Journal of Neuroimaging

2005

DOI: 10.1177/1051228405277343

|View full text |Cite

|

Sign up to set email alerts

|

Clinical and Angiographic Results of Dilatation Procedures for Symptomatic Intracranial Atherosclerotic Disease

Adnan I. Qureshi

¹

,

M. Fareed K. Suri

²

,

Amir M. Siddiqui³

et al.

Abstract: This single-center study demonstrates the feasibility and effectiveness (for secondary stroke prevention) of angioplasty and/or stent placement for treatment of ICAD.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Optimal Act For Neuroendovascular Procedures1

Procedural Anesthesia1

Anatomic Outcome Technical Success1

Citation Types

Supporting

0

Mentioning

3

Contrasting

0

Year Published

2009

2009

2024

2024

Publication Types

Select...

Article6

Relationship

Self Cite0

Independent6

Authors

Journals

Cited by 7 publications

(3 citation statements)

References 29 publications

Supporting

0

Mentioning

3

Contrasting

0

Order By: Relevance

“…Reported target ACT ranges have varied from 150 -200 seconds to 350 -400 seconds. [50][51][52][53] Data regarding the optimal ACT for neuroendovascular procedures are scant because testing methods and ACT goal ranges are not commonly reported. Most of the evidence available is based on experts' opinion and/or extrapolated from PCI literature.…”

Section: Optimal Act For Neuroendovascular Proceduresmentioning

confidence: 99%

Point-of-Care Testing for Anticoagulation Monitoring in Neuroendovascular Procedures

¹

,

²

,

³

2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY: POC testing is defined as diagnostic testing at or near the site of patient care. Rapid measurement of the intensity of anticoagulation and, more recently, platelet inhibition allows dose titration of adjuvant medications such a heparin and antiplatelet agents during neuroendovascular procedures. However, knowledge among practicing physicians regarding the pathophysiologic basis of these measurements and variations in knowledge about the differences among devices is often limited. This review discusses the role of anticoagulation in endovascular procedures and the currently available POC tests for anticoagulation monitoring. ABBREVIATIONS:ACT ϭ activated clotting time; Anti-Xa ϭ quantitative chromogenic heparin assay; aPTT ϭ activated partial thromboplastin time; AT ϭ antithrombin; CI ϭ confidence interval; GP IIb/IIIa ϭ glycoprotein IIb/IIIa; Hemonox-CT ϭ Hemonox clotting time; HIT ϭ heparin-induced thrombocytopenia; HMT ϭ Heparin Management Test; IV ϭ intravenous; LMWH ϭ low-molecularweight heparin; MI ϭ myocardial infarction; OR ϭ odds ratio; PCI ϭ percutaneous coronary intervention; POC ϭ point of care; UFH ϭ unfractionated heparin T hromboembolism ensues from activation of platelets and the coagulation cascade and is a major source of complications during endovascular procedures. Multiple studies have demonstrated accelerated platelet activation during coronary and cerebral angioplasty.1,2 The coagulation cascade (Fig 1) consists of a sequential conversion of a series of proenzymes, or inactive precursor proteins (zymogens) to active enzymes, resulting in the formation of thrombus. It can be divided into 3 pathways: the extrinsic pathway (tissue factor and factor VIIa), which is the primary activator of the cascade; the intrinsic pathway (factors XIIa, XIa, IXa, and VIIIa), which amplifies the cascade; and the common pathway (factor Xa, factor Va, and thrombin), which generates thrombin and fibrin.Vessel injury and the introduction of foreign bodies set off the coagulation cascade.3 Catheters and wires used in endovascular procedures are thrombogenic, independent of intimal injury.3 Traversing atherosclerotic lesions with guidewires and catheters can dislodge plaque or thrombus. Inflation of balloons can produce intimal cracks, flaps, or dissections, all of which act as thrombogenic surfaces.3 In vivo studies have demonstrated that platelets rapidly accumulate on the stent surface after placement, especially if the underlying artery is injured. 4 The role of fibrin and platelets in stent-related thrombosis has been confirmed in pathologic studies. 5Anticoagulants and antiplatelet agents are, therefore, essential for reducing the rate of thromboembolic complications. On the other hand, their use may increase the risk of bleeding complications. In this review, we will focus on anticoagulants and available POC devices that measure anticoagulation. Brief Overview of Anticoagulant MedicationsAnticoagulants reduce the activity of proteases in the coagulation cascade. On the basis of their mechanism of ac...

“…Reported target ACT ranges have varied from 150 -200 seconds to 350 -400 seconds. [50][51][52][53] Data regarding the optimal ACT for neuroendovascular procedures are scant because testing methods and ACT goal ranges are not commonly reported. Most of the evidence available is based on experts' opinion and/or extrapolated from PCI literature.…”

Section: Optimal Act For Neuroendovascular Proceduresmentioning

confidence: 99%

Point-of-Care Testing for Anticoagulation Monitoring in Neuroendovascular Procedures

¹

,

²

,

³

2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY: POC testing is defined as diagnostic testing at or near the site of patient care. Rapid measurement of the intensity of anticoagulation and, more recently, platelet inhibition allows dose titration of adjuvant medications such a heparin and antiplatelet agents during neuroendovascular procedures. However, knowledge among practicing physicians regarding the pathophysiologic basis of these measurements and variations in knowledge about the differences among devices is often limited. This review discusses the role of anticoagulation in endovascular procedures and the currently available POC tests for anticoagulation monitoring. ABBREVIATIONS:ACT ϭ activated clotting time; Anti-Xa ϭ quantitative chromogenic heparin assay; aPTT ϭ activated partial thromboplastin time; AT ϭ antithrombin; CI ϭ confidence interval; GP IIb/IIIa ϭ glycoprotein IIb/IIIa; Hemonox-CT ϭ Hemonox clotting time; HIT ϭ heparin-induced thrombocytopenia; HMT ϭ Heparin Management Test; IV ϭ intravenous; LMWH ϭ low-molecularweight heparin; MI ϭ myocardial infarction; OR ϭ odds ratio; PCI ϭ percutaneous coronary intervention; POC ϭ point of care; UFH ϭ unfractionated heparin T hromboembolism ensues from activation of platelets and the coagulation cascade and is a major source of complications during endovascular procedures. Multiple studies have demonstrated accelerated platelet activation during coronary and cerebral angioplasty.1,2 The coagulation cascade (Fig 1) consists of a sequential conversion of a series of proenzymes, or inactive precursor proteins (zymogens) to active enzymes, resulting in the formation of thrombus. It can be divided into 3 pathways: the extrinsic pathway (tissue factor and factor VIIa), which is the primary activator of the cascade; the intrinsic pathway (factors XIIa, XIa, IXa, and VIIIa), which amplifies the cascade; and the common pathway (factor Xa, factor Va, and thrombin), which generates thrombin and fibrin.Vessel injury and the introduction of foreign bodies set off the coagulation cascade.3 Catheters and wires used in endovascular procedures are thrombogenic, independent of intimal injury.3 Traversing atherosclerotic lesions with guidewires and catheters can dislodge plaque or thrombus. Inflation of balloons can produce intimal cracks, flaps, or dissections, all of which act as thrombogenic surfaces.3 In vivo studies have demonstrated that platelets rapidly accumulate on the stent surface after placement, especially if the underlying artery is injured. 4 The role of fibrin and platelets in stent-related thrombosis has been confirmed in pathologic studies. 5Anticoagulants and antiplatelet agents are, therefore, essential for reducing the rate of thromboembolic complications. On the other hand, their use may increase the risk of bleeding complications. In this review, we will focus on anticoagulants and available POC devices that measure anticoagulation. Brief Overview of Anticoagulant MedicationsAnticoagulants reduce the activity of proteases in the coagulation cascade. On the basis of their mechanism of ac...

“…Angioplasty or stent-assisted angioplasty of cerebral arteries has been performed successfully under general anesthesia 2,54,59,61,70,83,84,87,113,129 or local anesthesia. 2,60,61,83,91,96,97,114,119,131,132 General anesthesia has the advantage of maximal reduction of motion artifacts. Procedure times may be reduced using general anesthesia.…”

Section: Procedural Anesthesiamentioning

confidence: 99%

“…The postangioplasty stenosis grade defining technical success varies from Յ20% residual stenosis, 70 Յ30% residual stenosis, 96 but most commonly Յ50% residual stenosis. 2,54,58,60,68,94,119 Most importantly, technical success should be heralded by freedom from ipsilateral ischemic or hemorrhagic strokes in the distribution of the treated target stenosis.…”

Section: Anatomic Outcome Technical Successmentioning

confidence: 99%

Reporting Standards for Angioplasty and Stent-Assisted Angioplasty for Intracranial Atherosclerosis

¹

,

²

,

³

et al. 2009

View full text Add to dashboard Cite

Background and Purpose-Intracranial cerebral atherosclerosis causes ischemic stroke in a significant number of patients.Technological advances over the past 10 years have enabled endovascular treatment of intracranial atherosclerotic stenosis. The number of patients treated with angioplasty or stent-assisted angioplasty for this condition is increasing. Given the lack of universally accepted definitions, the goal of this document is to provide consensus recommendations for reporting standards, terminology, and written definitions when reporting clinical and radiological evaluation, technique, and outcome of endovascular treatment using angioplasty or stent-assisted angioplasty for stenotic and occlusive intracranial atherosclerosis. (PubMed) from January 1997 to December 2007 was conducted with the goal to identify published endovascular cerebrovascular interventional data in stenotic intracranial atherosclerosis that could be used as benchmarks for quality assessment. We sought to identify those risk adjustment variables that affect the likelihood of success and complications. This document offers the rationale for different clinical and technical considerations that may be important during the design of clinical trials for endovascular treatment of intracranial stenotic and occlusive atherosclerosis. Included in this guidance document are suggestions for uniform reporting standards for such trials. These definitions and standards are primarily intended for research purposes; however, they should also be helpful in clinical practice and applicable to all publications. Conclusion-In summary, the definitions proposed represent recommendations for constructing useful research data sets. Summary of Report-ThisThe intent is to facilitate production of scientifically rigorous results capable of reliable comparisons between and among similar studies. In some cases, the definitions contained here are recommended by consensus of a panel of experts in this writing group for consistency in reporting and publication. These definitions should allow different groups to publish results that are directly comparable. (Stroke. 2009;40:e348-e365.)Key Words: anatomy Ⅲ angiography Ⅲ interventional neuroradiology Ⅲ neuroradiology Ⅲ reporting standard Ⅲ reporting terminology Ⅲ stenting T he goal of this writing group is to provide consensus recommendations for the arteriographic evaluation and endovascular treatment of intracranial atherosclerosis. These criteria are aimed to design clinical trials, to provide uniformity of definitions for appropriate selection and stratification of patients, and to allow analysis and meta-analysis of reported data. This document must not be construed as defining standardof-care. However, these reporting standards are intended for use in research protocols rather than for quality assessment in individual practice. These definitions represent one set of consensus recommendations for constructing useful research data sets. These definitions do not represent the only data that are important or useful i...

Influence of angioplasty and stenting on intracranial artery stenosis: preliminary results of high-resolution vessel wall imaging evaluation

¹

,

²

,

³

et al. 2022

View full text Add to dashboard Cite

No abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Product

Browser Extension Assistant by scite Citation Statement Search Reference Check Visualizations Dashboards Explore Journals Explore Organizations Explore Funders Embedding Badge Embedding Citation Search Pricing

Resources

Blog Help & FAQ Accessibility Statement API Terms For Universities & Governments For Researchers For Publishers For Corporate, Pharma & Enterprise Author Marketing Become an Affiliate Get an organization trial or quote scite Data & Services

About

News & Press Careers Read our Paper Coverage

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Copyright © 2024 scite LLC. All rights reserved.

Made with 💙 for researchers

Part of the Research Solutions Family.