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Basilar artery thrombosis during sexual intercourse
We report a young woman with a life-threatening basilar artery thrombosis during sexual intercourse, with a resulting locked-in syndrome. The positive high intensity transient signals (HITS) diagnosis showed a right-to-left shunt and is in line with paradoxic embolism. The molecular genetics revealed a homozygosity 4G/4G in the region PAI1, -675 (promoter polymorphism) as a risk factor for ischemic stroke. Sexual intercourse is a possible, albeit unusual stroke cause, especially in young people.
Source: Journal of Clinical Neuroscience - January 23, 2020 Category: Neuroscience Source Type: research
Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis
ConclusionsAortic valve sparing appears to be safe, and associated with reduced late mortality, thromboembolism/stroke and bleeding compared with composite valve grafting. Late durability is equivalent. Aortic valve sparing should be considered in patients with favorable aortic valve morphology.Graphical abstract
Source: The Annals of Thoracic Surgery - January 23, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research
Inflammation and Endothelial Function Relevant Genetic Polymorphisms and Carotid Plaque in Chinese Population.
CONCLUSION: The prevalence of carotid plaque was very high in the high-risk stroke population in southwestern China. Variants in genes involved in the endothelial function and inflammation were associated with the carotid plaque. The high-risk interactive genotype among rs7923349, rs1991013, rs1609682, and rs8081248 was independently associated with a higher risk of vulnerable plaque. PMID: 31956237 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - January 22, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Atherosclerotic plaque injury-mediated murine thrombosis models: advantages and limitations.
Authors: Karel M, Hechler B, Kuijpers M, Cosemans J Abstract In spite of current treatment strategies, myocardial infarction and stroke are still major causes of death worldwide. These events are triggered by damage of an atherosclerotic plaque, resulting in occlusive thrombus formation. Mouse studies have significantly contributed to our understanding of the mechanisms of atherogenesis and of thrombosis following plaque injury, but the extent to which the mouse serves as an accurate model of human disease is open to discussion. In this review, we provide a detailed overview and comparison of the described mouse mo...
Source: Platelets - January 22, 2020 Category: Hematology Tags: Platelets Source Type: research
Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis.
CONCLUSIONS: Aortic valve sparing appears to be safe, and associated with reduced late mortality, thromboembolism/stroke and bleeding compared with composite valve grafting. Late durability is equivalent. Aortic valve sparing should be considered in patients with favorable aortic valve morphology. PMID: 31981499 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - January 22, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Elbatarny M, Tam DY, Edelman JJ, Rocha RV, Chu MWA, Peterson MD, El-Hamamsy I, Appoo JJ, Friedrich JO, Boodhwani M, Yanagawa B, Ouzounian M, Canadian Thoracic Aortic Collaborative (CTAC) Investigators Tags: Ann Thorac Surg Source Type: research
Safety of Prophylactic Heparin in the Prevention of Venous Thromboembolism After Spontaneous Intracerebral Hemorrhage: A Meta-analysis
Conclusion Prophylactic heparin was associated with a nonsignificant increase in any hematoma enlargement and mortality, a nonsignificant reduction in extracranial hemorrhage, and a nonsignificant increase in the incidence of major disability in patients with sICH. It is probably safe to administer heparin to prevent VTE in patients with sICH. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - January 21, 2020 Category: Neurosurgery Authors: Pan, Xi Li, Jihui Xu, Lan Deng, Shengming Wang, Zhi Tags: Review Article Source Type: research
Drug interactions and pharmacogenetic factors contribute to variation in apixaban concentration in atrial fibrillation patients in routine care
In this study, we assessed the impact of interacting medication and pharmacogenetic variation to better explain apixaban concentration differences among 358 Caucasian AF patients. Genotyping (ABCG2,ABCB1,CYP3A4*22,CYP3A5*3) was performed by TaqMan assays, and apixaban quantified by mass spectrometry. The typical patient was on average 77.2 years old, 85.5 kg, and had a serum creatinine of 103.1 µmol/L. Concomitant amiodarone, an antiarrhythmic agent and moderate CYP3A/ABCB1 inhibitor, the impaired-function variantABCG2 c.421C > A, and sex predicted higher apixaban concentrations when controlling for age, weig...
Source: Journal of Thrombosis and Thrombolysis - January 18, 2020 Category: Hematology Source Type: research
Accuracy of MRI T2*-weighted sequences (GRE-EPI) compared to CTA for detection of anterior circulation large vessel thrombus
ConclusionFast T2*W sequences demonstrated very good diagnostic performance and inter-reader agreement for detecting SVS in the M1 segment in patients with acute ischemic stroke.
Source: Emergency Radiology - January 18, 2020 Category: Emergency Medicine Source Type: research
Permanent Implantable Cardiac Support Systems.
CONCLUSION: A VAD system can be implanted as an alternative to cardiac transplan- tation or as a bridging treatment until the patient can be listed for transplantation and receive the transplant. Because of the organ s , only a minority of VAD patients ever receive a transplant. PMID: 31931951 [PubMed - in process]
Source: Deutsches Arzteblatt International - January 16, 2020 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
Development, validation and application of a new HPLC-DAD method for simultaneous quantification of apixaban, dabigatran, edoxaban and rivaroxaban in human plasma
Publication date: Available online 14 January 2020Source: Journal of Pharmaceutical and Biomedical AnalysisAuthor(s): Filipa Gouveia, Joana Bicker, Joana Santos, Marília Rocha, Gilberto Alves, Amílcar Falcão, Ana FortunaAbstractDirect oral anticoagulants (DOACs) have been commonly used for the treatment of venous thromboembolism and for the prevention of stroke in patients with atrial fibrillation. Despite not being initially recommended, monitoring DOACs plasma concentrations is now recognized as essential in emergency situations and in special populations. Moreover, the inter-individual variability found in real studi...
Source: Journal of Pharmaceutical and Biomedical Analysis - January 16, 2020 Category: Drugs & Pharmacology Source Type: research
The prediction of acute ischemic stroke patients ’ long-term functional outcomes treated with bridging therapy
Intravenous thrombolysis therapy (IVT) bridged with intra-arterial thrombectomy (IAT) has recently been recommended as favorable treatment option to ensure that the thrombolytic effect is delivered to the affe...
Source: BMC Neurology - January 16, 2020 Category: Neurology Authors: Yu-Jun Chang, Chi-Kuang Liu, Wen-Pei Wu, Shih-Chun Wang, Wei-Liang Chen and Chih-Ming Lin Tags: Research article Source Type: research
Left atrial appendage morphology and cardiac function in patients with sinus rhythm
ConclusionsThese findings suggest that impaired LA and LAA functions are related to changes of the LAA in patients with sinus rhythm.
Source: Journal of Echocardiography - January 16, 2020 Category: Cardiology Source Type: research
Moderate Levels of N-Terminal Pro-B-Type Natriuretic Peptide is Associated with Increased Risks of Total and Ischemic Strokes among Japanese: The Circulatory Risk in Communities Study.
CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners. PMID: 31932552 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - January 15, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Incidence of Thromboembolic Events in Oncology Patients Receiving Intraoperative Tranexamic Acid During Orthopedic Surgery: A Retrospective Review at a Comprehensive Cancer Center
We present a retrospective review of 104 patients with an oncologic diagnosis who received intraoperative tranexamic acid during orthopedic surgery. Overall, complication rates were low, including deep vein thrombosis (1.0%), pulmonary embolism (4.8%), stroke (0%), and myocardial infarction (0%). This preliminary evidence shows that antifibrinolytics such as tranexamic acid may be considered perioperatively in oncology patients without increased risk of thromboembolic events; however, further prospective trials are encouraged.
Source: A&A Case Reports - January 15, 2020 Category: Anesthesiology Tags: Innovation Source Type: research
Lower versus Standard INR Targets in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
CONCLUSION: Moderate quality evidence suggests lower INR targets reduce bleeding but increase thromboembolism in AF. The data are dominated by East-Asian studies, limiting generalizability to Western populations. Until higher quality data demonstrate otherwise, an INR range of 2 to 3 should remain standard for thromboembolic prophylaxis in AF. PMID: 31940677 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 15, 2020 Category: Hematology Authors: Pandey AK, Xu K, Zhang L, Gupta S, Eikelboom J, Cook O, McIntyre WF, Lopes RD, Crowther M, Belley-Côté EP, Whitlock RP Tags: Thromb Haemost Source Type: research
How Effective and Safe Is Factor XI Inhibition in Preventing Venous Thrombosis?
The introduction of the direct oral anticoagulants for stroke prevention in atrial fibrillation and the management of thromboembolism has transformed the care of patients with these disorders. These drugs, which selectively and reversibly inhibit factor Xa or thrombin in the common pathway of the coagulation cascade, have a wide therapeutic window; this allows for simplified dosing regimens without laboratory monitoring of most adult patients as contrasted to vitamin K antagonists. This class of drug is also associated with a lower bleeding risk than vitamin K antagonists, which has been most clearly demonstrated by a 50% ...
Source: JAMA - January 14, 2020 Category: General Medicine Source Type: research
Numerical Study of Atrial Fibrillation Effects on Flow Distribution in Aortic Circulation.
Abstract Atrial fibrillation (AF) is the most common type of arrhythmia, which undermines cardiac function. Atrial fibrillation is a multi-facet malady and it may occur as a result of other diseases or it may trigger other problems. One of the main complications of AF is stroke due to the possibility of clot formation inside the atrium. However, the possibility of stroke occurrence due to the AF and the location from which an embolus dispatches are subject of debate. Another hypothesis about the embolus formation during AF is thrombus formation in aorta and carotid arteries, embolus detachment and its movement. To...
Source: Annals of Biomedical Engineering - January 14, 2020 Category: Biomedical Engineering Authors: Deyranlou A, Naish JH, Miller CA, Revell A, Keshmiri A Tags: Ann Biomed Eng Source Type: research
Clot Analog Attenuation in Non-contrast CT Predicts Histology: an Experimental Study Using Machine Learning
AbstractExact histological clot composition remains unknown. The purpose of this study was to identify the best imaging variables to be extrapolated on clot composition and clarify variability in the imaging of thrombi by non-contrast CT. Using a CT-phantom and covering a wide range of histologies, we analyzed 80 clot analogs with respect to X-ray attenuation at 24 and 48 h after production. The mean, maximum, and minimum HU values for the axial and coronal reconstructions were recorded. Each thrombus underwent a corresponding histological analysis, together with a laboratory analysis of water and iron contents. Decision...
Source: Translational Stroke Research - January 14, 2020 Category: Neurology Source Type: research
Atherothrombosis Prevention and Treatment with Anti-interleukin-1 Agents
AbstractPurpose of ReviewDespite major advances in terms of prevention, diagnosis, risk-stratification, management and rehabilitation, atherosclerosis and atherothrombosis continue to have major morbidity and mortality implications worldwide. Since the unraveling of the pivotal role of inflammation in atherothrombosis pathophysiology, several focused treatments have been proposed with the ultimate goal of preventing or treating myocardial infarction, stroke, and peripheral artery disease. In particular, given the centrality of interleukin-1 (IL-1), targeted anti-IL-1 agents have attracted substantial attention and efforts....
Source: Current Atherosclerosis Reports - January 13, 2020 Category: Cardiology Source Type: research
Cerebral Vascular Complications of Pediatric Blunt Trauma
Ischemic and hemorrhagic stroke can occur in the setting of pediatric trauma, particularly those with head or neck injuries. The risk of stroke appears highest within the first two weeks after trauma. Stroke diagnosis may be challenging due to lack of awareness or concurrent injuries limiting detailed neurologic assessment. Other injuries may also complicate stroke management, with competing priorities for blood pressure, ventilator management, or antithrombotic timing. Here we review epidemiology, clinical presentation and diagnostic approach to blunt arterial injuries including dissection, cerebral sinovenous thrombosis,...
Source: Pediatric Neurology - January 10, 2020 Category: Neurology Authors: Maria M. Galardi, Jennifer M. Strahle, Alex Skidmore, Akash P. Kansagra, Kristin P. Guilliams Tags: Review Article Source Type: research
The real world use of combined P-glycoprotein and moderate CYP3A4 inhibitors with rivaroxaban or apixaban increases bleeding
AbstractThe use of direct oral anticoagulants for stroke prevention in atrial fibrillation continues to rise. Certain populations may be at higher risk for increased drug exposure and adverse events. Pharmacokinetic studies suggest increased exposure of rivaroxaban and apixaban with combined P-gp and moderate CYP3A4 inhibitors but the clinical relevance of this is unknown. This retrospective cohort study included patients receiving rivaroxaban or apixaban from January 1, 2012 to December 31, 2016 with a moderate inhibitor (amiodarone, dronedarone, diltiazem, verapamil) for at least 3 months in the drug –drug interaction ...
Source: Journal of Thrombosis and Thrombolysis - January 10, 2020 Category: Hematology Source Type: research
Cerebrovascular Complications of Pediatric Blunt Trauma
Ischemic and hemorrhagic stroke can occur in the setting of pediatric trauma, particularly those with head or neck injuries. The risk of stroke appears highest within the first two weeks after trauma. Stroke diagnosis may be challenging due to lack of awareness or concurrent injuries limiting detailed neurological assessment. Other injuries may also complicate stroke management, with competing priorities for blood pressure, ventilator management, or antithrombotic timing. Here we review epidemiology, clinical presentation, and diagnostic approach to blunt arterial injuries including dissection, cerebral sinovenous thrombos...
Source: Pediatric Neurology - January 10, 2020 Category: Neurology Authors: Maria M. Galardi, Jennifer M. Strahle, Alex Skidmore, Akash P. Kansagra, Kristin P. Guilliams Tags: Review Article Source Type: research
Management of major bleeding outcomes under antithrombotic therapy in real-life
Bleeding is the most serious undesirable event of antithrombotic therapy, though this treatment has shown benefits in terms of venous or arterial thrombosis prevention, particularly in case of atrial fibrillation, stroke, venous thromboembolism, and coronary disease.
Source: Thrombosis Research - January 10, 2020 Category: Hematology Authors: F. Moustafa, A. Corriger, C. Lambert, A. Barres, C. Camminada, D. Teissandier, J. Saint-Denis, F. Dutheil, J. Schmidt Tags: Letter to the Editors-in-Chief Source Type: research
Prevalence of aphasia after stroke in a hospital population in southern Brazil: a retrospective cohort study.
Conclusions: PWA may need more health care during hospitalization, because of the severity of the stroke, and their frailty. Further studies are needed to assess the direct impact of aphasia on inpatients. PMID: 31687916 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - November 5, 2019 Category: Neurology Authors: Lima RR, Rose ML, Lima HN, Cabral NL, Silveira NC, Massi GA Tags: Top Stroke Rehabil Source Type: research
Taurine Reduces tPA (Tissue-Type Plasminogen Activator)-Induced Hemorrhage and Microvascular Thrombosis After Embolic Stroke in Rat Basic Sciences
Conclusions—Our results suggest that taurine in combination with tPA may be a clinically feasible approach toward future attempts at combination stroke therapy.
Source: Stroke - June 25, 2018 Category: Neurology Authors: Rong Jin, Adam Y. Xiao, Shan Liu, Min Wang, Guohong Li Tags: Animal Models of Human Disease, Ischemic Stroke Original Contributions Source Type: research
Elevated Plasma D-Dimer Level Is Associated With Short-Term Risk of Ischemic Stroke in Patients With Acute Heart Failure Brief Report
We examined 721 consecutive hospitalized AHF patients with plasma D-dimer level on admission from our prospective registry between January 2013 and May 2016. The study end points were incidence of ischemic stroke during hospitalization and at 30 days after admission.Results—Of the total participants (mean age, 76 years; male, 60%; atrial fibrillation, 54%; mean left ventricular ejection fraction, 38%), in-hospital ischemic stroke occurred in 18 patients (2.5%) during a median hospitalization period of 21 days, and 30-day ischemic stroke occurred in 16 patients (2.2%). Higher D-dimer level on admission was an independent ...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Yasuhiro Hamatani, Toshiyuki Nagai, Michikazu Nakai, Kunihiro Nishimura, Yasuyuki Honda, Hiroki Nakano, Satoshi Honda, Naotsugu Iwakami, Yasuo Sugano, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Kazunori Toyoda, Satoshi Yasuda, Hiroyuki Yo Tags: Heart Failure, Ischemic Stroke Brief Reports Source Type: research
Low Levels of Caveolin-1 Predict Symptomatic Bleeding After Thrombolytic Therapy in Patients With Acute Ischemic Stroke Brief Report
Background and Purpose—Experimental models of cerebral ischemia demonstrate that the decrease in the caveolin-1 membrane protein results in an increase in endothelial permeability. Because this phenomenon is responsible for hemorrhagic transformation (HT) after cerebral ischemia, we aimed to determine whether caveolin-1 levels may predict bleeding after recombinant tissue-type plasminogen activator (r-tPA) administration in patients with acute stroke.Methods—We studied 133 patients with a first hemispheric stroke treated with r-tPA within 4.5 hours of symptom onset. HT was evaluated and classified on cranial computed t...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Mar Castellanos, Cecile van Eendenburg, Carme Gubern, Elisabet Kadar, Gemma Huguet, Josep Puig, Tomas Sobrino, Gerard Blasco, Joaquin Serena, Juan Manuel Sanchez Tags: Biomarkers, Endothelium/Vascular Type/Nitric Oxide, Blood-Brain Barrier, Ischemic Stroke Brief Reports Source Type: research
Association of Cancer Cell Type and Extracellular Vesicles With Coagulopathy in Patients With Lung Cancer and Stroke Brief Report
Conclusions—Our findings indicate that cancer cell type is associated with circulating EV levels and coagulopathy in patients with lung cancer and stroke.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Jong-Won Chung, Yeon Hee Cho, Myung-Ju Ahn, Mi Ji Lee, Gyeong-Moon Kim, Chin-Sang Chung, Oh Young Bang Tags: Biomarkers, Mechanisms, Translational Studies, Cerebrovascular Disease/Stroke, Thrombosis Brief Reports Source Type: research
Atrial Cardiopathy and the Risk of Ischemic Stroke in the CHS (Cardiovascular Health Study) Clinical Sciences
Conclusions—In addition to clinically apparent AF, other evidence of abnormal atrial substrate is associated with subsequent ischemic stroke. This finding is consistent with the hypothesis that thromboembolism from the left atrium may occur in the setting of several different manifestations of atrial disease.
Source: Stroke - March 26, 2018 Category: Neurology Authors: Hooman Kamel, Traci M. Bartz, Mitchell S.V. Elkind, Peter M. Okin, Evan L. Thacker, Kristen K. Patton, Phyllis K. Stein, Christopher R. deFilippi, Rebecca F. Gottesman, Susan R. Heckbert, Richard A. Kronmal, Elsayed Z. Soliman, W.T. Longstreth Jr Tags: Arrhythmias, Cardiomyopathy, Echocardiography, Electrocardiology (ECG), Ischemic Stroke Original Contributions Source Type: research
Predictors of Thrombolysis Administration in Mild Stroke Clinical Sciences
Conclusions—Mild acutely presenting stroke patients are more likely to receive thrombolysis if they are young, white, or Hispanic and arrive early to the hospital with more severe neurological presentation. Identification of predictors of thrombolysis is important in design of future studies to assess the use of thrombolysis for mild stroke.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Negar Asdaghi, Kefeng Wang, Maria A. Ciliberti-Vargas, Carolina Marinovic Gutierrez, Sebastian Koch, Hannah Gardener, Chuanhui Dong, David Z. Rose, Enid J. Garcia, W. Scott Burgin, Juan Carlos Zevallos, Tatjana Rundek, Ralph L. Sacco, Jose G. Romano Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research
Erythrocyte Fraction Within Retrieved Thrombi Contributes to Thrombolytic Response in Acute Ischemic Stroke Clinical Sciences
Conclusions—In EVT-attempted patients with acute ischemic stroke, IVT responsiveness would be closely associated with RBC fraction.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Mun Hee Choi, Geun Hwa Park, Jin Soo Lee, Sung Eun Lee, Seong-Joon Lee, Jang-Hee Kim, Ji Man Hong Tags: Ischemic Stroke Original Contributions Source Type: research
Patients With Undetermined Stroke Have Increased Atrial Fibrosis Brief Report
Conclusions—The LA phenotype that was found in patients with undetermined cause supports the hypothesis that an atrial disease may be associated with stroke.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Ana Catarina Fonseca, Pedro Alves, Nuno Inacio, Joao Pedro Marto, Miguel Viana–Baptista, Teresa Pinho–e–Melo, Jose M. Ferro, Ana G. Almeida Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke, Embolism Brief Reports Source Type: research
Thrombus Neutrophil Extracellular Traps Content Impair tPA-Induced Thrombolysis in Acute Ischemic Stroke Brief Report
Conclusions—This study suggests that thrombus NETs content may be responsible for reperfusion resistance, including mechanical or pharmacological approaches with intravenous tPA, irrespectively of their etiology. The efficacy of a strategy involving an administration of DNAse 1 in addition to tPA should be explored in the setting of AIS.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02907736.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Celina Ducroux, Lucas Di Meglio, Stephane Loyau, Sandrine Delbosc, William Boisseau, Catherine Deschildre, Malek Ben Maacha, Raphael Blanc, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Robert Fahed, Jean-Baptiste Michel, Michel Piotin, Laurence Salom Tags: Inflammation, Pathophysiology, Vascular Biology, Ischemic Stroke Brief Reports Source Type: research
Associations Between Collateral Status and Thrombus Characteristics and Their Impact in Anterior Circulation Stroke Clinical Sciences
Conclusions—Patients with lower thrombus burden and higher thrombus perviousness scores had higher collateral score. The positive effect of thrombus perviousness on clinical outcome was only present in patients with moderate and high collateral scores.Clinical Trial Registration—URL: http://www.trialregister.nl. Unique identifier: NTR1804 and URL: http://www.controlled-trials.com Unique identifier: ISRCTN10888758.
Source: Stroke - January 22, 2018 Category: Neurology Authors: Heitor C. Alves, Kilian M. Treurniet, Bruna G. Dutra, Ivo G. H. Jansen, Anna M.M. Boers, Emilie M.M. Santos, Olvert A. Berkhemer, Diederik W.J. Dippel, Aad van der Lugt, Wim H. van Zwam, Robert J. van Oostenbrugge, Hester F. Lingsma, Yvo B.W.E.M. Roos, Al Tags: Computerized Tomography (CT), Ischemic Stroke Original Contributions Source Type: research
Echocardiographic Risk Factors for Stroke and Outcomes in Patients With Atrial Fibrillation Anticoagulated With Apixaban or Warfarin Clinical Sciences
Conclusions—In anticoagulated patients with atrial fibrillation and risk factors for stroke, echocardiographic findings do not seem to add to the risk of thromboembolic events.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: Stroke - November 27, 2017 Category: Neurology Authors: Dragos Vinereanu, Renato D. Lopes, Hillary Mulder, Bernard J. Gersh, Michael Hanna, Pedro G.M. de Barros e Silva, Dan Atar, Lars Wallentin, Christopher B. Granger, John H. Alexander Tags: Arrhythmias, Echocardiography, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
Inhibition of CD147 (Cluster of Differentiation 147) Ameliorates Acute Ischemic Stroke in Mice by Reducing Thromboinflammation Basic Sciences
Conclusions—Inhibition of CD147 ameliorates acute ischemic stroke by reducing thromboinflammation. CD147 might represent a novel and promising therapeutic target for ischemic stroke and possibly other thromboinflammatory disorders.
Source: Stroke - November 27, 2017 Category: Neurology Authors: Rong Jin, Adam Y. Xiao, Rui Chen, D. Neil Granger, Guohong Li Tags: Basic Science Research, Ischemic Stroke Original Contributions Source Type: research
Fibrin Clot Permeability as a Predictor of Stroke and Bleeding in Anticoagulated Patients With Atrial Fibrillation Clinical Sciences
Background and Purpose—Formation of denser fiber networks has been reported in atrial fibrillation and ischemic stroke. In this longitudinal cohort study, we evaluated whether fibrin clot density may predict thromboembolic and bleeding risk in patients with atrial fibrillation on vitamin K antagonists.Methods—In 236 patients with atrial fibrillation receiving vitamin K antagonists treatment, we measured ex vivo plasma clot permeability (Ks), a measure of the pore size in fibrin networks.Results—During a median follow-up of 4.3 (interquartile range, 3.7–4.8) years, annual rates of ischemic stroke or transient ischem...
Source: Stroke - September 25, 2017 Category: Neurology Authors: Leszek Drabik, Paweł Wołkow, Anetta Undas Tags: Atrial Fibrillation, Ischemic Stroke, Thrombosis Original Contributions Source Type: research
Detection of Left Ventricular Thrombus by Cardiac Magnetic Resonance in Embolic Stroke of Undetermined Source Clinical Sciences
Background and Purpose—We aimed to use contrast-enhanced cardiac magnetic resonance (CE-CMR) imaging to elucidate the prevalence of left ventricular (LV) thrombus in patients suspected of embolic stroke of undetermined source (ESUS) with previous myocardial infarction or LV dysfunction (LV ejection fraction [LVEF]
Source: Stroke - August 28, 2017 Category: Neurology Authors: Junji Takasugi, Hiroshi Yamagami, Teruo Noguchi, Yoshiaki Morita, Tomotaka Tanaka, Yoshinori Okuno, Satoshi Yasuda, Kazunori Toyoda, Yasufumi Gon, Kenichi Todo, Manabu Sakaguchi, Kazuyuki Nagatsuka Tags: Diagnostic Testing, Magnetic Resonance Imaging (MRI), Ischemic Stroke, Embolism, Thrombosis Original Contributions Source Type: research
Abnormal P-Wave Axis and Ischemic Stroke Clinical Sciences
Conclusions—aPWA is independently associated with ischemic stroke. This association seems to be stronger for cardioembolic strokes. Collectively, our findings suggest that alterations in atrial electric activation may predispose to cardiac thromboembolism independent of atrial fibrillation.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Ankit Maheshwari, Faye L. Norby, Elsayed Z. Soliman, Ryan J. Koene, Mary R. Rooney, Wesley T. O’Neal, Alvaro Alonso, Lin Y. Chen Tags: Arrhythmias, Electrophysiology, Ischemic Stroke Original Contributions Source Type: research
Workup for Perinatal Stroke Does Not Predict Recurrence Clinical Sciences
Conclusions—Thrombophilia, arteriopathy, or cardioembolic risk factors were not predictive of recurrent events after perinatal stroke. Thrombophilia evaluation in perinatal stroke should only rarely be considered.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Laura L. Lehman, Jeanette Beaute, Kush Kapur, Amy R. Danehy, Miya E. Bernson-Leung, Hayley Malkin, Michael J. Rivkin, Cameron C. Trenor III Tags: Pediatrics, Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
Ischemic Stroke Clinical Sciences
Conclusions—Histological thrombus features vary significantly according to the underlying cause and may help to differentiate between cardioembolic and noncardioembolic stroke. In addition, our study supports the hypothesis that most cryptogenic strokes have a cardioembolic cause.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Peter B. Sporns, Uta Hanning, Wolfram Schwindt, Aglae Velasco, Jens Minnerup, Tarek Zoubi, Walter Heindel, Astrid Jeibmann, Thomas Ulrich Niederstadt Tags: Angiography, Revascularization, Cerebrovascular Disease/Stroke, Ischemic Stroke, Embolism Original Contributions Source Type: research
Enhanced Detection of Edema in Malignant Anterior Circulation Stroke (EDEMA) Score Brief Report
Conclusions—The EDEMA score identifies patients at high risk for potentially lethal malignant edema. Although it requires external validation, this scale could help expedite triage decisions in this patient population.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Charlene Jennifer Ong, Jeffrey Gluckstein, Osvaldo Laurido-Soto, Yan Yan, Rajat Dhar, Jin-Moo Lee Tags: Clinical Studies, Cerebrovascular Disease/Stroke, Ischemic Stroke, Thrombosis Brief Reports Source Type: research
Randomized, Multicenter Trial of ARTSS-2 (Argatroban With Recombinant Tissue Plasminogen Activator for Acute Stroke) Clinical Sciences
Conclusions—In patients treated with r-tPA, adjunctive argatroban was not associated with increased risk of symptomatic intracerebral hemorrhage and provides evidence that a definitive effectiveness trial is indicated.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique Identifier: NCT01464788.
Source: Stroke - May 22, 2017 Category: Neurology Authors: Andrew D. Barreto, Gary A. Ford, Loren Shen, Claudia Pedroza, Jon Tyson, Chunyan Cai, Mohammad H. Rahbar, James C. Grotta, on behalf of the ARTSS-2 Investigators Tags: Clinical Studies, Cerebrovascular Disease/Stroke, Ischemic Stroke, Thrombosis Original Contributions Source Type: research
Genetic Drivers of von Willebrand Factor Levels in an Ischemic Stroke Population and Association With Risk for Recurrent Stroke Clinical Sciences
Background and Purpose—von Willebrand factor (vWF) plays an important role in thrombus formation during cerebrovascular damage. We sought to investigate the potential role of circulating vWF in recurrent cerebrovascular events and identify genetic contributors to variation in vWF level in an ischemic stroke population.Methods—We analyzed the effect of circulating vWF on risk of recurrent stroke using survival models in the VISP trial (Vitamin Intervention for Stroke Prevention) and the use of vWF in reclassification over traditional factors. We conducted a genome-wide association study) with imputation, based on 1000 G...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Stephen R. Williams, Fang–Chi Hsu, Keith L. Keene, Wei–Min Chen, Godfrey Dzhivhuho, Joe L. Rowles III, Andrew M. Southerland, Karen L. Furie, Stephen S. Rich, Bradford B. Worrall, Michele M. Sale Tags: Biomarkers, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
CHA2DS2-VASc Score (Congestive Heart Failure, Hypertension, Age >=75 Doubled, Diabetes Mellitus, Prior Stroke or Transient Ischemic Attack Doubled, Vascular Disease, Age 65-74, Female) for Stroke in Asian Patients With Atrial Fibrillation Clinical Sciences
Background and Purpose—The CHA2DS2-VASc stroke score (congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65–74, female) is used in most guidelines for risk stratification in atrial fibrillation (AF), but most data for this score have been derived in Western populations. Ethnic differences in stroke risk may be present. Our objective was to investigate risk factors for stroke in AF and application of the CHA2DS2-VASc score in an Asian AF population from Korea.Methods—A total of 5855 oral anticoagulant–naive nonval...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Tae-Hoon Kim, Pil-Sung Yang, Jae-Sun Uhm, Jong-Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y.H. Lip Tags: Arrhythmias, Risk Factors, Ischemic Stroke Original Contributions Source Type: research
Nongated Cardiac Computed Tomographic Angiograms for Detection of Embolic Sources in Acute Ischemic Stroke Clinical Sciences
Conclusions—Including the heart and ascending aorta in a routine non–ECG-gated computed tomographic angiogram enhances an existing imaging modality, with no increased incidence of contrast-induced nephropathy and minimal increase in radiation dose. This may help in the detection of high-risk cardiac and aortic sources of embolism in acute stroke patients.
Source: Stroke - April 24, 2017 Category: Neurology Authors: Leonard L.L. Yeo, Staffan Holmin, Tommy Andersson, Erik Lundstrom, Anil Gopinathan, Er Luen Lim, Benȷamin S.H. Leong, Win Sen Kuan, Eric Ting, Benȷamin Y.Q. Tan, Sterling Ellis Eide, Edgar L.K. Tay Tags: Computerized Tomography (CT), Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
Ischemic Stroke After Treatment of Intraprocedural Thrombosis During Stent-Assisted Coiling and Flow Diversion Brief Report
Conclusions—Current protocols for treatment of intraprocedural thrombosis associated with placement of intra-arterial devices were effective in preventing ischemic stroke in ≈80% of cases. Current smoking was the only independent predictor of ischemic stroke.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Nimer Adeeb, Christoph J. Griessenauer, Justin M. Moore, Paul M. Foreman, Hussain Shallwani, Rouzbeh Motiei-Langroudi, Raghav Gupta, Carlos E. Baccin, Abdulrahman Alturki, Mark R. Harrigan, Adnan H. Siddiqui, Elad I. Levy, Christopher S. Ogilvy, Ajith J. Tags: Cerebral Aneurysm, Ischemic Stroke Brief Reports Source Type: research
Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke Clinical Sciences
Conclusions—Coexistent SCD had no significant impact on the safety or outcome of thrombolytic therapy in acute ischemic stroke. Although the sample size is relatively small, these data suggest that adults with SCD and acute ischemic stroke should be treated with thrombolysis, if they otherwise qualify. Addition studies, however, should track the intracranial hemorrhage rate and provide information on other SCD-related care such as transfusion.
Source: Stroke - February 27, 2017 Category: Neurology Authors: Robert J. Adams, Margueritte Cox, Shelly D. Ozark, Julie Kanter, Phillip J. Schulte, Ying Xian, Gregg C. Fonarow, Eric E. Smith, Lee H. Schwamm Tags: Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research
Intravenous Thrombolysis in Unknown-Onset Stroke Clinical Sciences
Conclusions—Our data suggest no excess risk of symptomatic intracerebral hemorrhage but increased mortality and reduced favorable outcome in patients with UKO stroke compared with patients treated within the approved time window.
Source: Stroke - February 27, 2017 Category: Neurology Authors: Laura Dorado, Niaz Ahmed, Gotz Thomalla, Manuel Lozano, Branko Maloȷcic, Mushtaq Wani, Monica Millan, Ales Tomek, Antoni Davalos Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China Clinical Sciences
Conclusions—Adherence to stroke performance metrics has increased over time, but significant opportunities remain for further improvement. Continuous stroke quality improvement program should be developed as a national priority in China.
Source: Stroke - October 24, 2016 Category: Neurology Authors: Li, Z., Wang, C., Zhao, X., Liu, L., , Li, H., Shen, H., Liang, L., Bettger, J., Yang, Q., Wang, D., Wang, A., Pan, Y., Jiang, Y., Yang, X., Zhang, C., Fonarow, G. C., Schwamm, L. H., Hu, B., Peterson, E. D., Xian, Y., Wang, Y., Tags: Clinical Studies, Health Services, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Contributions Source Type: research