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Multi‐modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!
ConclusionsThe incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90‐day mRS outcomes. Renal profiling and waiting for a baseline serum‐creatinine are an unnecessary delay to emergency reperfusion treatment.
Source: International Journal of Stroke - August 26, 2015 Category: Neurology Authors: Timothy E. Ang, Andrew Bivard, Christopher Levi, Henry Ma, Chung Y. Hsu, Bruce Campbell, Geoffrey Donnan, Stephen M. Davis, Mark Parsons Tags: Research Source Type: research

Mechanisms of Stroke in Patients with Chronic Kidney Disease.
Abstract BACKGROUND: Given the increasing worldwide prevalence of chronic kidney disease (CKD), it is critical to decrease the associated risk of debilitating vascular complications, including stroke, congestive heart failure, myocardial infarction, and peripheral vascular disease. Treatment options for reducing the risk of all subtypes of stroke in patients with CKD remain limited. For patients with end-stage kidney disease (ESKD), novel applications of noninvasive imaging may help personalize the type of dialysis and dialysis prescription for patients at high-risk. SUMMARY: This manuscript reviews the heigh...
Source: American Journal of Nephrology - August 27, 2019 Category: Urology & Nephrology Authors: Ghoshal S, Freedman BI Tags: Am J Nephrol Source Type: research

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran
Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not ‘routine’. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated p...
Source: Emergency Medicine Journal - January 15, 2014 Category: Emergency Medicine Authors: Alikhan, R., Rayment, R., Keeling, D., Baglin, T., Benson, G., Green, L., Marshall, S., Patel, R., Pavord, S., Rose, P., Tait, C. Tags: Poisoning/Injestion, Open access, Drugs: cardiovascular system, Stroke, Poisoning Review Source Type: research

126 * extra-anatomic revascularisation for distal occlusion of the left or right common carotid artery in acute type a aortic dissection with cerebral malperfusion
Conclusion: Extra-anatomic bypass for distal LCCA or RCCA occlusion presents a valuable bail-out technique to restore cerebral perfusion during AADA repair, potentially reducing the increased incidence of neurological complications in patients with cerebral malperfusion.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Luehr, M., Etz, C. D., Lehmkuhl, L., Misfeld, M., Bakhtiary, F., Borger, M., Mohr, F. Tags: Complicated type A aortic dissection: Malperfusion and outcome Source Type: research

Extra-anatomic revascularization for preoperative cerebral malperfusion due to distal carotid artery occlusion in acute type A aortic dissection AORTIC SURGERY
CONCLUSION Extra-anatomic bypass for LCCA or RCCA occlusion allows for early selective cerebral perfusion during AADA repair, and may reduce the risk of neurological complications in patients with preoperative cerebral malperfusion.
Source: European Journal of Cardio-Thoracic Surgery - January 13, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Luehr, M., Etz, C. D., Nozdrzykowski, M., Lehmkuhl, L., Misfeld, M., Bakhtiary, F., Borger, M. A., Mohr, F.-W. Tags: Great vessels AORTIC SURGERY Source Type: research