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Economic evaluation of intravenous alteplase for stroke with the time of onset between 4.5 and 9 hours
Conclusion For patients with AIS with a time of onset between 4.5 and 9 hours, perfusion imaging-guided intravenous alteplase was likely to be cost-effective in China and was cost-effective in the US when compared with placebo.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Chen, J., Liang, X., Tong, X., Han, M., Ji, L., Zhao, S., Hu, Z., Liu, A. Tags: Open access, Socioeconomics Source Type: research

O-067 Super large-bore ingestion of clot (SLIC) leads to high first-pass effect in thrombectomy for large vessel occlusion
ConclusionOur initial experience with the SLIC technique resulted in achieving first-pass effect (mTICI≥2C) in 70.5%. Navigation of the SLBA catheter extender over the Tenzing insert was successful and safe in this early experience.Disclosures F. Massari: None. G. Dabus: 2; C; Medtronic, Microvention, Cerenovus, Penumbra, Stryker, InNeuroCo, Route 92. G. Cortez: None. J. Singh: None. A. Kuhn: None. V. Naragum: None. V. Anagnostakou: None. R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker and CNX. 2; C; Medtronic, Balt, Stryker, Q’Apel medical, Codman Neuro (J&J), Cerenovus, Microvention, Imperati...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Massari, F., Dabus, G., Cortez, G., Singh, J., Kuhn, A., Naragum, V., Anagnostakou, V., Hanel, R., Gounis, M., Puri, A. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

P-013 Designing and prototyping a novel balloon-stent device for minimally invasive temporary aneurysm occlusion and embolization
ConclusionA balloon-stent device allows for longer neuro-interventional procedures by providing continuous perfusion without arresting blood flow during balloon inflation. In addition, this novel medical device provides a smooth surface at the aneurysm neck for consistent device placement, minimization of parent vessel trauma, elimination of ischemic effects distal to the parent artery, and minimization of intra-saccular flow remnants pre- and post-treatment.Abstract P-013 Figure 1a) FPR results from theoretical estimation, benchtop modeling, and computational fluid dynamic (CFD) simulation. B) balloon component of the bal...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Asgari, O., Fennell, B., Norris, N., Ducruet, A., Becker, T. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

Preeclampsia: Linking Placental Ischemia with Maternal Endothelial and Vascular Dysfunction.
This article aims to discuss the current understanding of the diagnosis and pathophysiology of PE, as well as associated organ damage, maternal and fetal outcomes, and potential therapeutic avenues. © 2021 American Physiological Society. Compr Physiol 11:1315-1349, 2021. PMID: 33295016 [PubMed - in process]
Source: Comprehensive Physiology - December 11, 2020 Category: Physiology Tags: Compr Physiol Source Type: research

Transcranial Doppler Ultrasound During Critical Illness in Children: Survey of Practices in Pediatric Neurocritical Care Centers*
Conclusions: At least 27 pediatric neurocritical care centers use transcranial Doppler during clinical care. In the majority of centers, studies are performed and interpreted by credentialed personnel, and findings are used to guide clinical management. Further studies are needed to standardize these practices.
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Neurocritical Care Source Type: research

Age-Dependence of Flow Homeostasis in the Left Ventricle
Conclusions: In average, blood spends 1 to 3 beats inside the LV with very low shear stress rates. The apical region is the most prone to blood stasis, particularly in mid-aged adults. The washout of blood in the normal LV is age-dependent due to physiological changes in the degree of apical penetration of the filling waves. Introduction Cardioembolic stroke is a major source of mortality and disability worldwide and blood stasis one of its major determinants (Adams et al., 1986). Left ventricular (LV) function has evolved to maximize mechanical efficiency and ensure organ perfusion at a low cost of energy and fill...
Source: Frontiers in Physiology - April 25, 2019 Category: Physiology Source Type: research

Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT. Introduction Endovascular recanalization therapy (ERT) has been adopted as standard stroke care in patients with acute ischemic stroke (1–6). Time to recanalization and degree of recanalization are the most important predictors of clinical outcomes after ERT (7). Before recanalization, an effort to reduce the time from symptom onset to reperfusion is critical for penumbral salvage. After recanalization...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment
Conclusion In this study, reduced CBF and FA and increased MD in the inner NAWM layers for both PVWMH and DWMH suggested extensive WM alterations beyond the visible WM lesions commonly observed on clinical MRI of svMCI subjects. CBF penumbras cover more extensive WM at risk than DTI penumbras, suggesting the likelihood that compromised CBF precedes white matter integrity changes, and CBF penumbras may be a potential target for the prevention of further microstructural white matter damage. The imaging parameters investigated, however, did not correlate to cognition. Author Contributions YZ, QX, and XG conceived and desig...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Combining Human Umbilical Cord Blood Cells With Erythropoietin Enhances Angiogenesis/Neurogenesis and Behavioral Recovery After Stroke
In conclusion, our results suggest that hUCBC infusion in combination with EPO administration demonstrates therapeutic efficacy in the treatment of stroke-induced injury by promoting neurogenesis and angiogenesis. Further research that delineates the therapeutic mechanism of systemically administered hUCBC and EPO is required. Ethics Statement All experimental procedures involving animals were performed in accordance with the Guide for the Care and Use of Laboratory Animals as adopted and promulgated by the U. S. National Institutes of Health and were approved by CHA University Institutional Animal Care & Use Com...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Cardiovascular Programming During and After Diabetic Pregnancy: Role of Placental Dysfunction and IUGR
This study demonstrated that the incidence of ischemic heart disease and death were three times higher among men with low birth weight compared to men with high birth weight (5). Epidemiological investigations of adults born at the time of the Dutch famine between 1944 and 1945 revealed an association between maternal starvation and a low infant birth weight with a high incidence of hypertension and coronary heart disease in these adults (23). Furthermore, Painter et al. reported the incidence of early onset coronary heart disease among persons conceived during the Dutch famine (24). In that regard, Barker's findin...
Source: Frontiers in Endocrinology - April 8, 2019 Category: Endocrinology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Management of Chronic Hypertension Following Intracerebral Hemorrhage
Acute blood pressure control after a cerebrovascular event is integral in the immediate care of these patients to preserve perfusion to ischemic areas and prevent intracerebral bleeding. The majority of patients with ischemic stroke or intracerebral hemorrhage (ICH) present with preexisting hypertension and therefore require a treatment plan after the acute phase. The presence of chronic hypertension after ICH has often been discussed as a modifiable risk factor for recurrent events. Clinical evidence is relatively lacking for clinicians to understand the extent of blood pressure lowering and the optimal agents to use in t...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

DEFUSE-3 Trial: Reinforcing Evidence for Extended Endovascular Intervention Time Window for Ischemic Stroke
The incidence of ischemic stroke in the United States is 3.29 per 1000 persons per year, making it the first and fourth greatest causes of disability and mortality, respectively.1 Previous randomized clinical trials (RCTs) investigating acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) have shown that endovascular intervention is clinically beneficial when performed within 6 hours of onset.2-7 A few of these RCTs had perfusion imaging inclusion criteria, showing superior results when compared with similar RCTs without such criteria.
Source: World Neurosurgery - February 17, 2018 Category: Neurosurgery Authors: Dallas L. Sheinberg, David J. McCarthy, Eric C. Peterson, Robert M. Starke Tags: News and Opinion Source Type: research

Wide Variability in Prethrombectomy Workflow Practices in the United States: A Multicenter Survey INTERVENTIONAL
CONCLUSIONS: Prethrombectomy workflows vary widely between experienced centers. Improved awareness of real-world workflows and their variations may help to guide institutions in designing their own protocols of care.
Source: American Journal of Neuroradiology - December 15, 2017 Category: Radiology Authors: Kansagra, A. P., Meyers, G. C., Kruzich, M. S., Cross, D. T., Moran, C. J. Tags: INTERVENTIONAL Source Type: research

How Patient Demographics, Imaging, and Beliefs Influence Tissue-Type Plasminogen Activator Use: A Survey of North American Neurologists Clinical Sciences
Conclusions— Diagnostic certainty and likelihood of treatment with tissue-type plasminogen activator increase with additional clinical data, with the history being the most important factor for diagnostic and treatment decisions. Respondents had difficulty in interpreting the results of CT perfusion scans although they had little impact on treatment decisions. We did not identify treatment bias based on patient age, race, or sex.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Shamy, M. C. F., Pugliese, M., Meisel, K., Rodriguez, R., Kim, A. S., Stahnisch, F. W., Smith, E. E. Tags: Computerized Tomography (CT), Ethics and Policy, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research