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Specialty: Emergency Medicine
Procedure: Angiography

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Total 79 results found since Jan 2013.

Prediction of Large Vessel Occlusions in Acute Stroke: National Institute of Health Stroke Scale Is Hard to Beat*
Objectives: Endovascular treatment for acute ischemic stroke with a large vessel occlusion was recently shown to be effective. We aimed to develop a score capable of predicting large vessel occlusion eligible for endovascular treatment in the early hospital management. Design: Retrospective, cohort study. Setting: Two tertiary, Swiss stroke centers. Patients: Consecutive acute ischemic stroke patients (1,645 patients; Acute STroke Registry and Analysis of Lausanne registry), who had CT angiography within 6 and 12 hours of symptom onset, were categorized according to the occlusion site. Demographic and clinical informati...
Source: Critical Care Medicine - May 17, 2016 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Can Emergency Physicians Perform Carotid Artery Point-of-Care Ultrasound to Detect Stenosis in Patients with TIA and Stroke? A Pilot Study
The objective of this study was to determine the test characteristics of carotid artery point-of-care ultrasound (POCUS) in detecting greater than 50% stenosis in patients presenting with TIA/stroke.Methods:We conducted a prospective cohort study on a convenience sample of adult patients presenting to a comprehensive stroke centre with TIA or stroke between June –October 2017. Carotid POCUS was performed. Primary outcome measure, stenosis ≥ 50%, was determined by the final radiology report of CTA. A blinded POCUS expert separately...
Source: Western Journal of Emergency Medicine - April 13, 2020 Category: Emergency Medicine Source Type: research

Performance of Carotid Point-of-Care Ultrasound to Detect Severe Stenosis in TIA and Stroke: A Pilot Study
The objective of this study was to determine the test characteristics of carotid artery point-of-care ultrasound (POCUS) in detecting greater than 50% stenosis in patients presenting with TIA/stroke.Methods:We conducted a prospective cohort study on a convenience sample of adult patients presenting to a comprehensive stroke centre with TIA or stroke between June –October 2017. Carotid POCUS was performed. Primary outcome measure, stenosis ≥ 50%, was determined by the final radiology report of CTA. A blinded POCUS expert separately...
Source: Western Journal of Emergency Medicine - January 1, 2020 Category: Emergency Medicine Source Type: research

Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke
We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Chen-Hsiung Huang, Hui-Chun Huang, Kang-Hsu Lin, Wei-Kung Chen, Chon-Haw Tsai Tags: Case Reports Source Type: research

An 80-year-old man with acute onset of right upper limb weakness
An 80-year-old man with a history of hypertension was referred under the suspicion of stroke. He suffered from acute onset of right upper limb weakness 4 h before presenting to our emergency department. He did not have dysarthria, facial palsy or positive pronator sign. But decreased right radial pulse and cold upper limb with cyanosis were noted. Emergent CT angiography was performed and revealed isolated spontaneous right subclavian artery dissection (figure 1A), which extended to axillary artery with compression of true lumen by thrombosed false lumen (figure 1B). He then received heparinisation treatment and the w...
Source: Emergency Medicine Journal - May 13, 2013 Category: Emergency Medicine Authors: Hsieh, M.-S., Hung, Y.-Y., Hu, S.-Y., Tsan, Y.-T. Tags: Open access, Drugs: cardiovascular system, Stroke, Hypertension, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics Images in emergency medicine Source Type: research

Ischemic Stroke
Acute ischemic stroke carries the risk of morbidity and mortality. Since the advent of intravenous thrombolysis, there have been improvements in stroke care and functional outcomes. Studies of populations once excluded from thrombolysis have begun to elucidate candidates who might benefit and thus should be engaged in the process of shared decision-making. Imaging is evolving to better target the ischemic penumbra salvageable with prompt reperfusion. Availability and use of computed tomography angiography identifies large-vessel occlusions, and new-generation endovascular therapy devices are improving outcomes in these pat...
Source: Emergency Medicine Clinics of North America - October 5, 2017 Category: Emergency Medicine Authors: Courtney R. Cassella, Andy Jagoda Source Type: research

Augmenting Denver criteria yields increased BCVI detection, with screening showing markedly increased risk for subsequent ischemic stroke
ConclusionsThe increase in detection rate for BCVI justifies more liberal screening protocols.
Source: Emergency Radiology - February 12, 2019 Category: Emergency Medicine Source Type: research

Modern Neuroimaging Techniques in Diagnosing Transient Ischemic Attack and Acute Ischemic Stroke
Neuroimaging should be obtained for all patients suspected of having acute ischemic stroke or transient ischemic attack. Noncontrast head computed tomography (CT) scans are used to exclude hemorrhage, evaluate for early brain injury, and exclude stroke mimics. CT angiography assists in identifying proximal vessel occlusions, dissection, or high-grade arterial stenoses. Additional imaging techniques have emerged to improve selection of patients likely to benefit from therapies. Artificial intelligence applications assist in acute stroke imaging assessment, identifying acute hemorrhage, and predicting risk of endovascular in...
Source: Emergency Medicine Clinics of North America - November 18, 2020 Category: Emergency Medicine Authors: Karen Greenberg, Julie Bykowski Source Type: research

Utilization of CT angiography of the head and neck in the era of endovascular therapy for acute ischemic stroke: a retrospective study
ConclusionLittle is known of the impacts on healthcare resources that have resulted from the system-wide changes made necessary by the widespread adoption of EVT. Our study shows that at our site, these system changes have resulted in large increases in CTA utilization with very small numbers of patients ultimately undergoing EVT or carotid intervention.
Source: Emergency Radiology - March 12, 2022 Category: Emergency Medicine Source Type: research

Delayed Diagnosis of Carotid Artery Dissection Complicates Ischemic Stroke Treatment
A 32-year-old woman with several days of vomiting consumed 1 dose of promethazine for symptomatic relief. Soon thereafter, she presented to a rural emergency department with nausea, vomiting, headache, slurred speech, and right-sided upper- and lower-extremity weakness. The initial clinical impression was that of a dystonic reaction for which she received the appropriate therapy for the suspected condition. When her symptoms did not improve, she was transferred by ground ambulance to a large community hospital where she was diagnosed by brain magnetic resonance imaging and carotid magnetic resonance angiography with a mass...
Source: Air Medical Journal - September 1, 2013 Category: Emergency Medicine Authors: Azeemuddin Ahmed, Achint Singh, Elizabeth C. Hassebroek, Kris Baerenwald Tags: Peer Reviewed Source Type: research

Pre-procedure Change in Arterial Occlusion in Acute Ischemic Stroke Patients undergoing Endovascular Treatment by CT Angiography
The American Heart Association/American Stroke Association guidelines strongly recommend a noninvasive intracranial vascular study such as CT angiogram in acute stroke patient if endovascular treatment is contemplated.
Source: The American Journal of Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Adnan I. Qureshi, Mushtaq H. Qureshi, Farhan Siddiq, Daraspreet Kainth, Ameer E. Hassan, Alberto Maud Tags: Original Contribution Source Type: research

Preprocedure change in arterial occlusion in acute ischemic stroke patients undergoing endovascular treatment by computed tomographic angiography
The American Heart Association/American Stroke Association guidelines strongly recommend a noninvasive intracranial vascular study such as computed tomographic (CT) angiogram in acute stroke patient if endovascular treatment is contemplated.
Source: The American Journal of Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Adnan I. Qureshi, Mushtaq H. Qureshi, Farhan Siddiq, Daraspreet Kainth, Ameer E. Hassan, Alberto Maud Tags: Original Contribution Source Type: research

Delayed bilateral massive stroke following a road traffic accident
A 72-year-old man was found unresponsive. Initial assessment revealed a Glasgow Coma Score of 4 (E1, V1, M2) with equal and reactive small pupils. The patient's past medical history included alcohol excess, osteoarthritis and a transient ischaemic attack. Of note the patient was involved in a high speed road traffic accident 3 days prior, suffering only seemingly minor injuries. The patient underwent CT scanning which revealed extensive bilateral frontoparietal lobe infarctions (figure 1). CT angiography demonstrated a small calibre internal carotid artery (ICA) on the right, together with complete occlusion of the le...
Source: Emergency Medicine Journal - August 14, 2014 Category: Emergency Medicine Authors: Coulter, I. C., Korsen, H. Tags: Drugs: cardiovascular system, Coma and raised intracranial pressure, Stroke, Radiology, Osteoarthritis, Clinical diagnostic tests, Radiology (diagnostics), Ethics Images in emergency medicine Source Type: research