The clinical application of purine nucleosides as biomarkers of tissue Ischemia and hypoxia in humans in vivo.
This article reviews purine nucleoside production in ischemia, the development of purine analysis technology and details results of the studies investigating purine nucleosides as a biomarker of ischemia with suggestions for areas of future research. PMID: 31321992 [PubMed - as supplied by publisher]
CONCLUSIONS: Carotid endarterectomy was associated with a lower incidence of mortality compared to carotid artery stenting for patients with contralateral carotid occlusion. Regarding stroke, myocardial infarction, and transient ischemic attack, there was no significant difference between the two groups. More randomized controlled trials and prospective cohorts are necessary to help further clarify the ideal approach for these patients. PMID: 31027468 [PubMed - as supplied by publisher]
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
CONCLUSIONS: In this small case series, hybrid revascularisation of carotid tandem lesions in symptomatic patients seems feasible and safe. Long-term data show a relatively high number of any adverse events. These surgical outcomes need to be offset against the natural course in patients with a symptomatic carotid tandem lesion. PMID: 30987818 [PubMed - as supplied by publisher]
AbstractBackground&PurposeInternational recommendations advocate that carotid endarterectomy (CEA) should be performed within two weeks from the index event in symptomatic carotid artery stenosis (sCAS) patients. However, there are controversial data regarding the safety of CEA performed during the first two days of ictus. The aim of this international, multicenter study was to prospectively evaluate the safety of urgent (0 ‐2 days) in comparison to early (3‐14 days) CEA in patients with sCAS.MethodsConsecutive patients with non ‐disabling (mRS‐scores≤2) acute ischemic strokes (AIS) or Transient Ischemic Att...
The objective was to investigate outcomes of very urgent (
CONCLUSIONS: GAPC associated with sequential carotid cross-clamping appeared to be safe and effective in prevention of major neurological and cardiologic complications during CEA. PMID: 29633744 [PubMed - in process]
Conclusion: A strong association was found to exist between perioperative stroke and in-hospital mortality and morbidity after combined CABG and CEA. CEA procedures are thought to mitigate the high stroke rate of 3-5% post-CABG, but our study found that combined procedures exhibit a similar stroke risk undercutting their effectiveness. Further investigative studies on combined CABG+CEA are needed to assess risk-stratification for better patient selection and examine other preventative strategies to minimize the risk of ischemic strokes.
Authors: Chaturvedi S, Hachinski V Abstract Preview All transient ischemic attacks are not created equal. However, they are a medical emergency, and all patients should be hospitalized for urgent evaluation of their risk for stroke or myocardial infarction. For optimal management, it must be determined whether an ischemic attack affects the anterior or posterior circulation. In this article, the authors review current medical options for stroke prevention and the indications for carotid endarterectomy. PMID: 29219705 [PubMed]
CONCLUSION: This PSM based observation reconfirmed previous trial results in both asymptomatic and symptomatic patients with carotid artery stenosis in routine clinical practice: CEA showed lower 30 day MACE and mid-term restenosis rates than CAS. PMID: 28893482 [PubMed - as supplied by publisher]
Conclusions Although CAS may be more strongly associated with periprocedural stroke/death compared with CEA, it could be a good alternative to CEA in terms of long term durability and outcomes.