scholarly journals Rotational vertebral artery occlusion: Mechanisms and long-term outcome

2013 ◽  
Vol 333 ◽  
pp. e175
Author(s):  
K.-D. Choi ◽  
J.-H. Choi ◽  
J.-D. Seo ◽  
H.-J. Cho ◽  
S.-H. Kim ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Artery Occlusion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vertebral Artery Occlusion

The Comparison of STA-MCA Bypass and BMT for Symptomatic Internal Carotid Artery Occlusion Disease A Systematic Review and Meta-analysis of Long-term Outcome

2020 ◽  
Author(s):  
Xinyu Yang ◽  
Shifei Cai ◽  
Hao Fan ◽  
Chao Peng ◽  
Yuzhang Wu
Keyword(s):  
Carotid Artery ◽  
Assessment Tool ◽  
Statistical Significance ◽  
Superficial Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Symptomatic Carotid

Abstract Background: Superficial temporal artery (STA) - middle cerebral artery (MCA) bypass surgery now being widely used in moyamoya disease, and its therapeutic value in SICAO remains divergent. Methods: A systematic search was performed in PUBMED, EMBASE and Cochrane Databases in Feb.2020, and updated in Jun.2019. We have strict inclusion and exclusion criteria. Cochrane Bias Risk Assessment Tool was used to assess the quality of included RCTs. Review Manager 5.3 was used for analysis results in terms of comparing the STA-MCA bypass and BMT. For dichotomous variable outcomes, Risk Ratio (RRs) and 95% confidence intervals (95%CIs) were calculated for the assessment.Results: The total patient cohort consisted of 2419 patients, of whom 1188(49.1%) patients had been grouped in STA-MCA bypass, 1231(50.9%) patients had divided into BMT group. Mean follow-up of including patients was 29 months. The RRs of the seven studies was 1.01, and the 95% confidence interval was .89-1.15, with statistical significance, Z=.13, P=.89, sustaining that STA-MCA bypass was not superior to BMT in symptomatic carotid artery occlusion disease.Conclusion: STA-MCA bypass and BMT were associated with similar rates of a composite of long-term stroke. And the risk of long-term overall stroke was mildly higher with BMT. At present, each patient should receive more precise treatment, by reasonably assess the individual differences of each patient to reduce the recurrence rate of stroke.

Long-Term Outcome of Tubridge Flow Diverter(S) in Treating Large Vertebral Artery Dissecting Aneurysms—A Pilot Study

2016 ◽  
Vol 27 (3) ◽  
pp. 345-350 ◽  
Author(s):  
Y.-B. Fang ◽  
W.-L. Wen ◽  
P.-F. Yang ◽  
Y. Zhou ◽  
Y.-N. Wu ◽  
...  
Keyword(s):  
Pilot Study ◽  
Vertebral Artery ◽  
Flow Diverter ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dissecting Aneurysms

Long-term Angiographic and Clinical Outcome Following Stenting by Flow Reversal Technique for Chronic Occlusions Older Than 3 Months of the Cervical Carotid or Vertebral Artery

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Tomonori Iwata ◽  
Takahisa Mori ◽  
Hiroyuki Tajiri ◽  
Yuichi Miyazaki ◽  
Masahito Nakazaki
Keyword(s):  
Clinical Outcome ◽  
Vertebral Artery ◽  
Clinical Investigation ◽  
Flow Reversal ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Hemodynamic Compromise ◽  
Ischemic Attack

Abstract BACKGROUND Long-term angiographic and clinical outcome following stenting by flow reversal technique (FRT) for chronic occlusions (COs) of the cervical internal carotid artery (ICA) or vertebral artery (VA) is unknown. OBJECTIVE The aim of our retrospective study was to investigate the feasibility, safety, and long-term outcome of stenting by FRT for COs of the cervical ICA or VA. METHODS Included for analysis were patients (1) who underwent stenting for COs of the ICA or VA older than 3 months by FRT, and (2) who finished at least 1-year follow-up angiographic and clinical investigation. Criteria of stenting for CO in the ICA or VA were patients (1) who experienced minor strokes, a transient ischemic attack, or transient symptoms probably due to hemodynamic compromise or insufficiency, (2) angiographic complete occlusion of the ICA or VA, and (3) occlusion limited in the cervical area of the affected artery. RESULTS During the study period, 6 patients underwent stenting by FRT for cervical COs successfully, ICAs in 4 cases and VAs in 2 cases. The prestenting angiographically estimated occlusion length ranged from 50 to 130 mm. Total length of the deployed stents ranged from 30 to 108 mm. No complications occurred during the periprocedural period. Neither transient ischemic events nor restenosis has occurred during the follow-up period. CONCLUSION COs of the cervical carotid or vertebral arteries older than 3 months can be opened safely with FRT, and 1-year angiographic and long-term clinical outcome is favorable.

Abstract TP98: Aging-Related Impairment in Post-Ischemic O-GlcNAcylation Activation Critically Contributes to Stroke Outcome

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Zhuoran Wang ◽  
Xuan Li ◽  
Ulrike Hoffmann ◽  
Huaxin Sheng ◽  
Wei Yang
Keyword(s):  
Artery Occlusion ◽  
Stroke Outcome ◽  
Term Outcome ◽  
Hexosamine Biosynthetic Pathway ◽  
Long Term Outcome ◽  
Aged Brain ◽  
Xbp1 Mrna ◽  
The Unfolded Protein Response

Introduction: Activity of the unfolded protein response (UPR) declines with age. The most conserved UPR branch is mediated by inositol- requiring enzyme-1 (IRE1). Once activated, IRE1 is converted to an endonuclease that splices X-box binding protein-1 (Xbp1) mRNA, leading to production of a new 54-kDa protein, XBP1s. XBP1s was recently shown to be capable of up-regulating expression of all major hexosamine biosynthetic pathway (HBP) enzymes. HBP generates UDP-GlcNAc, the sugar donor for O-GlcNAc modification (O-GlcNAcylation). These pathways together form the IRE1/XBP1s/HBP/O-GlcNAc axis. Our previous data demonstrated a pivotal role of this axis in stroke outcome, especially in the aged brain. Here, we expanded on our previous findings and further elucidated that aging-related impairment in post-ischemic O-GlcNAcylation activation critically contributes to stroke outcome. Methods: Permanent and transient middle cerebral artery occlusion (MCAO) surgeries were performed on young and aged animals. Conditional XBP1 transgenic (XBP1s-TG) and knockout (Xbp1-cKO) mice were used to determine the role of the XBP1 branch in stroke outcome. Thiamet-G was used to increase O-GlcNAcylation. Short- and long-term stroke studies were conducted. Functional outcome was evaluated by various behavioral tests. Results and Conclusions: In line with our previous data, XBP1s-TG mice exhibited improved stroke outcome, and boosting O-GlcNAcylation with thiamet-G rescued worse stroke outcome observed in Xbp1-cKO mice. Moreover, intervention with thiamet-G to enhance O-GlcNAcylation in the brain improved not only long-term outcome after transient MCAO in young mice, but also long-term functional recovery after permanent MCAO in aged rats, likely due to its rescue effect on impaired O-GlcNAcylation activation in the aged brain. Finally, we discovered that UDP-GlcNAc production under the physiologic state and after ischemia was compromised in the aged brain, which constitutes a potential mechanism responsible for impaired O-GlcNAcylation activation after stroke. Together, the findings strengthen our notion that targeting pro-survival pathways that are activated in the young, but not the aged, ischemic brain is a new promising therapeutic strategy in stroke.

Favorable Long-Term Outcomes for Positional Vertebral Artery Occlusion with Treatment Strategy Prioritizing Spinal Fusion Surgery

2018 ◽  
Vol 114 ◽  
pp. e792-e799 ◽  
Author(s):  
Yasuhiro Takeshima ◽  
Fumihiko Nishimura ◽  
Ichiro Nakagawa ◽  
Yasushi Motoyama ◽  
Young-Su Park ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Spinal Fusion ◽  
Treatment Strategy ◽  
Artery Occlusion ◽  
Long Term Outcomes ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Vertebral Artery Occlusion
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