Journal of vascular and interventional neurology最新文献

{"title":"Percutaneous Cervical Sympathetic Block for Pain Control after Internal Carotid Artery Dissection. A Report of Two Cases.","authors":"Omar Saeed,&nbsp;Asif A Khan,&nbsp;Nabeel A Herial,&nbsp;Emrah Aytac,&nbsp;Adnan I Qureshi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Medical treatment of cranio-cervical pain can be suboptimal in patients with internal carotid artery (ICA) dissection. We report the use of cervical sympathetic block for treatment of pain in two patients with ICA dissection.</p><p><strong>Case reports: </strong>A 58-year-old man and a 43-year-old woman presented with severe cranio-cervical pain associated with left and right ICA dissection confirmed by magnetic resonance imaging and cerebral angiography. Due to suboptimal control of pain with medical treatment, cervical sympathetic block was performed under fluoroscopic guidance using 20 ml of bupivacaine injected lateral to the posterior aspect of sixth vertebral body in both patients. On self-reported pain scale, the 58-year-old man reported improvement in pain intensity from 8/10 pain to 0/10 within 1 h of blockade. The patient remained relatively pain free for the 24-h post blockade. Mild recurrence of pain was noted on Day 2. The 43-year-old woman reported improvement in pain intensity from 6/10 pain to 0/10 within 1 h of blockade. The patient remained pain free for five days with recurrence to previous intensity.</p><p><strong>Conclusion: </strong>Cervical sympathetic blockade in patients with ICA dissection may be an effective option in the event of suboptimal pain control with medical treatment; however, the technique may be limited due to relatively short duration of action.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 3","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317290/pdf/jvin-9-3-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34769184","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":"Capillary Index Score and Correlation with Outcomes in Acute Ischemic Stroke: A Meta-analysis.","authors":"Manoj Jagani,&nbsp;Waleed Brinjikji,&nbsp;Mohammad H Murad,&nbsp;Alejandro A Rabinstein,&nbsp;Harry J Cloft,&nbsp;David F Kallmes","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and purpose: </strong>The capillary index score (CIS) has been recently introduced as a metric for rating the collateral circulation of ischemic stroke patients. Multiple studies in the last five years have evaluated the correlation of good CIS with clinical outcomes and suggested the use of CIS in selecting patients for endovascular treatment. We performed a meta-analysis of these studies comparing CIS with clinical outcomes.</p><p><strong>Methods: </strong>We conducted a computerized search of three databases from January 2011 to November 2015 for studies related to CIS and outcomes. A CIS = 0 or 1 is considered poor (pCIS) and a CIS = 2 or 3 is considered favorable (fCIS). Using random-effect meta-analysis, we evaluated the relationship of CIS to neurological outcome (modified Rankin scale score ≤ 2), recanalization, and post-treatment hemorrhage. Meta-regression analysis of good neurological outcome was performed for adjusting baseline National Institutes of Health Stroke Scale (NIHSS) between groups.</p><p><strong>Results: </strong>Six studies totaling 338 patients (212 with fCISs and 126 with pCISs) were included in the analysis. Patients with fCIS had higher likelihood of good neurological outcome [relative risk (RR) = 3.03; confidence interval (CI) = 95%, 2.05-4.47; <i>p</i> < 0.001] and lower risk of post-treatment hemorrhage (RR = 0.38; CI = 95%, 0.19-0.93; <i>p</i> = 0.04) as compared with patients in the pCIS group. When adjusting for baseline NIHSS, patients with fCIS had higher RR of good neurological outcome when compared with those with pCIS (RR = 2.94; CI = 95%, 1.23-7, <i>p</i> < 0.0001). Favorable CIS was not associated with higher rates of recanalization.</p><p><strong>Conclusions: </strong>Observational evidence suggests that acute ischemic stroke patients with fCIS may have higher rates of good neurological outcomes compared with patients with pCIS, independent of baseline NIHSS. CIS may be used as another tool to select patients for endovascular treatment of acute ischemic stroke.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 3","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317285/pdf/jvin-9-3-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34769254","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":"A Modified Method for Creating Elastase-Induced Aneurysms by Ligation of Common Carotid Arteries in Rabbits and Its Effect on Surrounding Arteries.","authors":"Daraspreet Kainth,&nbsp;Pascal Salazar,&nbsp;Cyrus Safinia,&nbsp;Ricky Chow,&nbsp;Ornina Bachour,&nbsp;Sasan Andalib,&nbsp;Alexander M McKinney,&nbsp;Afshin A Divani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and purpose: </strong>Rabbit models of intracranial aneurysms are frequently used in pre-clinical settings. This study aimed to demonstrate an alternative, extravascular method for creating elastase-induced aneurysms, and how ligation of the right common carotid arteries (RCCA) can impact flow redistribution into left CCA (LCCA).</p><p><strong>Methods: </strong>Elastase-induced aneurysms in 18 New Zealand rabbits (4.14 ± 0.314 kg) were created by applying 3-5 U of concentrated elastase solution to the exterior of the right and left CCA roots (RCCA and LCCA). After the induction of the aneurysm, the aneurysm was either kept intact to the rest of the corresponding CCA, severed from the rest of the CCA to allow for a free standing aneurysm, or was anchored to nearby tissue to influence the angle and orientation of the aneurysm with respect to the parent vessel. Ultrasound studies were performed before and after creation of aneurysms to collect blood flow measurements inside the aneurysm pouch and surrounding arteries. Prior to sacrificing the animals, computed tomography angiography studies were performed. Harvested aneurysmal tissues were used for histological analysis.</p><p><strong>Results: </strong>Elastase-induced aneurysms were successfully created by the extravascular approach. Histological studies showed that the biological response was similar to human cerebral aneurysms and previously published elastase-induced rabbit aneurysm models. Ultrasound measurements indicated that after the RCCA was ligated, blood flow significantly increased in the LCCA at one-month follow-up.</p><p><strong>Conclusion: </strong>An alternate method for creating elastase-induced aneurysms has been demonstrated. The novel aspects of our method allow for ligation of one or both common carotid arteries to create a single or bilateral aneurysm with an ability to control the orientation of the induced aneurysm.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 3","pages":"26-35"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317289/pdf/jvin-9-3-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34769183","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":"Assessment of Skeletal Muscle Perfusion using Contrast-Enhanced Ultrasonography: Technical Note.","authors":"Adnan I Qureshi,&nbsp;Muhammad A Saleem,&nbsp;Emrah Aytac,&nbsp;Shawn S Wallery","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Intravenous contrast-enhanced ultrasonography is a recently developed technique for assessment of tissue perfusion, but has not been used for assessment of skeletal muscle perfusion.</p><p><strong>Methods: </strong>We studied a 42-year-old woman in whom myonecrosis was suspected due to systemic vasculitis and ischemia. The biceps brachii (right) and quadriceps femoris (vastus medialis) on right-hand side and subsequently left-hand side were imaged. Intravenous bolus of activated perflutren lipid microspheres was injected and B-Flow color mode (brown color) was used within a selected region of interest to image the passage of contrast through muscle parenchyma throughout three cardiac cycles.</p><p><strong>Results: </strong>Visual interpretation of muscle perfusion was performed based on the maximal intensity of contrast in the muscle, and the speed of contrast replenishment. No deficits were noted in the perfusion pattern. The arterial phase demonstrated stellate vascularity, centrifugal filling, and homogeneous hypervascularity at peak enhancement.</p><p><strong>Conclusions: </strong>The bolus of contrast resulted in good signal persistence and satisfactory imaging for multiple muscle groups.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 3","pages":"41-44"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317291/pdf/jvin-9-3-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34769185","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":"Correlation of Acute M1 Middle Cerebral Artery Thrombus Location with Endovascular Treatment Success and Clinical Outcome.","authors":"Seyedmehdi Pavabvash,&nbsp;Shayandokht Taleb,&nbsp;Shahram Majidi,&nbsp;Adnan I Qureshi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>The location of the arterial occlusion can help with prognostication and treatment triage of acute stroke patients. We aimed to determine the effects of M1 distance-to-thrombus on angiographic recanalization success rate and clinical outcome following endovascular treatment of acute M1 occlusion.</p><p><strong>Methods: </strong>All acute ischemic stroke patients with M1 segment middle cerebral artery (MCA) occlusion on admission CT angiography (CTA) who underwent endovascular treatment were analyzed. The distance between thrombus origin and internal carotid artery (ICA) bifurcation was measured on admission CTA. The modified thrombolysis in cerebral infarction (mTICI) grades 2<i>b</i> (>50% of distal branch filling) and 3 (complete) were considered as successful recanalization. Favorable outcome was defined by 3-month follow-up modified Rankin scale (mRs) score ≤2.</p><p><strong>Results: </strong>Successful recanalization was achieved in 24 (71%) of 34 consecutive patients included in this study. The M1 distance-to-thrombus was shorter among patients with successful recanalization (5.4 ± 5.4 mm) versus those without (11.3 ± 7.6 mm, <i>p</i> = 0.015). The successful recanalization rate was higher among patients with M1 distance-to-thrombus ≤6 mm (odds ratio: 8, 95% confidence interval: 1.37-46.81, <i>p</i> = 0.023) compared with those with distance-to-thrombus >6 mm. There was no significant correlation between M1 distance-to-thrombus and 3-month mRs (rho: 0.131, <i>p</i> = 0.461); however, the distance-to-thrombus negatively correlated with admission National Institutes of Health Stroke Scale (NIHSS) scores (rho: -0.350, p=0.043). On the other hand, successful recanalization and admission NIHSS score were the only independent predictors of favorable outcome.</p><p><strong>Conclusion: </strong>Shorter distance of M1 thrombus from ICA bifurcation is associated with higher rate of successful recanalization following endovascular treatment.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 3","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317287/pdf/jvin-9-3-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34769256","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":"The Effect of Diagnostic Catheter Angiography on Outcomes of Acute Ischemic Stroke Patients Being Considered for Endovascular Treatment.","authors":"Adnan I Qureshi,&nbsp;Muhammad A Saleem,&nbsp;Emrah Aytaç,&nbsp;Ahmed A Malik","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The risk of catheter-based angiograms alone (non-therapeutic angiogram that does not lead to therapeutic intervention) in acute ischemic stroke patients who are considered for endovascular treatment is not well studied.</p><p><strong>Methods: </strong>We compared the rates of neurological deterioration within 24 h; symptomatic intracranial hemorrhage (ICH) within 30 h; acute kidney injury (AKI) and major non-ICH within five days; and functional independence (defined by modified Rankin scale of 0-2) at three months among subjects who underwent a non-therapeutic catheter-based angiogram with subjects who did not undergo catheter-based angiogram in a multicenter clinical trial. Logistic regression analyses was performed to adjust for age, baseline Alberta stroke program early CT score (ASPECTS) strata (0-7 and 8-10), and baseline National Institutes of Health Stroke Scale (NIHSS) score strata (≤9, 10-19, and ≥20).</p><p><strong>Results: </strong>Compared with subjects who did not undergo any catheter-based angiogram (<i>n</i> = 222), 89 subjects who underwent a non-therapeutic catheter-based angiogram had similar adjusted rates of neurological deterioration [odds ratio (OR) = 1; 95% confidence interval (CI) 0.4-2.3; p = 1] and symptomatic ICH (OR = 0.4; 95% CI 0.1-1.8; <i>p</i> = 0.2). There was no difference in the adjusted rates of AKI, or non-ICH between the two groups. The rate of functional independence at three months was significantly higher among the patients who received a catheter-based angiogram (OR = 2; 95% CI 1.1-3.5; <i>p</i> = 0.016) after adjusting for potential confounders.</p><p><strong>Conclusion: </strong>Non-therapeutic catheter-based angiograms in acute ischemic stroke patients who are being considered for endovascular treatment do not adversely affect patient outcomes.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 3","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317292/pdf/jvin-9-3-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34769186","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":"Safety of Dual Antiplatelet Therapy After Carotid Endarterectomy for Prevention of Restenosis: A Single Center Experience.","authors":"Miguel A Barboza, José Chang, Alvaro Hernández, Emmanuel Martínez, Huberth Fernández, Gerardo Quirós, Johanna Salazar, Allan Ramos-Esquivel, Alberto Maud","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of recurrent carotid stenosis after carotid endarterectomy varies from 1% to 37% with only 0-8% symptomatic restenosis. Safety of short-term (30 days) dual-antiplatelet therapy has not been established in this type of procedure.</p><p><strong>Aims: </strong>To investigate the safety of dual antiplatelet therapy after carotid endarterectomy to prevent restenosis.</p><p><strong>Methods: </strong>We retrospectively identified all the patients who underwent carotid endarterectomy (symptomatic or asymptomatic) treated at our center between July 2010 and July 2013 according to local protocols. All patients received a dose of 100 mg of aspirin daily immediately after carotid endarterectomy, with subsequent 100 mg of aspirin daily for the rest of the study period, and some patients received 75 mg of Clopidogrel for 30 days starting immediately after surgical procedure (dual therapy group), assigned according to medical criteria. Duplex carotid ultrasound and clinical assessments were performed at 30 days and 1 year after the procedure.</p><p><strong>Results: </strong>A total of 44 patients (71.2 ± 7.9 years old; 77.2% symptomatic) were analyzed; 35 of them with dual therapy (79.54%). At 30 days, two patients from the mono-therapy group developed restenosis (22.2%), compared to none in dual therapy group (<i>p</i>=0.04). At one year follow-up, only one patient from the dual group showed restenosis (<i>p</i>=0.10). No deaths, major bleeding or new strokes were reported in both groups.</p><p><strong>Conclusions: </strong>Short-term dual antiplatelet therapy with aspirin and clopidogrel after carotid endarterectomy might be associated with a lower incidence of restenosis. This observation must be validated in a prospective trial.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 2","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967256","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":"Does Virtual Reality-based Kinect Dance Training Paradigm Improve Autonomic Nervous System Modulation in Individuals with Chronic Stroke?","authors":"Luciana Maria Malosá Sampaio, Savitha Subramaniam, Ross Arena, Tanvi Bhatt","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity and low resting heart rate variability (HRV) are associated with an increased cardiovascular deconditioning, risk of secondary stroke and mortality. Aerobic dance is a multidimensional physical activity and recent research supports its application as a valid alternative cardiovascular training. Furthermore, technological advances have facilitated the emergence of new approaches for exercise training holding promise, especially those methods that integrate rehabilitation with virtual gaming.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate cardiac autonomic modulation in individuals with chronic stroke post-training using a virtual reality - based aerobic dance training paradigm.</p><p><strong>Methods: </strong>Eleven community-dwelling individuals with hemiparetic stroke [61.7( ± 4.3) years] received a virtual reality-based dance paradigm for 6 weeks using the commercially available Kinect dance video game \"Just Dance 3.\" The training was delivered in a high-intensity tapering method with the first two weeks consisting of 5 sessions/week, next two weeks of 3 sessions/week and last two weeks of 2 sessions/week, with a total of 20 sessions. Data obtained for HRV analysis pre- and post-intervention consists of HRV for ten minutes in (1) supine resting position; (2) quiet standing. High-frequency (HF) power measures as indicators of cardiac parasympathetic activity, low-frequency (LF) power of parasympathetic-sympathetic balance and LF/HF of sympatho-vagal balance were calculated. YMCA submaximal cycle Ergometer test was used to acquire VO₂ max pre- and post-intervention. Changes in physical activity during dance training were assessed using Omran HJ-321 Tri-Axis Pedometer.</p><p><strong>Results: </strong>After training, participants demonstrated a significant improvement in autonomic modulation in the supine position, indicating an improvement in LF=48.4 ( ± 20.1) to 40.3 ( ± 8.0), <i>p</i>=0.03; HF=51.5 ( ± 19) to 59.7 ( ± 8), <i>p</i>= 0.02 and LF/HF=1.6 ( ± 1.9) to 0.8 ( ± 0.26), <i>p</i>=0.05]. Post-training the participants had significantly higher VO_2max. Number of steps during dance intervention significantly increased from the 1^st to the 20^th session (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>The current study is the first to assess the effect of a virtual reality-based aerobic dance training paradigm on HRV among individuals with chronic stroke. Given that the paradigm used in this study improves cardiac autonomic control, future studies should incorporate dance as an adjuvant therapy into clinical treatment program and assess its long-term efficacy.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 2","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72212229","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":"Use of Intra-aortic- Balloon Pump Counterpulsation in Patients with Symptomatic Vasospasm Following Subarachnoid Hemorrhage and Neurogenic Stress Cardiomyopathy.","authors":"Fawaz Al-Mufti,&nbsp;Nicholas Morris,&nbsp;Shouri Lahiri,&nbsp;William Roth,&nbsp;Jens Witsch,&nbsp;Iona Machado,&nbsp;Sachin Agarwal,&nbsp;Soojin Park,&nbsp;Philip M Meyers,&nbsp;E Sander Connolly,&nbsp;Jan Claassen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-aortic counterpulsation balloon pumps (IABPs) have been widely used to augment hemodynamics in critically ill patients with cardiogenic shock and have recently been proposed as a management strategy for subarachnoid hemorrhage (SAH) patients with neurogenic stress cardiomyopathy (NSC). Prior case series have described the use of IABP as a means to manage cardiogenic shock in this patient population; however, we sought to describe our experience with IABP as a means to wean vasopressor requirement while augmenting hemodynamics and maintaining pressures at goal.</p><p><strong>Methods: </strong>Five patients were identified from a single center, prospective, observational cohort study that received an IABP for the management of ischemia related to cerebral vasospasm in the setting of NSC. We evaluated all cases for efficacy of IABP in reducing vasopressor requirement, and complications.</p><p><strong>Results: </strong>Vasopressor requirements were reduced by a mean of 50% (range 25-65%) following IABPs placement within 24-48 h. There were no significant complications from IABPs. Out of the five patients, the outcome in three cases was favorable (mRS≤1). Two patients suffered delayed cerebral ischemia (DCI), one patient passed away due to severe sepsis, and one patient was left with severe disability. Only one patient required anticoagulation and that was for a preexisting deep venous thrombosis.</p><p><strong>Conclusion: </strong>The use of IABPs may be beneficial as an adjunctive therapy in SAH patients with concomitant symptomatic vasospasm and NSC.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 1","pages":"28-34"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925763/pdf/jvin-9-1-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34724068","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":"Small Intracranial Aneurysm Treatment Using Target (®) Ultrasoft (™) Coils.","authors":"Gaurav Jindal,&nbsp;Timothy Miller,&nbsp;Moronke Iyohe,&nbsp;Ravi Shivashankar,&nbsp;Vikram Prasad,&nbsp;Dheeraj Gandhi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>The introduction of small, soft, complex-shaped microcoils has helped facilitate the endovascular treatment of small intracranial aneurysms (IAs) over the last several years. Here, we evaluate the initial safety and efficacy of treating small IAs using only Target(®) Ultrasoft(™) coils.</p><p><strong>Materials and methods: </strong>A retrospective review of a prospectively maintained clinical database at a single, high volume, teaching hospital was performed from September 2011 to May 2015. IAs smaller than or equal to 5.0 mm in maximal dimension treated with only Target(®) Ultrasoft(™) coils were included.</p><p><strong>Results: </strong>A total of 50 patients with 50 intracranial aneurysms were included. Subarachnoid hemorrhage from index aneurysm rupture was the indication for treatment in 23 of 50 (46%) cases, and prior subarachnoid hemorrhage (SAH) from another aneurysm was the indication for treatment in eight of 50 (16%) cases. The complete aneurysm occlusion rate was 70% (35/50), the minimal residual aneurysm rate was 14% (7/50), and residual aneurysm rate was 16% (8/50). One intraoperative aneurysm rupture occurred. Three patients died during hospitalization from clinical sequelae of subarachnoid hemorrhage. Follow-up at a mean of 13.6 months demonstrated complete aneurysm occlusion in 75% (30/40) of cases, near complete occlusion in 15% (6/40) of cases, and residual aneurysm in 10% (4/40) of cases, all four of which were retreated.</p><p><strong>Conclusion: </strong>Our initial results using only Target(®) Ultrasoft(™) coils for the endovascular treatment of small intracranial aneurysms demonstrate initial excellent safety and efficacy profiles.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"9 1","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925766/pdf/jvin-9-1-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34724071","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}