Missed cerebrovascular events during prolonged sedation for COVID-19 pneumonia

The subclavian steal effect indicates atherosclerotic disease of the supraaortic vessels but rarely causes cerebrovascular events in itself. Noninvasive imaging providing detailed anatomic as well as hemodynamic information would therefore be desirable. From a group of 25 consecutive patients referred for MR angiography, four with absent or highly attenuated signal in one of the vertebral arteries on 3D multislab time-of-flight MR angiography were selected to undergo 3D time-resolved contrast-enhanced MR angiography. The time-resolved 3D contrast series (source images and MIPs) were evaluated visually and by graphic analysis of time-intensity curves derived from the respective V1 and V3 segments of both vertebral arteries on the source images. In two cases with high-grade proximal left subclavian stenosis, time-resolved 3D ce-MRA was able to visualise retrograde contrast filling of the left VA. There was a marked delay in time-to-peak between the left and right V1 segments in one case and a shallower slope of enhancement in another. In the other two cases, there was complete or collateralised segmental occlusion of the VAs.

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MRI-plaqueimaging detects carotid plaques with a high risk for future cerebrovascular events

Aktuelle Neurologie ◽

10.1055/s-0029-1238332 ◽

2009 ◽

Vol 36 (S 02) ◽

Author(s):

L Esposito ◽

S Sadikovic ◽

R Feurer ◽

D Sepp ◽

C Winkler ◽

...

Keyword(s):

High Risk ◽

Carotid Plaques ◽

Cerebrovascular Events

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Assessment of quality of life in patients with the effects of transient ischemic stroke

East European Journal of Neurology ◽

10.33444/2411-5797.2016.6(12).37-39 ◽

2016 ◽

pp. 37-39

Author(s):

A. Babirad

Keyword(s):

Quality Of Life ◽

Ischemic Stroke ◽

Large Scale ◽

Cerebrovascular Diseases ◽

Control Measures ◽

Sociological Research ◽

Cerebrovascular Events ◽

Sf 36 ◽

Angioplasty And Stenting

Cerebrovascular diseases are a problem of the world today, and according to the forecast, the problem of the near future arises. The main risk factors for the development of ischemic disorders of the cerebral circulation include oblique and aging, arterial hypertension, smoking, diabetes mellitus and heart disease. An effective strategy for the prevention of cerebrovascular events is based on the implementation of large-scale risk control measures, including the use of antiagregant and anticoagulant therapy, invasive interventions such as atheromectomy, angioplasty and stenting. In this connection, the efforts of neurologists, cardiologists, angiosurgery, endocrinologists and other specialists are the basis for achieving an acceptable clinical outcome. A review of the SF-36 method for assessing the quality of life in patients with the effects of transient ischemic stroke is presented. The assessment of quality of life is recognized in world medical practice and research, an indicator that is also used to assess the quality of the health system and in general sociological research.

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Controlling Hypertension and Stroke Prevention – From Guideline to Clinical Practice

Asia Pacific Cardiology ◽

10.15420/apc.2011:3:1:30 ◽

2011 ◽

Vol 3 (1) ◽

pp. 30

Author(s):

Anding Xu ◽

Zefeng Tan ◽

◽

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Clinical Trials ◽

Clinical Practice ◽

Stroke Prevention ◽

Modifiable Risk Factors ◽

Cerebrovascular Events

Hypertension is the most important of the prevalent and modifiable risk factors for stroke. Based on evidence, blood pressure (BP) lowering is recommended in guidelines for the prevention of stroke. However, there are still some uncertainties in the guidelines for controlling BP and preventing stroke in patients with previous cerebrovascular events, such as the goal BP, who to treat and which class of BP-lowering drugs to use. This article discusses these questions by reviewing guidelines and corresponding clinical trials, with the aim of reducing the gap between guidelines and clinical practice.

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Chronic Mechanical Circulatory Support for Patients with End-stage Heart Failure as a Definitive Treatment Option

European Cardiology Review ◽

10.15420/ecr.2010.8.2.22 ◽

2010 ◽

Vol 6 (4) ◽

pp. 22

Author(s):

Patrycja Ganslmeier ◽

Christof Schmid ◽

◽

Keyword(s):

Heart Failure ◽

Mechanical Circulatory Support ◽

Definitive Treatment ◽

Circulatory Support ◽

Randomized Evaluation ◽

Fda Approval ◽

Cerebrovascular Events ◽

Device Placement ◽

End Stage Heart Failure ◽

End Stage

Mechanical circulatory support for end-stage heart failure has become routine and is now increasingly used as definitive treatment. Several small devices qualify for this purpose, but only a few have gained US Food and Drug Administration (FDA) approval as yet. Several studies, including the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study, the Investigation of Non-transplant-Eligible Patients Who Are Inotrope Dependent (INTrEPID) and the HeartMate (HM) II trial have confirmed a significantly improved quality of life and functional capacity after device placement. However, cerebrovascular events, infection and device malfunction still pose a considerable risk to patients and hinder widespread use.

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Clinical Implications of the SYNTAX Study

Interventional Cardiology Review ◽

10.15420/icr.2009.4.1.48 ◽

2009 ◽

Vol 4 (1) ◽

pp. 48 ◽

Cited By ~ 1

Author(s):

Patrick Serruys ◽

Scot Garg ◽

◽

Keyword(s):

Percutaneous Coronary Intervention ◽

De Novo ◽

Artery Bypass ◽

Bypass Graft ◽

Coronary Intervention ◽

Syntax Score ◽

Cerebrovascular Events ◽

Percutaneous Coronary ◽

Syntax Study ◽

Better Than

Recent years have seen an ongoing debate as to whether coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) is the most appropriate revascularisation strategy for patients with coronary heart disease (CAD). The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) study was conducted with the intention of defining the specific roles of each therapy in the management of de novo three-vessel disease or left main CAD. Interim results after 12 months show that PCI leads to significantly higher rates of major adverse cardiac or cerebrovascular events compared with CABG (17.8 versus 12.4; p=0.002), largely owing to increased rates of repeat revascularisation. However, CABG was much more likely to lead to stroke. Interestingly, categorisation of patients by severity of CAD complexity according to the SYNTAX score has shown that there are certain patients in whom PCI can yield results that are comparable to, if not better than, those achieved with CABG. Careful clinical evaluation and comprehensive assessment of CAD severity, alongside application of the SYNTAX score, can aid practitioners in selecting the most suitable therapy for each individual CAD patient.

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Stroke Prophylaxis by Percutaneous Closure of Patent Foramen Ovale and Left Atrial Appendage

Interventional Cardiology Review ◽

10.15420/icr.2011.6.1.67 ◽

2011 ◽

Vol 6 (1) ◽

pp. 67

Author(s):

Antonio L Bartorelli ◽

Claudio Tondo ◽

◽

Keyword(s):

Left Atrial ◽

Patent Foramen Ovale ◽

Stroke Risk ◽

Left Atrial Appendage ◽

Cryptogenic Stroke ◽

Atrial Appendage ◽

Foramen Ovale ◽

Percutaneous Procedures ◽

Cerebrovascular Events

Innovative percutaneous procedures for stroke prevention have emerged in the last two decades. Transcatheter closure of the patent foramen ovale (PFO) is performed in patients who suffered a cryptogenic stroke or a transient ischaemic attach (TIA) in order to prevent recurrence of thromboembolic events. Percutaneous occlusion of the left atrial appendage (LAA) has been introduced to reduce stroke risk in patients with atrial fibrillation (AF). The role of PFO and LAA in the occurrence of cerebrovascular events and the interventional device-based therapies to occlude the PFO and LAA are discussed.

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