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Education: Lessons
Procedure: Angiography
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Total 36 results found since Jan 2013.
The Great Contrast Shortage of 2022 —Lessons learnt in Australia
ConclusionOur findings demonstrate that the IBCM shortage crisis had a very significant impact on the delivery of healthcare. While V/Q scans could (partially) substitute for CTPA studies in suspected pulmonary emboli, there appeared to be no valid alternative for CTNA studies in stroke calls. The unexpected and critical shortage of IBCM forced healthcare professionals to conserve resources, prioritise indications, triage patients based on risk, explore alternate imaging strategies and prepare for similar events recurring in the future.
Source: Journal of Medical Imaging and Radiation Oncology - May 18, 2023 Category: Radiology Authors: Giles Kisby,
James H Seow,
Greg Schie,
Constantine C Phatouros,
Kay ‐Vin Lam,
Tracey Muir,
Sally Burrows,
Paul M Parizel Tags: Medical Imaging —Original Article Source Type: research
The Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: Ten Years of Lessons Learned and Adjustments in Practice from the WorldWideWEB Consortium
This study comprised 671 patients (median age 61.4 years; 71.2% female) with 682 intracranial aneurysms. Over time, we observed an increasing tendency to treat patients presenting with ruptured aneurysms and aneurysms with smaller neck, diameter, and dome widths. Furthermore, we observed a trend towards more off-label use of the WEB for sidewall aneurysms and increased adoption of transradial access for WEB deployment. Moreover, the proportion of patients with adequate WEB o cclusion immediately and at last follow-up was significantly higher in more recent year cohorts, as well as lower rates of compaction and retreatment...
Source: Translational Stroke Research - September 6, 2022 Category: Neurology Source Type: research
Diffuse low-grade glioma misdiagnosed as acute cerebral infarction: A case report
We report a case of DLGG detected by computed tomography and magnetic resonance imaging (MRI).
Patient concerns:
A 58-year-old man suddenly phantom smells for half an hour and was previously healthy.
Diagnoses:
Computed tomography findings showed a leaf-shaped slightly hypodense shadow in the right temporal lobe with no obvious mass effect and an unclear boundary. MRI findings showed diffuse and slightly longer T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI)signal in the right temporal lobe and hippocampus, slight hyperintensity on diffusion-weighted imaging, diffuse swelling in the right temporal lobe ...
Source: Medicine - September 2, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Intramedullary spinal cord abscess associated with right-to-left shunt via right superior vena cava draining into left atrium: A case report
We report the first case of ISCA associated with RSVC-LA RL shunt.
Patient concerns:
A 36-year-old man developed progressive paraparesis, dysuria, and spontaneous pain in the lumbar region and lower extremities. Spinal magnetic resonance imaging revealed an intramedullary lesion extended from Th12 to L2 with ring-shaped gadolinium enhancement. Cerebrospinal fluid (CSF) study exhibited a marked pleocytosis, and CSF culture grew Streptococcus intermedius. Cardiovascular computed tomography angiography identified RSVC-LA RL shunt, which caused transient acute cardiac syndrome due to air embolus.
Diagnoses:
The p...
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Endovascular therapy for acute basilar artery occlusion caused by vertebral artery dissection: Case report
We describes a case of basilar artery (BA) occlusion caused by extracranial VAD, in which we used a stent-retriever to achieve thrombectomy in the BA through the contralateral vertebral artery (VA).
Patient concerns:
A 32-year-old male presented with a sudden-onset headache accompanied by articulation disorder, left-sided weakness, and tinnitus in the left ear.
Diagnosis:
Digital subtraction angiography showed the V1 to V2 segment dissection of the left VA and occlusion of the BA.
Interventions:
Thrombectomy was performed through the thinner right VA with three passes of the Solitaire FR device 4 ×...
Source: Medicine - November 24, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Basilar dolichoectasia with intermural hematoma accompanied by cerebral microbleeds and white matter hyperintensities: A case report
Rationale:
The clinical manifestations of basilar dolichoectasia (BD) are variable. The diagnosis is based on imaging measurements. Digital subtraction angiography displays only the dilated vascular lumen and lacks visualization of the arterial wall. High-resolution Magnetic resonance imaging (MRI) can identify intramural hematoma; therefore, it may be more suitable for the imaging evaluation of BD. However, most of the existing literature pertaining to BD lacks vascular wall assessment.
Patient concerns:
A 65-year-old Chinese man perceived weakness of the left upper and lower limb, double vision, dizziness, nau...
Source: Medicine - August 20, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
E-131 Transfemoral versus transradial approach for cerebral angiography: A patient preference survey
ConclusionsAt our institution, most patients preferred transradial over transfemoral approach. Most common reasons included pain, recovery time and bruising. Although the effectiveness and safety of transradial approach for non-diagnostic neurointervention remains uncertain and continues to technically evolve, it may be the best option for diagnostic angiograms considering the patients’ preference.Disclosures J. Cappuzzo: None. A. Aguirre: None. A. Monteiro: None. K. Vakharia: None. N. Ruggiero: None. M. Waqas: None. R. Dossani: None. J. Davies: 1; C; National Center for Advancing Translational Sciences of the Nation...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Cappuzzo, J., Aguirre, A., Monteiro, A., Vakharia, K., Ruggiero, N., Waqas, M., Dossani, R., Davies, J., Siddiqui, A., Levy, E. Tags: Electronic poster abstracts Source Type: research
Intracardiac thrombus in a patient with mitral bioprosthesis and atrial fibrillation treated with direct oral anticoaugulant: A case report
Rationale:
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased morbidity, especially stroke and heart failure. There is also increasing awareness that atrial fibrillation is a major cause of embolic events which in 75% of cases are complicated by cerebrovascular accidents.
Patient concerns:
A 50-year-old woman with mitral bioprosthesis under warfarin for nonvalvular atrial fibrillation was referred to our Coronary Intensive Care Unit due to acute myocardial infarction without evidence of significant coronary artery stenosis.
Diagnoses:
Cardiovascular examination...
Source: Medicine - June 11, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation: A case report
Rationale:
Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization.
Patient concerns:
A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission.
Diagnoses:
Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA.
Interventions:
Thrombectomy with 3 passes of the Solitai...
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Acute basilar artery occlusion with recurrent shivering: A case report
Rationale:
Shivering is an important physiological response of the body that causes muscle tremors to maintain temperature homeostasis. Traumatic brain injuries that affect the hypothalamus cause hypothermia, and physical removal of suprasellar tumors causes thermoregulation imbalance. However, no study has reported shivering due to ischemic stroke.
Patient concerns:
A 58-year-old male patient was admitted to our emergency department to evaluate severe stenosis of the basilar artery. While waiting for further examination, he exhibited coarse shivering and severe dysarthria.
Diagnosis:
Brain computed tomography angi...
Source: Medicine - September 25, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
The resolution of carotid arterial thrombus by oral anticoagulation after IV thrombolysis for chemotherapy-induced stroke: A case report
Rationale:
Cancer-related stroke has been regarded as an emerging subtype of ischemic event. Acute treatment for this subtype may include the antiplatelet agents, anticoagulants, or endovascular intervention.
Patient concerns:
A 63-year-old woman with sudden-onset right hemiparesis and conscious change was sent to our emergency department. The patient had underlying sigmoid adenocarcinoma and received chemotherapy FOLFIRI (FOL, folinic acid; F, fluorouracil; and IRI, irinotecan) with targeted therapy cetuximab following lower anterior resection since the diagnosis was made.
Diagnoses:
Brain magnetic resonance angio...
Source: Medicine - August 28, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Bilateral pontine infarction with basilar artery fenestration: A case report
Rationale:
Basilar artery (BA) fenestration is a congenital anomaly with duplicated BA, which can cause ischemic stroke. However, the stroke mechanism is not clearly verified in patients with BA fenestration.
Patient concerns:
Here, we report a case of 64-year-old man with well-controlled hypertension admitted with dysarthria, only.
Diagnoses:
Diffusion weighted image showed a bilateral symmetric pontine infarction sparing the midline. BA fenestration was observed from magnetic resonance angiography.
Intervention:
High-resolution magnetic resonance image (MRI) and 4D flow MRI was performed to verify the mechanis...
Source: Medicine - August 7, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Management of paradoxical embolism in a patient with coexisting patent foramen ovale and masked pulmonary arteriovenous fistula: A case report
Rationale:
Paradoxical embolism (PE) is an important cause of cryptogenic stroke, particularly in young patients, which usually have a relation with an unexpected route in circulation. Here we report a rare case of cryptogenic stroke carried 2 uncommon malformations.
Patient concerns:
A 48-year-old female experienced double neurological events in just 2 months.
Diagnosis:
Patent foramen ovale was diagnosed with transesophageal echocardiography and successfully occluded in the first admission due to stroke. In the second admission, chest tomographic angiography found a chordae shadow in the right middle lobe, was th...
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
r-tPA with loading dose of clopidogrel and aspirin therapies for capsular warning syndrome attributed to middle cerebral artery atherosclerotic stenosis: A CARE-compliant case report
Rationale:
The capsular warning syndrome (CWS) is a rare and special type of transient ischemic attacks (TIAs) syndrome. The pathophysiology of CWS is very complicate, and intracranial atherosclerotic stenosis (ICAS) is rare cause. Moreover, the effective and standard therapy has not yet been established.
Patient concerns:
A 47-year-old man experienced repeated and exacerbated TIAs of right hemiparesis and dysarthria. Fourteen hours after the first episode of TIAs, he developed more severe right hemiparesis and dysarthria, the National Institute of Health Stroke Scale (NIHSS) score was 12 points, and did not recover i...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Cerebral sinovenous thrombosis in a child with ulcerative colitis: A case report
Rationale:
Cerebral sinovenous thrombosis (CVT) associated with inflammatory bowel disease (IBD) is infrequent, but clinically nonnegligible due to its high disability and fatality rates.
Patient concerns:
A 12-year-old child with newly developed ulcerative colitis (UC) suffered from a sudden left-sided hemiparesis and numbness.
Diagnoses:
Cerebral sinovenous thrombosis due to ulcerative colitis was diagnosed in this girl.
Interventions:
The patient was treated with blood transfusion and anticoagulation therapy. Digital subtraction angiography (DSA) and urokinase thrombolysis were implemented followed.
Outcomes...
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
