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Incremental Value of Live/Real Time Three‐Dimensional over Two‐Dimensional Transesophageal Echocardiography in the Assessment of Atrial Septal Pouch
In conclusion, this retrospective study highlights the incremental value of 3DTEE over 2DTEE in the comprehensive assessment and characterization of ASPs, which can aid in the clarification of their role in cryptogenic stroke patients.
Source: Echocardiography - November 1, 2015 Category: Cardiology Authors: Mahmoud Elsayed, Ming C. Hsiung, L. David Meggo‐Quiroz, Mostafa Elguindy, Begum Uygur, Rohit Tandon, Tolga Guvenc, Nurgul Keser, Mustafa G. Vural, Serkan Bulur, Jugal R. Chahwala, Firoozeh Abtahi, Navin C. Nanda Tags: Research from or in Collaboration with the University of Alabama at Birmingham Source Type: research

TCT 2015: Thrombectomy no benefit in Medtronic’s Export studies
Thrombus aspiration in heart attack patients showed no benefit and raised the risk of stroke, according to a pair of studies of percutaneous coronary interventions using Medtronic‘s (NYSE:MDT) Export aspiration catheter, presented today at the annual Transcatheter Cardiovascular Therapies conference in San Francisco. Early thrombectomy’s promise Totaled? The 10,064-patient Total study compared PCI alone and PCI with thrombectomy in ST-elevated myocardial infarctions within 12 hours of onset. The primary endpoint (a composite of cardiovascular death, recurrent myocardial infarction, cardiogenic shock, or class...
Source: Mass Device - October 13, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiovascular Clinical Trials Medtronic TCT 2015 Source Type: news

A Case of Recurrent Ischemic Stroke Involving Subacute, Progressive Intracranial Cerebral Arterial Sclerosis Prior to Diagnosis with -mutated Polycythemia Vera
A 58-year-old man presenting with no vascular risk factors visited our hospital with right hemiparesis and total aphasia. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintensities in watershed distributions in the left hemisphere. Magnetic resonance angiography (MRA) revealed stenosis of the middle cerebral artery, despite normal MRA findings 2 months prior. One year after the first stroke, the patient experienced a recurrent ischemic stroke involving the left anterior choroidal artery, pulmonary embolism, and deep venous thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2015 Category: Neurology Authors: Tomohisa Nezu, Shiro Aoki, Kazuhide Ochi, Sayaka Sugihara, Tetsuya Takahashi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto Tags: Case Studies Source Type: research

Impact of transesophageal echocardiography on clinical management of patients over age 50 with cryptogenic stroke and normal transthoracic echocardiogram
CONCLUSIONIn our study population, when performed subsequent to a normal TTE in patients aged >50 years with cryptogenic stroke, TEE demonstrated a high diagnostic value, but had minimal incremental effect on patient management. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine
Source: Journal of Hospital Medicine - September 21, 2015 Category: Hospital Management Authors: Brian Marino, Abhishek Jaiswal, Seth Goldbarg, Gary L. Bernardini, Todd Kerwin Tags: Original Research Source Type: research

Thrombus Characteristics Are Related to Collaterals and Angioarchitecture in Acute Stroke.
CONCLUSIONS: Clot length and baseline collateral status are independent predictors of clot hyperdensity on NCCT and blooming artifact on gradient recall echo. Longer clots are more likely to be hyperdense and to bloom more, probably because portions of these clots are freshly formed locally due to of stasis of blood around the original clot. This stasis could be because of poor collaterals and inefficient angio-architecture within the cerebral arterial tree. PMID: 26365832 [PubMed - as supplied by publisher]
Source: The Canadian Journal of Neurological Sciences - September 14, 2015 Category: Neurology Authors: Qazi EM, Sohn SI, Mishra S, Almekhlafi MA, Eesa M, d'Esterre CD, Qazi AA, Puig J, Goyal M, Demchuk AM, Menon BK Tags: Can J Neurol Sci Source Type: research

Younger Stroke Patients With Large Pretreatment Diffusion-Weighted Imaging Lesions May Benefit From Endovascular Treatment Clinical Sciences
Conclusions— There was a growing risk for poor outcome and symptomatic intracerebral hemorrhage with increasing pretreatment DWI lesion volumes. Nevertheless, favorable outcome was achieved in every third patient with DWI lesions >70 mL after successful endovascular reperfusion, whereas after poor or failed reperfusion, outcome was favorable in only every 12th patient. Therefore, endovascular treatment might be considered in patients with large DWI lesions, especially in younger patients.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Gilgen, M. D., Klimek, D., Liesirova, K. T., Meisterernst, J., Klinger-Gratz, P. P., Schroth, G., Mordasini, P., Hsieh, K., Slotboom, J., Heldner, M. R., Broeg-Morvay, A., Mono, M.-L., Fischer, U., Mattle, H. P., Arnold, M., Gralla, J., El-Koussy, M., Jun Tags: Acute Cerebral Infarction, Thrombolysis, Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Comparison of susceptibility-weighted and perfusion-weighted magnetic resonance imaging in the detection of penumbra in acute ischemic stroke
Conclusions DWI-SWI mismatch is a good marker for evaluating ischemic penumbra in stroke patients with cerebral infarction. SWI can detect thrombus in the affected vessels, and may be useful for guiding intra-arterial thrombolytic therapy.
Source: Journal of Neuroradiology - August 14, 2015 Category: Radiology Source Type: research

White Matter Lesions Double the Risk of Post-Thrombolytic Intracerebral Hemorrhage Clinical Sciences
Conclusions— WMLs visible on computed tomography are associated with a more than doubled risk of sICH in patients treated with intravenous thrombolysis for acute ischemic stroke.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Curtze, S., Haapaniemi, E., Melkas, S., Mustanoja, S., Putaala, J., Sairanen, T., Sibolt, G., Tiainen, M., Tatlisumak, T., Strbian, D. Tags: Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Distance to thrombus on MR angiography predicts outcome of middle cerebral artery occlusion treated with IV thrombolysis
Conclusions DT on CE-MRA is reliably measurable, correlates inversely with FLAIR-vascular hyperintensities, and predicts outcome in patients with acute MCA occlusion treated with IVT.
Source: Neuroradiology - July 11, 2015 Category: Radiology Source Type: research

Stroke of a cardiac myxoma origin
Conclusion: Cardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct. Resumo Objetivo: As características clínicas do acidente vascular cerebral causado ...
Source: Revista Brasileira de Cirurgia Cardiovascular - June 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Susceptibility vessel sign on T2* magnetic resonance imaging and recanalization results of mechanical thrombectomy with stent retrievers: a multicentre cohort study
ConclusionsThe success of recanalization in acute stroke patients treated with stent retrievers was related to thrombus length but not to the presence of SVS.
Source: European Journal of Neurology - March 19, 2015 Category: Neurology Authors: S. Soize, A. L. Batista, C. Rodriguez Regent, D. Trystram, M. Tisserand, G. Turc, I. Serre, W. Ben Hassen, M. Zuber, D. Calvet, J.‐L. Mas, J.‐F. Meder, J. Raymond, L. Pierot, C. Oppenheim, O. Naggara Tags: Original Article Source Type: research

Oral direct thrombin inhibitor as an alternative in the management of cerebral venous thrombosis: a series of 15 patients
ConclusionsWe report the largest series of cerebral vein thrombosis patients treated with dabigatran. Clinical outcome was excellent in most patients and not different from other studies. Dabigatran could possibly be considered an alternative to warfarin; nevertheless, further prospective assessment with randomized controlled studies is warranted.
Source: International Journal of Stroke - February 1, 2015 Category: Neurology Authors: Marcelo D. Mendonça, Raquel Barbosa, Vera Cruz‐e‐Silva, Sofia Calado, Miguel Viana‐Baptista Tags: Research Source Type: research

Imaging of occlusive thrombi in acute ischemic stroke
Thrombi, or clots, often occlude proximal segments of the cerebral arterial circulation in acute ischemic stroke. Thromboembolic occlusion or thrombi superimposed on atherosclerotic plaque are the principal focus of acute stroke therapies such as thrombolysis or thrombectomy. We review the imaging characteristics of thrombi on multimodal computed tomography and magnetic resonance imaging, angiography, and ultrasonography, summarizing recent studies that facilitate therapeutic decision‐making from these noninvasive studies. Information about the location, size, and imaging characteristics can be ascertained using these te...
Source: International Journal of Stroke - December 26, 2014 Category: Neurology Authors: Gregory G. Gasparian, Nerses Sanossian, Mark S. Shiroishi, David S. Liebeskind Tags: Review Source Type: research

Flow-Diverting Stents for Intracranial Bifurcation Aneurysm Treatment
CONCLUSION: Symptomatic modifications of side branches after flow diverter treatment depend on the extent and type of collateral supply. ABBREVIATIONS: DSA, digital subtraction angiography DWI, diffusion-weighted imaging FD, flow-diverter stent FLAIR, fluid-attenuated inversion recovery MCA, middle cerebral artery mRS, modified Rankin Scale OKM, O'Kelly-Marotta
Source: Neurosurgery - November 20, 2014 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

Cryptogenic Stroke Following Abdominal Free Flap Breast Reconstruction Surgery
Conclusion Surgeons and cardiologists should be aware of this cerebrovascular complication secondary to PFO following major reconstructive surgery such as microvascular breast reconstruction. It also serves to challenge microvascular surgeons to reconsider routine use of central venous pressure lines in free flap patients who might otherwise have good peripheral vessels for postoperative fluids and antibiotic administration.
Source: International Journal of Surgery Case Reports - November 11, 2014 Category: Surgery Source Type: research

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