Progression of carotid near-occlusion to complete occlusion: related factors and clinical implications.

Background: The clinical consequences and factors related to the progression from a carotid near-occlusion (CNO) to a complete occlusion are not well established. Our aim is to describe the rate, predictive factors and clinical implications of the progression to complete carotid occlusion (PCCO) in a population of patients with symptomatic CNO.

Methods: We conducted a multicenter, nationwide, prospective study from January 2010 to May 2016.

Association of High Serum Levels of Growth Factors with Good Outcome in Ischemic Stroke: a Multicenter Study.

The main objective of this research work was to study the association of serum levels of growth factors (GF) and SDF-1α with the functional outcome and reduction of lesion volume in ischemic stroke patients. In this multicenter study, 552 patients with non-lacunar stroke (male, 62.1%; mean age, 68.

MRI predicts intracranial hemorrhage in patients who receive long-term oral anticoagulation.

Objective: We tested the hypothesis that the risk of intracranial hemorrhage (ICH) in patients with cardioembolic ischemic stroke who are treated with oral anticoagulants (OAs) can be predicted by evaluating surrogate markers of hemorrhagic-prone cerebral angiopathies using a baseline MRI.

Methods: Patients were participants in a multicenter and prospective observational study. They were older than 64 years, had a recent cardioembolic ischemic stroke, and were new users of OAs.

Neutrophil extracellular traps are increased in patients with acute ischemic stroke: prognostic significance.

Neutrophil extracellular traps (NETs) are networks of DNA, histones, and proteolytic enzymes produced by activated neutrophils through different mechanisms. NET formation is promoted by activated platelets and can in turn activate platelets, thus favoring thrombotic processes. NETs have been detected in venous and arterial thrombosis, but data in stroke are scarce.

Circulating MicroRNAs as Novel Biomarkers of Stenosis Progression in Asymptomatic Carotid Stenosis.

Background And Purpose: Progression of asymptomatic carotid artery stenosis (ACAS) in patients with >50% luminal narrowing is considered a potential risk factor for ischemic stroke; however, subclinical molecular biomarkers of ACAS progression are lacking. Recent studies suggest a regulatory function for several microRNAs (miRNAs) on the evolution of carotid plaque, but its role in ACAS progression is mostly unknown. The aim of our study was to investigate a wide miRNA panel in peripheral blood exosomes from patients with ACAS to associate circulating miRNA expression profiles with stenosis progression.

Combination of Thrombolysis and Statins in Acute Stroke Is Safe: Results of the STARS Randomized Trial (Stroke Treatment With Acute Reperfusion and Simvastatin).

Background And Purpose: The STARS trial (Stroke Treatment With Acute Reperfusion and Simvastatin) was conducted to demonstrate the efficacy and safety of simvastatin treatment in acute stroke.

Methods: STARS07 was a multicentre, phase IV, prospective, randomized, double-blind, placebo-controlled trial. Patients with Acute ischemic stroke recruited within 12 hours from symptom onset were randomized to oral simvastatin 40 mg or placebo, once daily for 90 days.

Downstream Migration and Fragmentation of a Spontaneous Calcific Embolus after Thrombolysis in a Patient with Ischemic Stroke.

We report a successful treatment experience with systemic thrombolysis in a patient with acute ischemic stroked caused by spontaneous calcific embolus, which resulted in clinical improvement and embolus fragmentation.

Short- and long-term outcomes in non-aneurysmal non-perimesencephalic subarachnoid hemorrhage.

Objective: Our aim was to assess the short- and long-term prognosis in patients suffering from non-aneurysmal non-perimesencephalic SAH (Na-NPM-SAH).

Methods: Based on admission CT-scan, SAH was categorized as perimesencephalic (PM) or non-perimesencephalic (NPM). Based on digital subtraction angiography (DSA) results, patients were classified as normal DSA (Na-SAH) or aneurysmal SAH (aSAH).

Characterisation of DWI-MRI confirmed cerebral infarcts in patients with subarachnoid haemorrhage and their association with MMP-9 levels.

Objectives: It has been suggested that metalloproteinase-9 (MMP-9) could predict the onset of cerebral vasospasm after subarachnoidal haemorrhage (SAH). The aim of this study was to analyse, in patients with SAH, the difference between patients with MRI ischaemic infarcts and patients without, and to investigate the role of metalloproteases as a prognostic factor for ischaemic infarcts.

Methods: Sixty eight consecutive patients with SAH and diffusion-weighted magnetic resonance imaging (DWI-MRI) done 3 weeks after SAH.

Volumetric assessment of the carotid bifurcation: an alternative concept to stenosis grading.

Background: To design a volumetric method for the assessment of carotid atheromatosis (CA) based on computed tomography (CT) angiography and three-dimensional (3D) reconstructions; to analyze the accuracy and optimal threshold values to differentiate between equivalent degrees of severity by duplex scanning and CT angiography (two-dimensional maximum intensity projection [2D MIP]; internal carotid artery stenosis [ICS] <50%; ICS >50%); and to assess the method's suitability to detect progression of CA.

Design: suitability and accuracy of a new diagnostic method.

Population: 90 carotid bifurcations (45 patients) were assessed with duplex scanning and CT angiography, and reevaluated after 12 ± 2 months follow-up.

Assessment of platelet function in acute ischemic stroke patients previously treated with aspirin.

Background: Platelet inhibition measured by platelet function tests could be critical to understand the reasons for early recurrence and to guide therapeutic recommendations. We assess the platelet function during the acute phase of ischemic stroke in patients pretreated with aspirin who continue their treatment with aspirin only, are started on clopidogrel only, or add clopidogrel to aspirin.

Methods: Sixty-four patients were taking aspirin before the stroke.

Red blood cell distribution width in patients with cryptogenic stroke.

Background: There is no information about a possible association of red blood cell distribution width (RDW) with cryptogenic stroke (CS). We aimed to analyze the association of RDW with CS.

Patients And Methods: One hundred and sixty-three patients with CS were included along with 186 healthy controls.

TXA2 synthesis and COX1-independent platelet reactivity in aspirin-treated patients soon after acute cerebral stroke or transient ischaemic attack.

Introduction: The pharmacological target of aspirin is the inhibition of cyclooxygenase-1 (COX1) and thromboxane-A2 (TX) synthesis. Very few data are available on TX assessment in patients with stroke. We studied platelet TX synthesis, COX1-independent platelet reactivity, the influence of platelet-erythrocyte interactions and the potential association between platelet responses and the severity of stroke, evaluated with a clinical score (NIHSS).

Diabetes does not affect outcome of symptomatic carotid stenosis treated with endovascular techniques.

Background: The influence of diabetes on carotid revascularization techniques is controversial, with few data regarding angioplasty and stenting (CAS). Our purpose was to analyze whether its presence constitutes a risk factor for poor outcome of patients with carotid stenosis treated with CAS.

Methods: We compared 30-day and long term morbidity and mortality, as well as restenosis rates, of non diabetic and diabetic patients with symptomatic carotid stenosis treated with endovascular techniques.

Embolism and impaired washout: a possible explanation of border zone strokes in hypereosinophilic syndrome.

We describe 4 patients with stroke caused by hypereosinophilic syndrome, all of whom presented with border zone infarcts, and discuss the possible underlying mechanism. Cardioembolism (endomiocardial fibrosis) would coexist with impaired washout (perfusion disturbance due to high eosinophil count and/or eosinophil-derived substances), explaining the watershed characteristics of the infarcts.

The study of deep brain structures by transcranial duplex sonography and imaging resonance correlation.

Transcranial duplex sonography (TCS) currently provides us with images of deep brain structures with sufficient resolution. We chose 2 sonographic quantitative parameters: the diameter of the third ventricle and a measurement not used by TCS to date, the midbrain area. Their reliability and reproducibility were assessed using magnetic resonance imaging (MRI) as the reference.

Late clinical and radiological complications of stereotactical radiosurgery of arteriovenous malformations of the brain.

Introduction: Post-radiation injury of patients with brain arteriovenous malformations (AVM) include blood-brain barrier breakdown (BBBB), edema, and necrosis. Prevalence, clinical relevance, and response to treatment are poorly known. We present a series of consecutive brain AVM treated with stereotactic radiosurgery describing the appearance of radiation injury and clinical complications.

Postradiosurgery hemorrhage rates of arteriovenous malformations of the brain: influencing factors and evolution with time.

Background And Purpose: The long-term benefit of radiosurgery of brain arteriovenous malformations (AVM), especially nonhemorrhagic cases, is controversial. We calculated hemorrhage rates pre- and posttreatment and analyzed the risk factors for bleeding based on cases followed at our site.

Methods: One hundred eight patients, age 36 ± 17 years, 56 men.

Long-term outcome in patients with carotid artery stenting and contralateral carotid occlusion: a single neurovascular center prospective analysis.

Introduction: The aim of this study was to analyze the clinical features and early and late outcome of patients treated with carotid artery stenting for carotid stenosis with occlusion of the contralateral vessel (CAS-CCO), and compare them to patients without occlusion (CAS-NO).

Methods: From 1999 through 2010, 426 patients with 479 procedures were prospectively recorded, 61 patients (14.3%) CAS-CCO, and 365 patients CAS-NO.

[Long-term development of carotid stenosis treated by endovascular means: a prospective study in a neurovascular unit].

Aims: Even today, unlike endarterectomy, long-term development in carotid angioplasty has still not been well defined. The aim of this study is to describe both the short- and long-term development and the rate of restenosis in a consecutive series of patients with carotid stenosis who underwent endovascular treatment at the Hospital Universitario La Fe; a distinction is made between patients with and without symptoms.

Patients And Methods: From 1999 to 2010, 426 patients were submitted to a carotid angioplasty (25.

[In-hospital ischemic strokes in patients admitted to Cardiology and Cardiac Surgery departments. Multi-centre registry].

Background And Objective: Patients admitted to Cardiology and Cardiac Surgery Departments have an increased risk of ischemic stroke (IS). We analyzed clinical characteristics, quality of neurological care and mortality of in-hospital strokes (IHS) in these departments.

Patients And Method: Prospective registry of in-hospital ISs in Cardiology and Cardiac Surgery in 13 Spanish hospitals during 2008.

Influence of COX-inhibiting analgesics on the platelet function of patients with subarachnoid hemorrhage.

Background: Platelet function of patients with subarachnoid hemorrhage (SAH) may play an important part in both rebleeding and delayed cerebral ischemia, but little is known about aggregation pathways during the acute phase of stroke. Analgesics are used regularly in the first days after bleeding, and some can potentially inhibit the cyclooxygenase (COX) enzyme. We examined the platelet function of patients with SAH in order to describe their basal situation and determine whether the administration of intravenous nonsteroidal antiinflammatory drugs (NSAIDs) affected platelet aggregation.