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Lori’s Stroke Required Help From Doctors An Hour Away. Telemedicine Provided It.
Editor’s note: Our previous stories this American Stroke Month featured warning signs heeded and missed. Today we shift gears to showcase a textbook response to a stroke, including the crucial role of telestroke, a way for experts at another facility to help care for a patient via a webcam-type connection. The CHRONIC Care Act, which includes a provision to require Medicare to cover telestroke, will be discussed Tuesday during a hearing of the Senate Finance Committee. Lori Hoopingarner savored her occasional weekend getaway. Between running her financial advising company, raising a 10-year-old daughter and 6-year-old s...
Source: Healthy Living - The Huffington Post - May 15, 2017 Category: Consumer Health News Source Type: news

Impact of Mechanical Thrombectomy on the Organization of the Management of Acute Ischemic Stroke
Background: Several trials and meta-analyses have recently demonstrated the superiority of endovascular therapy over standard medical treatment in patients presenting with acute ischemic stroke. In order to offer the best possible treatment to a maximum number of patients, many stroke care networks probably have to be reorganized. After analyzing the reliability of data in the literature, an algorithm is suggested for a pre-hospital and in-hospital alert system to improve the timeliness of subsequent treatment: a drip-and-ship approach. Summary: Five recent well-designed randomized studies have demonstrated the benefit of ...
Source: European Neurology - January 16, 2016 Category: Neurology Source Type: research

Asymptomatic Females Are at Higher Risk for Perioperative TIA/Stroke and Males Are at Higher Risk for Long-Term Mortality after Carotid Artery Stenting: A Vascular Quality Initiative Analysis
Int J Angiol DOI: 10.1055/s-0040-1712506The study aims to review the sex differences with respect to transient ischemic attack (TIA)/stroke and death in the perioperative period and on long-term follow-up among asymptomatic patients treated with carotid stenting (CAS) in the vascular quality initiative (VQI). All cases reported to VQI of asymptomatic CAS (ACAS) patients were reviewed. The primary end point was risk of TIA/stroke and death in the in-hospital perioperative period and in the long-term follow-up. The secondary end point was to evaluate predictors of in-hospital perioperative TIA/stroke and mortality on long-te...
Source: International Journal of Angiology - September 15, 2020 Category: Cardiology Authors: Erben, Young Li, Yupeng Da Rocha-Franco, Joao A. Tawk, Rabih G. Barrett, Kevin M. Freeman, William D. Lin, Michelle Huang, Josephine F. Miller, David Farres, Houssam Brott, Thomas G. Meschia, James F. Hakaim, Albert G. Tags: Original Article Source Type: research

E-030 clinical and angiographic outcomes in endovascular treatment of tandem vessel occlusions in acute ischemic stroke
ConclusionEndovascular treatment of tandem arterial occlusions in acute ischemic stroke is feasible, safe, and yields excellent angiographic and good clinical outcomesDisclosuresM. Grigoryan: None. D. Haussen: None. A. Lima: None. J. Grossberg: None. A. Anderson: None. S. Belagaje: None. F. Nahab: None. M. Frankel: None. R. Nogueira: 2; C; Covidien, Steering Committee for the SWIFT and SWIFT Prime Trials and Core Lab for the STAR Trial, Stryker, PI for the TREVO-2 and DAWN Trials, Penumbra, Executive Committee for the 3D Separator Trial.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Grigoryan, M., Haussen, D., Lima, A., Grossberg, J., Anderson, A., Belagaje, S., Nahab, F., Frankel, M., Nogueira, R. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Stroke : How can "time is brain" be translated into clinical practice?
DISCUSSION: Measures to optimize therapy times are mostly organizational and cause little or no extra costs. When implemented these measures can lead to a significant improvement in therapy times and functional patient outcome. PMID: 26728155 [PubMed - as supplied by publisher]
Source: Der Radiologe - January 4, 2016 Category: Radiology Authors: Ragoschke-Schumm A Tags: Radiologe Source Type: research

Intraoperative Stroke During Robotic Totally Endoscopic Coronary Artery Bypass
THE INCIDENCE OF stroke after coronary artery bypass graft (CABG) surgery is between 1% and 5% and is one of the most detrimental complications.1 Off-pump CABG is associated with a lower stroke rate than traditional on-pump CABG (0.7% v 1.4%).2 Stroke after CABG is associated with increased morbidity and mortality and increased cost secondary to longer hospital stays and rehabilitation. The authors ’ presented case demonstrates the complexity of perioperative management of a patient scheduled for elective off-pump total endoscopic coronary artery bypass (TECAB) grafting with recent transient ischemic attack (TIA), stroke...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 7, 2019 Category: Anesthesiology Authors: Jennette D. Hansen, Mark A. Chaney, Michael Essandoh, Jean Starr, BobbieJean Sweitzer Tags: Case Conference Source Type: research

Effects of Workflow Optimization in Endovascularly Treated Stroke Patients – A Pre-Post Effectiveness Study
This study analyzes the effect of optimized workflow on periprocedural timings and its potential influence on clinical outcome. Data were extracted from a prospectively maintained university hospital stroke database. The standard ope rating procedure was established in February 2014. Of the 368 acute stroke patients undergoing endovascular treatment between 2008 and 2015, 278 patients were treated prior to and 90 after process optimization. Outcome measures were periprocedural time intervals and residual functional impairment. A fter implementation of the SOP, time from symptom onset to reperfusion was significantly reduce...
Source: PLoS One - December 29, 2016 Category: Biomedical Science Authors: Katharina Schregel Source Type: research

Conscious Sedation versus General Anesthesia for Patients with Acute Ischemic Stroke Undergoing Endovascular Therapy: A Systematic Review and Meta-Analysis.
Abstract The aim of this study is to compare the effect of conscious sedation (CS) with general anesthesia (GA) on clinical outcomes in patients with acute ischemic stroke (AIS) undergoing endovascular therapy (EVT). MEDLINE, EMBASE, and Cochrane Central Registers of Controlled Trials (from inception to July 2017) were searched for reports on CS and GA of AIS undergoing EVT. Two reviewers assessed the eligibility of the identified studies and extracted data. Data were analyzed using the fixed-effects model, and the sources of heterogeneity were explored by sensitive analysis. Trial sequential analysis was conducte...
Source: Biomed Res - May 24, 2018 Category: Research Authors: Jing R, Dai HJ, Lin F, Ge WY, Pan LH Tags: Biomed Res Int Source Type: research

Anesthetic considerations for endovascular treatment in stroke therapy
Purpose of review The introduction of clot removement by endovascular treatment (EVT) in 2015 has improved the clinical outcome of patients with acute ischemic stroke (AIS) due to a large vessel occlusion (LVO). Anesthetic strategies during EVT vary widely between hospitals, with some departments employing local anesthesia (LA), others performing conscious sedation (CS) or general anesthesia (GA). The optimal anesthetic strategy remains debated. This review will describe the effects of anesthetic strategy on clinical and radiological outcomes and hemodynamic parameters in patients with AIS undergoing EVT. Recent fin...
Source: Current Opinion in Anaesthesiology - July 26, 2022 Category: Anesthesiology Tags: NON-OPERATING ROOM ANESTHESIA (NORA): Edited by Richard D. Urman Source Type: research

Response to a letter regarding a paper entitled, “Post-intervention TCD examination may be useful to predict outcome in acute ischemic stroke patients with successful intra-arterial intervention”
We thank Dr. Dale Ding for his thoughtful comments regarding our previous study, entitled “Post-intervention TCD examination may be useful to predict outcome in acute ischemic stroke patients with successful intra-arterial (IA) intervention” . He clearly presented the potential utility of the pulsatility index (PI) of the middle cerebral artery citing a recent study reported by Uzuner et al. . As he pointed out, our study has a limitation regarding the definition of the poor outcome. Because our study was retrospective and limited to hospitalization records, we defined poor outcomes as in-hospital death or decompressiv...
Source: Journal of the Neurological Sciences - January 21, 2014 Category: Neurology Authors: Junya Aoki, Larry N. Raber, Irene L. Katzan, Muhammad Shazam Hussain, Ferdinand K. Hui, Ken Uchino Tags: Letters to the Editor Source Type: research

Perioperative Acute Ischemic Stroke Increases Mortality After Noncardiac, Nonvascular, and Non-Neurologic Surgery: A Retrospective Case Series
To identify the predictors of in-hospital mortality in patients who develop perioperative acute ischemic stroke (PAIS) associated with noncardiac, nonvascular, and non-neurologic surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 3, 2019 Category: Anesthesiology Authors: Hong Wang, Shuang-ling Li, Jing Bai, Dong-xin Wang Tags: Original Article Source Type: research

Hemodynamic Management of Patients During Endovascular Treatment of Acute Ischemic Stroke Under Conscious Sedation: A Retrospective Cohort Study
Background: Anesthetic modality and hemodynamic management during mechanical thrombectomy (MT) for acute ischemic stroke (AIS) are potential contributors to the success of revascularization. The aims of our study were to review the hemodynamic management by anesthesiologists and clinical outcomes in patients undergoing MT under conscious sedation. Methods: Retrospective cohort study of patients with anterior circulation AIS from January 2012 to March 2016. Primary outcome was hemodynamic intervention, defined as administration of vasoactive drugs to maintain systolic blood pressure (BP) between 140 and 180 mm Hg. ...
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Anesthetic Management for Endovascular Treatment of Stroke in Patients With Coronavirus Disease 2019: A Case Series
A significant number of patients with coronavirus disease 2019 develop strokes with large vessel obstructions that may require endovascular treatment for revascularization. Our series focuses on periprocedural issues and the anesthetic management of these patients. We analyzed medical records of 5 patients with positive reverse transcription polymerase chain reaction tests for severe acute respiratory syndrome coronavirus 2 during their hospitalization who underwent endovascular treatment at our hospital between March and mid-June 2020. We found that our patients were different from the typical patients with ischemic strok...
Source: A&A Case Reports - May 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research

New Data From Two Large Studies Reinforce Effectiveness of Dual Pathway Inhibition (DPI) with XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Coronary Artery Disease (CAD) and/or Peripheral Artery Disease (PAD)
RARITAN, N.J., May 23, 2022 – Findings from the XARELTO® (rivaroxaban) Phase 3 COMPASS Long-Term Open Label Extension (LTOLE) study and the XARELTO® in Combination with Acetylsalicylic Acid (XATOA) registry have been published in the European Society of Cardiology’s (ESC) European Heart Journal, Cardiovascular Pharmacotherapy. Additionally, the XATOA registry was presented at the American Congress of Cardiology’s 71st Annual Scientific Session (ACC.22). These studies provide further evidence supporting the role of dual pathway inhibition (DPI) with the XARELTO® vascular dose (2.5 mg twice daily plus aspirin 100 mg...
Source: Johnson and Johnson - May 23, 2022 Category: Pharmaceuticals Source Type: news

FDA Approves Expanded Peripheral Artery Disease (PAD) Indication for XARELTO ® (rivaroxaban) Plus Aspirin to Include Patients After Lower-Extremity Revascularization (LER) Due to Symptomatic PAD
RARITAN, N.J., August 24, 2021 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that the U.S. Food and Drug Administration (FDA) has approved an expanded peripheral artery disease (PAD) indication for the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily plus aspirin 100 mg once daily) to include patients following recent lower-extremity revascularization (LER) due to symptomatic PAD. The approval is based on data from the Phase 3 VOYAGER PAD study. With this approval, XARELTO® is the first and only therapy indicated to help reduce the risks of major cardiovascular (CV) events in p...
Source: Johnson and Johnson - August 24, 2021 Category: Pharmaceuticals Tags: Innovation Source Type: news

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