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Specialty: Anesthesiology
Condition: Ischemic Stroke

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Total 275 results found since Jan 2013.

Percutaneous Coronary Artery Revascularization and Transcatheter Aortic Valve Replacement: Is There a Who, Why, and When?
WITH A PREVALENCE in aortic stenosis (AS) patients of 25% to 50%, concomitant coronary artery disease (CAD) has proven to be an independent risk factor for patients undergoing transcatheter aortic valve replacement (TAVR).1 Currently there is no standard- or guideline-driven approach for these patients, and many new challenges have emerged in this population. In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Bacigalupo et al.2 report a case of a patient with recent percutaneous coronary intervention (PCI) for obstructive CAD who underwent TAVR complicated by in-stent thrombosis and an ischemic stroke ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 20, 2019 Category: Anesthesiology Authors: Oscar D. Aljure, Michael Fabbro Tags: Editorial Source Type: research

Low-dose dexmedetomidine provides hemodynamics stabilization during emergence and recovery from general anesthesia in patients undergoing carotid endarterectomy: a randomized double-blind, placebo-controlled trial
ConclusionsLow-dose dexmedetomidine improves hemodynamic stability during emergence and recovery from general anesthesia in patients receiving carotid endarterectomy.Trial registry numberUMIN000010607.
Source: Journal of Anesthesia - January 17, 2019 Category: Anesthesiology Source Type: research

Pulse pressure and perioperative stroke
Purpose of review Central pulse pressure (PP), a marker of vascular stiffness, is a novel indicator of risk for perioperative morbidity including ischemic stroke. Appreciation for the mechanism by which vascular stiffness leads to organ dysfunction along with understanding its clinical detection may lead to improved patient management. Recent findings Vascular stiffness is associated with increased mortality and neurologic, cardiac, and renal injury in nonsurgical and surgical patients. Left ventricular hypertrophy and diastolic dysfunction along with microcirculatory changes in the low vascular resistance, high blood...
Source: Current Opinion in Anaesthesiology - January 8, 2019 Category: Anesthesiology Tags: CARDIOVASCULAR ANESTHESIA: Edited by Manuel L. Fontes Source Type: research

Cesarean Hysterectomy in a Parturient With Morbidly Adherent Placenta Complicated by Postoperative Ischemic Stroke Secondary to Vertebral Artery Dissection: A Case Report
We report a case of cesarean hysterectomy in a parturient with morbidly adherent placenta that was complicated by an estimated blood loss of 25 L, with the usage of massive transfusion protocols. On the third postoperative day, symptomatology suggestive of a stroke was elicited. Imaging showed a right vertebral artery dissection with cerebellar, midbrain, and pontine infarcts. She showed gradual recovery in the following months with almost complete return to baseline function. We present this case to highlight vertebral artery dissection as a potential complication after peripartum massive blood transfusion and to consid...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Outcomes of Anesthesia Selection in Endovascular Treatment of Acute Ischemic Stroke
Conclusions: The data indicated that the selection of GA or CS during EVT had no impact on the independent outcomes of patients with anterior circulation occlusion.
Source: Journal of Neurosurgical Anesthesiology - December 11, 2018 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Endovascular treatment of acute ischaemic stroke under conscious sedation: Predictors of poor outcomes
Conclusion: The outcome of patients who underwent endovascular treatment of AIS under CS depends on the mTICI score, NIHSS score and history of previous TIA.
Source: Indian Journal of Anaesthesia - December 10, 2018 Category: Anesthesiology Authors: Umeshkumar Athiraman Arbi Ben Abdallah Akash Kansagra Rene Tempelhoff Source Type: research

Anesthetic Management of a Patient With Ongoing Thrombolytic Therapy During Decompressive Craniectomy: A Case Report
We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed. Fibrinolytic coagulopathy was successfully managed by monitoring fibrinogen levels and with the administration of cryoprecipitate and tranexamic acid.
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Pre ‐hospital thrombolysis of ischemic stroke in the emergency service system—A case report from the Treat‐NASPP trial
Acta Anaesthesiologica Scandinavica, EarlyView.
Source: Acta Anaesthesiologica Scandinavica - November 14, 2018 Category: Anesthesiology Authors: Karianne Larsen, Kristi G. Bache, Eirik Franer, Lars H. Tveit, Maren R. Hov, Christian G. Lund, Volker Solyga, Hans Morten Lossius Tags: CASE REPORT Source Type: research

Regional Versus General Anesthesia for Carotid Endarterectomy: Do We Need Another Randomized Trial?
STROKE CURRENTLY remains the second cause of death among all patients with cardiovascular disease.1 Carotid endarterectomy (CEA) is a safe and effective surgical technique that lowers the risk of ischemic stroke in patients with carotid artery stenosis secondary to atherosclerotic disease.2 CEA is associated with improved neurologic and cognitive function and quality of life.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 4, 2018 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Vladimir A. Shmyrev, Valery A. Nepomniashchikh Tags: Editorial Source Type: research

Tissue oximetry during cardiac surgery and in the cardiac intensive care unit: A prospective observational trial.
Conclusions: Tissue oximetry at the paraspinal muscle correlates with cerebral oximetry values while at the arm does not. Further research is needed to evaluate the role of tissue oximetry on outcomes such as acute renal failure, prolonged need for mechanical ventilation, stroke, vascular ischemic complications, prolonged ICU and hospital length of stay, and mortality in cardiac surgery. PMID: 30333329 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - October 1, 2018 Category: Anesthesiology Authors: Heller BJ, Deshpande P, Heller JA, McCormick P, Lin HM, Huang R, Fischer G, Weiner MM Tags: Ann Card Anaesth Source Type: research

Anesthetic management of endovascular treatment for acute ischemic stroke: Influences on outcome and complications.
CONCLUSIONS: General anesthesia and conscious sedation are both safe alternatives for anesthetic management of patients submitted to endovascular thrombectomy. No anesthetic management is universally recommended and hopefully the ongoing randomized clinical trials will shed some light on the best approach; meanwhile, the choice of anesthesia should be based on the patient's individual characteristics. Regarding neuroprotection, hemodynamic stability is currently the most important strategy, as no pharmacological method has been proven effective in humans. PMID: 30195628 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - September 10, 2018 Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research

Anaesthesia for Endovascular Treatment of Acute Ischemic Stroke: Still Controversial?
This article reviews recent research on anaesthetic management of acute ischemic stroke revascularization. With emphasis on the effect of anaesthesia type on outcome, we will discuss controversial discoveries and future perspectives.Recent FindingsA substantial number of retrospective observational studies have suggested that general anaesthesia (GA) compared to conscious sedation (CS) is associated with worse outcomes after endovascular therapy for acute ischemic stroke. In contrast, recent randomized trials reported no difference in outcomes in ischemic stroke patients receiving either GA or CS during revascularization w...
Source: Current Anesthesiology Reports - September 1, 2018 Category: Anesthesiology Source Type: research

Off ‐hour admission and impact on neurological outcome in endovascular treatment for acute ischemic stroke
Acta Anaesthesiologica Scandinavica, EarlyView.
Source: Acta Anaesthesiologica Scandinavica - August 17, 2018 Category: Anesthesiology Authors: Pia L öwhagen Hendén , Alexandros Rentzos , Jan‐Erik Karlsson , Lars Rosengren , Jonatan Oras , Sven‐Erik Ricksten Source Type: research

Defining an Intraoperative Hypotension Threshold in Association with Stroke in Cardiac Surgery
Conclusions Hypotension is a potentially modifiable risk factor for perioperative stroke. The study ’s findings suggest that mean arterial pressure may be an important intraoperative therapeutic hemodynamic target to reduce the incidence of stroke in patients undergoing cardiopulmonary bypass.
Source: Anesthesiology - August 14, 2018 Category: Anesthesiology Source Type: research

Endovascular thrombectomy in acute ischemic stroke: new treatment guide
Purpose of review Recent randomized clinical trials (RCTs) have demonstrated strong efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions (LVO). SIESTA, AnSTROKE, GOLIATH showed no deleterious effects of general anesthesia on patient outcome after EVT compared with conscious sedation. DAWN and DEFUSE 3 are extending the time window for EVT up to 24 h in carefully selected patients. This review discusses the current literature on the rapidly expanding subject of endovascular stroke therapy and optimal anesthetic management. Recent findings Recent retrospective studie...
Source: Current Opinion in Anaesthesiology - August 1, 2018 Category: Anesthesiology Tags: NON-OPERATING ROOM ANESTHESIA: Edited by Mark S. Weiss Source Type: research