Journal of vascular and interventional neurology最新文献

{"title":"Long Acting Liposomal Bupivacaine for Percutaneous Sympathetic Stellate Ganglion Blockade: A Technical Note.","authors":"Adnan I Qureshi,&nbsp;Muhammad A Waqas,&nbsp;Vikram Jadhav,&nbsp;Muhammad A Saleem,&nbsp;Jeff Campbell,&nbsp;Shawn S Wallery","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>We describe the use of long acting liposomal bupivacaine for percutaneous stellate ganglion blockade to treat severe headaches following internal carotid artery dissection.</p><p><strong>Methods: </strong>A 43-year old woman developed right-sided refractory headache after right internal carotid artery dissection. Patient underwent percutaneous stellate ganglion block using bupivacaine hydrochloride (0.25%-20 ml) in the past with short acting relief. Liposomal bupivacaine (EXPAREL) 13.3 mg/mL (1.3%) solution diluted with preservative-free normal saline: a total solution of 20 ml (52 mg of bupivacaine) was injected at the level of the lower portion of body of the sixth cervical vertebra, medial to the right internal carotid artery. The response to sympathetic block was assessed by a neurologist not involved in the procedure.</p><p><strong>Results: </strong>After the stellate ganglion block with bupivacaine hydrochloride, patient was headache free immediately after the block but with recurrence of pain on Day 3 with return to peak intensity by Day 4. After the stellate ganglion blockade with liposomal bupivacaine hydrochloride, patient reported recurrence of pain on Day 15 post injection with return to peak intensity by Day 17. The patient reported an episode of aura which consisted of visual scintillations on Day 2 which lasted for five days and resolved spontaneously.</p><p><strong>Conclusion: </strong>Liposomal bupivacaine injection for stellate ganglion blockade can result in a more prolonged effect compared with bupivacaine hydrochloride.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 5","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683018/pdf/jvin-9-5-10.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35275133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracranial Four-Vessel Dissection with Reversible Cerebral Vasoconstriction Syndrome in a Habitual Cocaine User Presenting with Thunderclap Headache.","authors":"Spurthi Sunil Surpur,&nbsp;Raghav Govindarajan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 5","pages":"54"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683019/pdf/jvin-9-5-11.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35275134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment of Spontaneous Intracranial Internal Carotid Dissection in a Young Patient Affected by Systemic Lupus Erythematosus: A Case Report.","authors":"Sergio Racchiusa,&nbsp;Marcello Longo,&nbsp;Gianmarco Bernava,&nbsp;Antonio Pitrone,&nbsp;Rosario Papa,&nbsp;Francesca Granata,&nbsp;Giuseppe Centorrino,&nbsp;Sergio Lucio Vinci","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) increases the risk of cerebrovascular events due to vascular changes, resulting in the weakening of the vessel walls. Moreover, patients with SLE have more incidence of arterial lesions such as dissections. Internal carotid dissection (ICA) is an infrequent cause of ischemic stroke, representing 2% of all ischemic events. We present a case of ischemic stroke, caused by a spontaneous dissection of intracranial ICA, treated with endovascular stent implantation, in a 22-year-old woman affected by SLE, newly diagnosed. ICA dissection with consequent ischemic stroke is an unusual first presentation of SLE disease. Our case highlights how, despite an infrequent occurrence, ICA dissection should be considered for young adults presenting with ischemic stroke, especially in those affected by SLE. This paper also shows the good technical result in the use of stenting in case of intracranial ICA dissection.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 5","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683017/pdf/jvin-9-5-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35575600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transradial Approach for Deployment of a Flow Diverter for an Intracranial Aneurysm in a Patient with a Type-3 Aortic Arch.","authors":"Geoffrey W Peitz,&nbsp;Bhavani Kura,&nbsp;Jeremiah N Johnson,&nbsp;Ramesh Grandhi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Flow diversion with the Pipeline embolization device (PED) is an effective treatment for giant and wide-neck intracranial aneurysms, but the standard transfemoral approach may not be feasible in patients with Type-3 aortic arches.</p><p><strong>Case report: </strong>An 84-year-old woman presented with a right internal carotid artery (ICA) giant aneurysm and a Type-3 aortic arch, necessitating a transradial approach for access to the right common carotid artery. A triaxial catheter system made for a stable platform for the deployment of two telescoping PEDs to treat the patient's right ICA giant aneurysm. The procedure was technically successful, and there were no immediate complications.</p><p><strong>Conclusion: </strong>The transradial approach allows for carotid access in patients with challenging aortic arches, and this report demonstrates its effectiveness for deployment of flow diverters, especially with a triaxial catheter system. The peripheral access point facilitates hemostasis, which is of great importance in patients on antiplatelet medications to prevent thrombotic complications of flow diverters.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 5","pages":"42-44"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683025/pdf/jvin-9-5-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35274679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Insights into Cerebrovascular Disorders: A Comprehensive Review.","authors":"Fawaz Al-Mufti, Ahmed Alkanaq, Krishna Amuluru, Rolla Nuoman, Ahmed Abdulrazzaq, Tamarah Sami, Halla Nuoaman, Caroline Hayes-Rosen, Charles J Prestigiacomo, Chirag D Gandhi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 5","pages":"21-32"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683023/pdf/jvin-9-5-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35575604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Reversible Cerebral Vasoconstriction Syndrome Associated with Eucalyptus: Case Report.","authors":"Daniel Lapid,&nbsp;Mohtashim Arbaab Qureshi,&nbsp;Ihtesham Aatif Quresh,&nbsp;Mohammed Rauf Afzal,&nbsp;Alberto Maud,&nbsp;Gustavo J Rodriguez,&nbsp;Rakesh Khatri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Reversible cerebral vasoconstrictive syndrome (RCVS) has characteristic clinical features, brain imaging and Angiographic features. The majority of RCVS cases are associated with the use of antidepressants, polysubstance abuse, and nasal decongestants. We here present a case that highlights the use of eucalyptus herbs as a possible precipitant factor for RCVS formation.</p><p><strong>Case presentation: </strong>A 42-year-old woman presented to the emergency department with a tingling sensation on the right-hand side of her body and a two-week progressive throbbing severe holocranial headache radiating to the neck, with associated nausea, photophobia, and phonophobia. She denied any seizures and recent trauma or fevers. She was not taking scheduled medications, but she had used inhaling vapors obtained from boiling eucalyptus leaves to alleviate sinus congestion. Initial imaging revealed subarachnoid hemorrhage at bilateral posterior parietal convexity leading to her admission into the intensive care unit. Further work up disclosed the presence of findings consistent with RCVS.</p><p><strong>Conclusion: </strong>In conclusion, we hereby postulate that some herbal remedies used in alternative medicine, including eucalyptus, could play a role in causing serotonergic symptoms including dizziness, diarrhea, and cerebral vasoconstriction. Understanding that eucalyptus has the potential to contribute to RCVS due to its serotoninergic activity may be of importance in the diagnosis and management of these patients.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 5","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683022/pdf/jvin-9-5-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35575603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Aggressive Cerebral Dural Arteriovenous Fistulae: Experience Using Endovascular Embolization.","authors":"Rajeev Sivasankar,&nbsp;Raju Augustine George,&nbsp;Rochan Pant,&nbsp;Samresh Sahu,&nbsp;Rohit Aggarwal,&nbsp;Aftab Alam","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 4","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501125/pdf/jvin-9-4-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35163733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of the Unfractionated Heparin versus Low-Molecular-Weight Heparin in Hospitalized Patients with Stroke Due to Atrial Fibrillation in Shiraz, South of Iran.","authors":"Nahid Hatam,&nbsp;Jamshid Bahmei,&nbsp;Khosro Keshavarz,&nbsp;Farnia Feiz,&nbsp;Reihaneh Sedghi,&nbsp;Afshin Borhani-Haghighi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Patients with atrial fibrillation (AF) make a unique group of strokes. Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are among the medications used for preventing blood coagulation. This study was carried out aiming at analyzing the cost effectiveness of LMWH versus UFH in hospitalized patients with stroke due to AF with respect to the Iranian population.</p><p><strong>Methods: </strong>This randomized study was an economic evaluation of cost effectiveness with the help of the cross-sectional data of 2013-2015. In this study, 74 patients had undergone treatment in two groups, before being evaluated. Half of the patients were treated by LMWH, while the other half was treated by UFH. Effectiveness criterion was prevention of new stroke recurrence.</p><p><strong>Results: </strong>Average medical direct costs, non-medical direct costs, and indirect costs of UFH were 110375 ± 40411$, 15594 ± 11511$, and 21723 ± 19933$, respectively. Same average medical direct costs, non-medical direct costs, and indirect costs of LMWH were 99573 ± 59143$, 9016 ± 17156$, and 10385 ± 10598$, respectively. The number of prevention of new strokes due to AF in LMWH and UFH was 2 and 0, respectively. Expected effectiveness in LMWH and UFH groups was 0.56 and 0.51, respectively. Moreover, the expected costs were 26737.61$ and 30776.18$, respectively. The incremental cost-effectiveness ratio for stroke due to AF was -150, 201, 26$ per prevention of stroke recurrence (<i>p</i>-values ≤ 0/05).</p><p><strong>Conclusion: </strong>The results of the cost-effectiveness analysis of LMWH versus UFH showed that LMWH is a dominant strategy for patients with stroke due to AF in Iranian population.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 4","pages":"6-12"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501122/pdf/jvin-9-4-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35163730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence of Femoral Nerve Injury among Patients Undergoing Transfemoral Percutaneous Catheterization Procedures in the United States.","authors":"Mohammad El-Ghanem,&nbsp;Ahmed A Malik,&nbsp;Andre Azzam,&nbsp;Hussam A Yacoub,&nbsp;Adnan I Qureshi,&nbsp;Nizar Souayah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The proximity of the femoral nerve to the femoral artery renders it vulnerable to injury during transfemoral percutaneous catheterization (TPC) procedures.</p><p><strong>Objective: </strong>To determine the incidence of femoral nerve injury in patients undergoing cardiac catheterization in a nationally representative inpatient database.</p><p><strong>Methods: </strong>We analyzed data released annually from the Nationwide Inpatient Sample. We pooled data from 2002 to 2010 and, using the ICD-9-CM procedure codes, identified patients who underwent TPC. We subsequently identified occurrences of femoral nerve injury in this cohort. Baseline characteristics, comorbid conditions, in-hospital complications, and discharge outcomes-including mortality, mild disability, and moderate-to-severe disability-were compared between patients with femoral neuralgia and those without.</p><p><strong>Results: </strong>Of the 15,894,201 patients who underwent percutaneous catheterization procedures, 597 (3.8 per 100,000 procedures) developed femoral nerve injury. The incidence of femoral nerve injury was higher in women: 57% versus 39%, <i>p</i> < 0.004. Patients with coexisting congestive heart failure or coagulopathy had a non-significant increase in the incidence of femoral nerve injury. There was no in-hospital mortality among patients who developed femoral nerve injury, but the rate of discharge to nursing facilities was higher in this cohort: 17% versus 6%, <i>p</i> < 0.001. After adjusting for age, gender, presence of congestive heart failure, and coagulopathy, femoral nerve injury during percutaneous catheterization procedures was independently associated with moderate-to-severe disability at discharge (odds ratio 2.3; 95% confidence interval 1.4-3.8; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Femoral nerve injury is a rare complication of percutaneous catheterization procedures that may increase the likelihood of moderate-to-severe disability at patient's discharge.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 4","pages":"54-58"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501121/pdf/jvin-9-4-10.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35164122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Nutech Functional Score with European Stroke Scale for Patients with Cerebrovascular Accident Treated with Human Embryonic Stem Cells: NFS for CVA Patients Treated with hESCs.","authors":"Geeta Shroff","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Stem cell therapy is a promising modality for treatment of patients with chronic cerebrovascular accident (CVA) in whom treatment other than physiotherapy or occupational therapy does not address the repair or recovery of the lost function. In this study, the author aimed at evaluating CVA patients treated with human embryonic stem cell (hESC) therapy and comparing their study outcomes with globally accepted European Stroke Scale (ESS) to that with novel scoring system, Nutech functional score (NFS), a 21-point positional and directional scoring system for assessing patients with CVA.</p><p><strong>Materials and methods: </strong>Patients diagnosed with CVA were assessed with NFS and ESS before and after hESC therapy. NFS assessed the patients in the direction of 1-5 (bad to good), where 5 was considered as the highest possible grade (HPG). The findings were obtained for the patients who scored HPG, and had shown improvement by at least one grade.</p><p><strong>Results: </strong>Overall, 66.7% of patients scored HPG level on the NFS scale and about 62.5% of the patients scored HPG according to the ESS scale. Approximately, 52.2% patients showed an improvement of 100% (by at least one grade) on NFS scale. None of the patients showed 100% improvement in the alteration of the score by at least one grade when scored with ESS.</p><p><strong>Conclusion: </strong>NFS and ESS scores show that a large population of CVA patients was benefitted with hESC therapy. NFS was found to give more convincing results than ESS, and overcomes the shortcomings of ESS.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 4","pages":"35-43"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501127/pdf/jvin-9-4-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35164119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}