Collateral Blood Flow and Ischemic Core Growth
AbstractTreatment of a large vessel occlusion in the acute ischemic stroke setting focuses on vessel recanalization, and endovascular thrombectomy results in favorable outcomes in appropriate candidates. Expeditious treatment is imperative, but patients often present to institutions that do not have neurointerventional surgeons and need to be transferred to a comprehensive stroke center. These treatment delays are common, and it is important to identify factors that mitigate the progression of the ischemic core in order to maximize the preservation of salvageable brain tissue. Collateral blood flow is the strongest factor ...
Source: Translational Stroke Research - June 14, 2022 Category: Neurology Source Type: research
Genome-Wide Association Study of Intracranial Artery Stenosis Followed by Phenome-Wide Association Study
AbstractThe genetic background of intracranial artery stenosis (ICAS), a major cause of ischemic stroke, remains elusive. We performed the world ’s first genome-wide association study (GWAS) of ICAS using DNA samples from Japanese subjects, to identify the genetic factors associated with ICAS and their correlation with clinical features. We also conducted a phenome-wide association study (PheWAS) of the top variant identified via GWAS to d etermine its association with systemic disease. The GWAS involved 408 patients with ICAS and 349 healthy controls and utilized an Asian Screening Array of venous blood samples. The Phe...
Source: Translational Stroke Research - June 14, 2022 Category: Neurology Source Type: research
LncRNAs: Promising Therapeutic Targets and Biomarkers for Ischemic Stroke
AbstractIschemic stroke is one of the leading causes of mortality and disability worldwide. Currently, options for ischemic stroke clinical therapy remain limited to intravenous thrombolysis and thrombectomy, which can only be applied to a minority of patients due to narrow therapeutic time window. Therefore, the discovery of new therapeutic targets and biomarkers is of great significance for ischemic stroke therapy. Long non-coding RNAs (lncRNAs) are the most extensive ncRNA transcripts and play critical roles in different kinds of diseases. Accumulative evidence suggests that lncRNAs are widely involved in multiple patho...
Source: Translational Stroke Research - June 13, 2022 Category: Neurology Source Type: research
Increased Blood Residence Time as Markers of High-Risk Patent Foramen Ovale
AbstractPrevious investigations have suggested that patients with patent foramen ovale (PFO) often have an atrial dysfunction, like to that observed in patients with atrial fibrillation (AF) which may concur to an increased risk of cryptogenic stroke. The aim of the study is to compare the atrial resident time (Rt) of PFO patients to those with sinus rhythm (SR) and AF using patient-specific 3D computational fluid dynamics (CFD) analysis. Models of left atrium (LA) hemodynamics were obtained from time-resolved CT scans and transthoracic echocardiography (TTE). Enrolled patients were divided into three groups: 30 healthy su...
Source: Translational Stroke Research - June 11, 2022 Category: Neurology Source Type: research
Neutrophil Extracellular Traps (NETs): A New Therapeutic Target for Neuroinflammation and Microthrombosis After Subarachnoid Hemorrhage?
AbstractNeutrophil extracellular traps (NETs) play a major role in intrinsic immunity by limiting and killing pathogens. Recently, a series of studies have confirmed that NETs are closely associated with vascular injury and microthrombosis. Furthermore, NETs play an important role in neuroinflammation after ischemic and hemorrhagic stroke. Neuroinflammation and microthrombosis after subarachnoid hemorrhage are key pathophysiological processes associated with poor prognosis, but their crucial formation mechanisms and interventions remain to be elucidated. Could NETs, as an emerging and important pathogenesis, be a new thera...
Source: Translational Stroke Research - June 11, 2022 Category: Neurology Source Type: research
Collateral Status and Outcomes after Thrombectomy
AbstractEndovascular treatment (EVT) using novel mechanical thrombectomy devices has been the gold standard for patients with acute ischemic stroke caused by large vessel occlusion. Selection criteria of randomized control trials commonly include baseline infarct volume with or without penumbra evaluation. Although the collateral status has been studied and is known to modify imaging results and clinical course, it has not been commonly used for trials. Many post hoc studies, however, revealed that collateral status can help predict infarct growth, recanalization success, decreased hemorrhagic transformation after EVT, and...
Source: Translational Stroke Research - June 10, 2022 Category: Neurology Source Type: research
Correction to: Inflammasome ‑Regulated Pyroptotic Cell Death in Disruption of the Gut‑Brain Axis After Stroke
(Source: Translational Stroke Research)
Source: Translational Stroke Research - June 9, 2022 Category: Neurology Source Type: research
Increased Number of Passes and Double Stent Retriever Technique Induces Cumulative Injury on Arterial Wall After Mechanical Thrombectomy in a Swine Model
AbstractThe number of stentriever passes during endovascular thrombectomy impacts clinical outcomes in acute ischemic stroke. Previous studies suggest that the simultaneous double stent retriever technique (DSRT) could improve the efficacy and reduce the number of passes. We aim to analyze the degree of vessel wall injury according to the number of passes and technique (single vs. simultaneous devices). Histological changes were evaluated in renal arteries (RAs) of swine models after thrombectomy (1, 2, or 3 passes) with single stent (SSRT) and DSRT. Thrombectomy passes were performed in 12 RA: 3 samples from each artery w...
Source: Translational Stroke Research - June 8, 2022 Category: Neurology Source Type: research
Collateral Flow in Intracranial Atherosclerotic Disease
AbstractIntracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke and transient ischemic attack (TIA) worldwide. The culprit of ICAD is frequently a high-grade intracranial atherosclerotic stenosis (ICAS) pertaining to the infarct territory, and by then, the ICAS is described as symptomatic. A high-grade ICAS may progressively limit cerebral perfusion downstream, demanding collateral compensation. Collateral circulation refers to the pre-existing and dynamic emergence of vascular channels that maintain and compensate for a failing principal vascular route. Collaterals through the Circle of Willis and ...
Source: Translational Stroke Research - June 8, 2022 Category: Neurology Source Type: research
Machine Learning –Based Identification of Target Groups for Thrombectomy in Acute Stroke
AbstractWhether endovascular thrombectomy (EVT) improves functional outcome in patients with large-vessel occlusion (LVO) stroke that do not comply with inclusion criteria of randomized controlled trials (RCTs) but that are considered for EVT in clinical practice is uncertain. We aimed to systematically identify patients with LVO stroke underrepresented in RCTs who might benefit from EVT. Following the premises that (i) patients without reperfusion after EVT represent a non-treated control group and (ii) the level of reperfusion affects outcome in patients with benefit from EVT but not in patients without treatment benefit...
Source: Translational Stroke Research - June 7, 2022 Category: Neurology Source Type: research
Vagus Nerve Stimulation for Stroke Motor Recovery —What Is Next?
(Source: Translational Stroke Research)
Source: Translational Stroke Research - June 2, 2022 Category: Neurology Source Type: research
Transcriptomic Profiling Reveals Discrete Poststroke Dementia Neuronal and Gliovascular Signatures
AbstractPoststroke dementia (PSD) is associated with pathology in frontal brain regions, in particular dorsolateral prefrontal cortex (DLPFC) neurons and white matter, remote from the infarct. We hypothesised that PSD results from progressive DLPFC neuronal damage, associated with frontal white matter gliovascular unit (GVU) alterations. We investigated the transcriptomic profile of the neurons and white matter GVU cells previously implicated in pathology. Laser-capture microdissected neurons, astrocytes and endothelial cells were obtained from the Cognitive Function After Stroke cohort of control, PSD and poststroke non-d...
Source: Translational Stroke Research - May 31, 2022 Category: Neurology Source Type: research
Cerebral Fractional Flow Reserve for Functional Evaluation of Intracranial Atherosclerotic Stenosis
(Source: Translational Stroke Research)
Source: Translational Stroke Research - May 30, 2022 Category: Neurology Source Type: research
Transplantation of Exercise-Induced Extracellular Vesicles as a Promising Therapeutic Approach in Ischemic Stroke
AbstractClinical evidence affirms physical exercise is effective in preventive and rehabilitation approaches for ischemic stroke. This sustainable efficacy is independent of cardiovascular risk factors and associates substantial reprogramming in circulating extracellular vesicles (EVs). The intricate journey of pluripotent exercise-induced EVs from parental cells to the whole-body and infiltration to cerebrovascular entity offers several mechanisms to reduce stroke incidence and injury or accelerate the subsequent recovery. This review delineates the potential roles of EVs as prospective effectors of exercise. The candidat...
Source: Translational Stroke Research - May 21, 2022 Category: Neurology Source Type: research
A Deep Learning-Based Automatic Collateral Assessment in Patients with Acute Ischemic Stroke
This study aimed to develop a supervised deep learning (DL) model for grading collateral status from dynamic susceptibility contrast magnetic resonance perfusion (DSC-MRP) images from patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) and compare its performance against experts ’ manual grading. Among consecutive LVO-AIS at three medical center sites, DSC-MRP data were processed to generate collateral flow maps consisting of arterial, capillary, and venous phases. With the use of expert readings as a reference, a DL model was developed to analyze collateral status with o utput classified into good and...
Source: Translational Stroke Research - May 21, 2022 Category: Neurology Source Type: research
