mechanical thrombectomy (MT) has been shown to be efficacious for treatment of emergent large vessel occlusion (ELVO) for acute ischemic stroke. The 2018 American Heart Association Guidelines for Management of Acute Ischemic Stroke recommend MT for patients with anterior circulation ELVO with ASPECTS ≥6 and groin puncture within 6 hours of symptom onset.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 17: All in the head (Neurointerventions) Source Type: research
ConclusionsA higher eGFR might have prognostic value for improvement in CVR after EC –IC bypass surgery in patients with CASD and misery perfusion.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
This study investigates in the temperature distribution of the head within selective brain cooling (SBC). Anatomically accurate geometries based on CT images of head and neck regions are used to develop the 3D geometry and physical model for the finite element modeling. Two cooling methods, the direct head surface cooling strategy and the combination cooling strategy of both head and neck, are evaluated to analyze the inducing hypothermia. The results show that for direct head surface cooling, the scalp and skull temperatures decrease significantly as the blood perfusion rate is constrained, but it is hard to affect the br...
Source: Medical and Biological Engineering and Computing - Category: Biomedical Engineering Source Type: research
Cerebrovascular diseases, i.e., acute stroke, are a common cause of serious long-term disability. Cerebral perfusion computed tomography (CPCT) can provide rapid, high-resolution, quantitative hemodynamic maps to assess and stratify perfusion in patients with acute stroke symptoms. However, CPCT imaging typically involves a substantial radiation dose due to its repeated scanning protocol. Therefore, in this paper, we present a low-dose CPCT image reconstruction method to yield high-quality CPCT images and high-precision hemodynamic maps by utilizing the great similarity information among the repeated scanned CPCT images. S...
Source: IEE Transactions on Medical Imaging - Category: Biomedical Engineering Source Type: research
ConclusionsAtherothrombotic lesions found by objectively graded computed tomography were predictors of neurologic deficit. Retrograde perfusion in the presence of a distal atherothrombotic lesion should be avoided whenever possible. Strategies based on the full assessment of the whole aortic morphology appear to be mandatory. Anticoagulation therapy should be performed very carefully to avoid intracranial hemorrhagic changes.Graphical abstract
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
AbstractWe evaluate the utility of providing a pulsatile blood flow by applying off-pump coronary artery bypass grafting (CABG) or intra-aortic balloon pumping (IABP) with conventional CABG to prevent perioperative stroke in patients with cerebral hypoperfusion on single-photon emission-computed tomography (SPECT). A total of 286 patients underwent isolated CABG with a cerebral magnetic resonance angiography (MRA) evaluation between 2006 and 2015. Seventy-five had significant stenosis and/or occlusion of craniocervical vessels; the other 211 had no significant stenosis. Cerebral SPECT was performed for 49 (SPECT group) of ...
Source: Heart and Vessels - Category: Cardiology Source Type: research
This study aimed to evaluate the significance of serum neuron-specific enolase (NSE) level as a predictor of neurologic injury in thoracic aortic surgery. Methods We neurologically assessed 60 consecutive patients who underwent thoracic aortic surgery for thoracic aortic aneurysm (n = 26) and aortic dissection (n = 34). Using moderate hypothermic circulatory arrest with antegrade cerebral perfusion, total arch replacement and hemiarch replacement were performed in 37 and 23 patients, respectively. Serum NSE levels in venous blood samples drawn before surgery and at 1 day after surgery we...
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Original Cardiovascular Source Type: research
Abstract Regional cardiac function analysis is important for the diagnosis and treatment planning of ischemic heart disease, but has not been sufficiently developed in the field of computed tomography (CT). Therefore, we propose a three-dimensional endocardial tracking framework for cardiac CT using local point cloud registration based on the iterative closest point with an integrated scale estimation algorithm. We also introduce regional function descriptors that express the curvature and stretching of the endocardium: Surface distortion (E) and Scaling rate (S). For a region-to-region comparison, we propose endo...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research
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