Computed tomography perfusion in patients of stroke with left ventricular assist device

AbstractLeft ventricular assist devices (LVAD) are widely applied for patients with severe heart failure as a bridge to heart transplantation as well as destination therapy. Patients with implanted LVAD have an increased risk of cerebral thrombosis and computed tomographic perfusion (CTP) has the potential to be performed for early diagnosis and treatment of acute ischemic stroke (AIS), including interventional thrombectomy. Here, we report our series of CTP examination in patients having suspected AIS after LVAD implantation. We retrospectively investigated 33 contrast-enhanced CTPs from January 2017 to December 2018 which were performed in 12 cases of patients because of possible neurological findings leading to suspected AIS during LVAD circulatory support who did not have definite ischemic findings nor intracerebral hemorrhage on non-contrast computed tomography. AIS with perfusion disturbance area was diagnosed in 11 (33.3%) out of a total of 33 CTPs in 4 (33.3%) out of 12 patients. Endovascular thrombectomy  (EVT) was successfully performed in this research study four times for three patients. CTP was able to detect and determine the indication for EVT without serious complications. CTP could potentially be the first-choice assessment for early diagnosis of AIS with recoverable ischemic penumbra in pa tients with LVAD implantation.
Source: Heart and Vessels - Category: Cardiology Source Type: research

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CONCLUSIONS: Recurrent stroke and intracranial hemorrhage were determined to be more prevalent at 5 years after TIA or minor stroke in Japanese patients than in non-Japanese patients. Strategies to mitigate the long-term risks of stroke, aside from adherence to current guidelines, should take Japanese-patient-specific residual risks into account. PMID: 32938836 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
AbstractObjectivesThe OVID study will demonstrate whether prophylactic-dose enoxaparin improves survival and reduces hospitalizations in symptomatic ambulatory patients aged 50 or older diagnosed with COVID-19, a novel viral disease characterized by severe systemic, pulmonary, and vessel inflammation and coagulation activation.Trial designThe OVID study is conducted as a multicentre open-label superiority randomised controlled trial.ParticipantsInclusion Criteria1. Signed patient informed consent after being fully informed about the study ’s background.2. Patients aged 50 years or older with a positive test for SARS-...
Source: Trials - Category: Research Source Type: clinical trials
Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
ConclusionThis MR study supports a causal association between smoking and a broad range of CVDs, in particular, coronary artery disease, heart failure, abdominal aortic aneurysm, ischaemic stroke, transient ischaemic attack, peripheral arterial disease, and arterial hypertension.
Source: European Heart Journal - Category: Cardiology Source Type: research
CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners. PMID: 31932552 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
CONCLUSIONS: Self-reported frequent eczema was associated with increased risk of mortality from CHD, but not other major CVD, in a Japanese general population. Since steroid usage was not considered, future studies should include it as a potential confounding factor. PMID: 30700678 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Authors: Kreuziger LB, Massicotte MP Abstract Mechanical circulatory support (MCS) is the overarching term that encompasses the temporary and durable devices used in patients with severe heart failure. MCS disturbs the hematologic and coagulation system, leading to platelet activation, activation of the contact pathway of coagulation, and acquired von Willebrand syndrome. Ischemic stroke and major hemorrhage occur in up to 30% of patients. Hematologists are an essential part of the MCS team because they understand the delicate balance between bleeding and clotting and alteration of hemostasis with antithrombotic th...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
ConclusionsOver the last two decades Polish urban stroke units may have achieved a significant reduction of the occurrence of some noninfectious complications (i.e. MI, exacerbated CHF and DVT). However, the list of conditions associated with stroke unit mortality includes not only MI and exacerbated CHF but also PE, gastrointestinal bleeding and recurrent stroke.
Source: Polish Journal of Neurology and Neurosurgery - Category: Neurosurgery Source Type: research
Authors: Manaktala R, Kluger J Abstract Patients with atrial fibrillation are at increased risk of having a cardioembolic stroke. The use of oral anticoagulation is now well established to prevent strokes in patients with atrial fibrillation and a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [2 points], diabetes mellitus, prior stroke/transient ischemic attack or thromboembolism [2 points], vascular disease, age 65 to 74 years, and sex category) score of greater than 1, beyond sex. However, the role of antiplatelet therapy, specifically aspirin in low-risk patients or as an alternative to ...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to describe the current knowledge in prevention and treatment of thrombotic (pump thrombosis and ischemic stroke) and bleeding (gastrointestinal and hemorrhagic stroke) complications in patients supported by continuous-flow left ventricular assist devices (CF-LVAD).Recent FindingsLeft ventricular assist devices (LVADs) are now widely used for the management of end-stage heart failure. Unfortunately, in spite of the indisputable positive impact LVADs have on patients, the frequency and severity of complications are limitations of this therapy. Stroke, pump thrombosis, a...
Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
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