Outcomes After Acute Ischemic Stroke in the United States: Does Residential ZIP Code Matter? Stroke

Background We sought to analyze the impact of socioeconomic status (SES) on in-hospital outcomes, cost of hospitalization, and resource use after acute ischemic stroke. Methods and Results We used the 2003–2011 Nationwide Inpatient Sample database for this analysis. All admissions with a principal diagnosis of acute ischemic stroke were identified by using International Classification of Diseases, Ninth Revision codes. SES was assessed by using median household income of the residential ZIP code for each patient. Quartile 1 and quartile 4 reflect the lowest-income and highest-income SES quartile, respectively. During a 9-year period, 775 905 discharges with acute ischemic stroke were analyzed. There was a progressive increase in the incidence of reperfusion on the first admission day across the SES quartiles (P-trend
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Stroke Source Type: research

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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...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Ahmed Mohamed Elhfnawy1*, Peter U. Heuschmann2, Mirko Pham3†, Jens Volkmann1† and Felix Fluri1,4 1Department of Neurology, University Hospital Würzburg, Würzburg, Germany 2Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany 3Institute of Diagnostic and Interventional Neuroradiology, University Hospital of Würzburg, Würzburg, Germany 4Department of Neurology, Kantonssptial St. Gallen, St. Gallen, Switzerland Background and Purpose: Internal carotid artery stenosis (ICAS)≥70% is a leading cause of ischemic cerebrovascular event...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
rnesniemi J Abstract OBJECTIVE/BACKGROUND: Sarcopenia is a predictor of mortality in elderly patients. Masseter area (MA) reflects sarcopenia in trauma patients. It was hypothesised that MA and Masseter density (MD) could be evaluated reliably from pre-operative computed tomography angiography (CTA) scans and that they predict post-operative survival in carotid endarterectomy (CEA) patients. METHODS: This was an observational registry study. Patients (n = 242) were operated on for asymptomatic stenosis (n = 32; 13.2%), amaurosis fugax (n = 41; 16.9%), transient ischaemic attack (...
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
We report a case of a 51year male patient who presented with the recurrent transient ischemic attacks and right facio-brachial weakness, the patient was promptly taken for carotid angiography and underwent successful stenting of the left internal carotid artery.Keywords:Carotid angiography,Carotid artery stenosis,Transient ischemic attackView:PDF (257.36 KB)Click here to download the PDF file.‹ Transient Stress Lymphocytosis in Cardiac Emergencies: A Clinicopathological Study of Under-recognized Entity at a Tertiary Care Cardiology Institute in North IndiaA Large Aortic Root Mycotic Aneurysm with Complete Heart Bloc...
Source: Journal of Cardiovascular Disease Research - Category: Cardiology Authors: Source Type: research
CONCLUSIONS: Endarterectomy was of some benefit for participants with 50% to 69% symptomatic stenosis (moderate-quality evidence), and highly beneficial for those with 70% to 99% stenosis without near-occlusion (moderate-quality evidence). We found no benefit in people with carotid near-occlusion (high-quality evidence). PMID: 28590505 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Background and Purpose—Complex vascular anatomy might increase the risk of procedural stroke during carotid artery stenting (CAS). Randomized controlled trial evidence that vascular anatomy should inform the choice between CAS and carotid endarterectomy (CEA) has been lacking.Methods—One-hundred eighty-four patients with symptomatic internal carotid artery stenosis who were randomly assigned to CAS or CEA in the ICSS (International Carotid Stenting Study) underwent magnetic resonance (n=126) or computed tomographic angiography (n=58) at baseline and brain magnetic resonance imaging before and after treatment. W...
Source: Stroke - Category: Neurology Authors: Tags: Magnetic Resonance Imaging (MRI), Revascularization, Stent, Cerebrovascular Disease/Stroke, Stenosis Original Contributions Source Type: research
ConclusionsIn patients undergoing carotid endarterectomy, a significant number of preoperative TILs demonstrated hemodynamic components, which were reversed postoperatively. The presence of such components was distinctively associated with the postoperative incidence of new ischemic lesions.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Magnetic Resonance Imaging (MRI), Cardiovascular Surgery, Cerebrovascular Disease/Stroke Original Research Source Type: research
CONCLUSIONS Plaques with high-intensity signals on TOF MRA were associated with IPH and evidence of intraplaque hypoxia. This fact may represent an opportunity to establish novel therapeutic agents targeting intraplaque hypoxia. PMID: 27367236 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
Conclusion According to our experiences and results, the simultaneous performance of CEA and CABG in patients with severe coexisting carotid artery disease who require coronary revascularization has proved to be a safe and efficacious operative strategy in these high-risk patients.
Source: Cor et Vasa - Category: Cardiology Source Type: research
We present a case in which we performed open surgery and achieved successful retrieval of the thrombus. A 40 year-old male patient presented with ischemic stroke and mild left hemiparesis. Computerized tomography and magnetic resonance imaging showed infarction in the right parieto-occipital area. Carotid Doppler study showed carotid stenosis on the right side. Further investigation with CT angiography of the neck vessels confirmed significant carotid artery occlusion with a free-floating thrombus in the internal carotid artery. Carotid endarterectomy was planned under EEG monitoring. The right carotid artery was exposed w...
Source: Hiroshima Journal of Medical Sciences - Category: Journals (General) Tags: Hiroshima J Med Sci Source Type: research
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