Conclusion A lower dose of ticagrelor (45 mg twice daily) appears to be a safe and effective in this small cohort of patients who are resistant to clopidogrel per P2Y 12 testing and who have increased risk of ischemic or hemorrhagic strokes due to neurovascular pathologies and implants. Further randomized studies are required to confirm these findings.
SCG, using a Micro-Infusion Device for transmural drug delivery. Methods Eight SCGs in four Yorkshire swine were surgically identified. After confirming appropriate sympathetic-mediated intracranial vasoconstriction response with SCG stimulation, an endovascular Micro-Infusion Device was used for transmural targeting of the SCG and delivery of 1.5-2mL of 1% lidocaine-contrast mixture to the perivascular space. (figure 1) Digital subtraction angiography was obtained at: 1) baseline; 2) with SCG stimulation; and 3) after lidocaine delivery to the SCG using the Micro-Infusion Device with concurrent SCG stimulation. Vessel diameters were measured and compared.Results Stimulation of the SCG resulted in significant ipsilateral vasoconstriction response in the cervico-cranial vasculature. Endovascular transmural delivery of lidocaine to the SCG and carotid perivascular tissue using the Micro-Infusion Device successfully inhibited sympathetic-mediated vasoconstriction despite subsequent SCG stimulation in all eight cervico-cranial vasculatures. All measured vessel diameter means were within 13% of, and non-statistically different from baseline measurements. Conclusions We demonstrate a novel endovascular technique of transmural delivery of lidocaine to the SCG and carotid artery perivascular tissues to inhibit sympathetic mediated cerebral vasospasm. These results suggest promising translation to humans for clinical use in patients suffering from cerebral vasospasm.
T-test)), although histological healing score was significantly higher in the experimental group (11.5±2.12 vs. 4.5±2.4, p=0.02) (figure 1). Conclusions MSC-derived EVs as an adjunct to endovascular coiling may improve the histological healing scores of aneurysms, potentially reducing the risk of aneurysm recurrence after endovascular coiling. Additional studies are needed to more rigorously investigate this effect.
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