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        Fracture of a Flow Diverter in the Cervical Internal Carotid Artery Due to Eagle Syndrome

        Pfaff Johannes A. R.,Weymayr Friedrich,Killer-Oberpflazer Monika 대한신경중재치료의학회 2023 Neurointervention Vol.18 No.1

        In Eagle syndrome, elongated styloid processes may provoke internal carotid dissection and pseudoaneurysm causing stroke and data regarding possible complications or long-term results of pseudoaneurysm treatment using a flow diverter are limited. We report a case of a dissection-related pseudoaneurysm in the left cervical carotid artery treated by implantation of a flow diverter. Follow-up imaging of the flow diverter showed fracture of a continuous radiopaque marker at 3 months and fracture of a second continuous radiopaque marker at 7 months, while contrasting of the vessel was preserved. At the time of angiographic control (8 months after implantation), the flow diverter and the extracranial left internal carotid artery were occluded, and the patient did not experience any symptoms throughout the period.

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        Higher Blood Pressure during Endovascular Thrombectomy in Anterior Circulation Stroke Is Associated with Better Outcomes

        Slaven Pikija,Vladimir Trkulja,Christian Ramesmayer,Johannes S. Mutzenbach,Monika Killer-Oberpfalzer,Constantin Hecker,Nele Bubel,Michael Ulrich Füssel,Johann Sellner 대한뇌졸중학회 2018 Journal of stroke Vol.20 No.3

        Background and Purpose Reports investigating the relationship between in-procedure blood pressure (BP) and outcomes in patients undergoing endovascular thrombectomy (EVT) due to anterior circulation stroke are sparse and contradictory. Methods Consecutive EVT-treated adults (modern stent retrievers, BP managed in line with the recommendations, general anesthesia, invasive BP measurements) were evaluated for associations of the rate of in-procedure systolic BP (SBP) and mean arterial pressure (MAP) excursions to >120%/<80% of the reference values (serial measurements at anesthesia induction) and of the reference BP/weighted in-procedure mean BP with post-procedure imaging outcomes (ischemic lesion volume [ILV], hemorrhages) and 3-month functional outcome (modified Rankin Scale [mRS], score 0 to 2 vs. 3 to 6). Results Overall 164 patients (70.7% pharmacological reperfusion, 80.5% with good collaterals, 73.8% with successful reperfusion) were evaluated for ILV (range, 0 to 581 cm3) and hemorrhages (incidence 17.7%). Higher rate of in-procedure SBP/MAP excursions to >120% was independently associated with lower ILV, while higher in-procedure mean SBP/MAP was associated with lower odds of hemorrhages. mRS 0-2 was achieved in 75/155 (48.4%) evaluated patients (nine had missing mRS data). Higher rate of SBP/MAP excursions to >120% and higher reference SBP/MAP were independently associated with higher odds of mRS 0-2, while higher ILV was associated with lower odds of mRS 0-2. Rate of SBP/MAP excursions to <80% was not associated with any outcome. Conclusions In the EVT-treated patients with BP managed within the recommended limits, a better functional outcome might be achieved by targeting in-procedure BP that exceeds the preprocedure values by more than 20%.

      • KCI등재

        Projected Numbers of Ischemic Strokes Recorded in the Austrian Stroke-Unit Registry from 2012 to 2075

        Wolfgang Hitzl,Eugen Trinka,Leonard Seyfang,Sebastian Mutzenbach,Katharina Stadler,Slaven Pikija,Monika Killer,Erasmia Broussalis 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.4

        Background and Purpose This study analyzed the number of patients with ischemic strokes recorded in the Austrian Stroke-Unit Registry with the aim of projecting this number from 2012 to 2075 and to highlight that the Austrian health system will face a dramatic in¬crease in older patients within the next few decades. Methods Current demographic information was obtained from EUROSTAT, and informa¬tion on age- and sex-stratified 1-year incidence rates of ischemic stroke were obtained from the Austrian Stroke-Unit Registry. Sensitivity analysis was performed by analyzing the pro¬jections based on predicted ageing, main, and growth population scenarios, and with stratifi¬cation by age and gender. Results The total number of ischemic strokes recorded in the Austrian Stroke-Unit Regis¬try was 8,690 in 2012 and is expected to increase to 15,826, 15,626, or 18,134 in 2075 accord¬ing to the ageing, main, and growth scenarios, respectively. The corresponding numbers of patients are projected to increase or decrease within different age strata as follows (100%=num¬ber of registered ischemic strokes in 2012): 0–40 years, 100%/99% (males/females); 40–50 years, 83%/83%; 50–60 years, 98%/97%; 60–70 years, 126%/119%; 70–80 years, 159%/139%; 80–90 years, 307%/199%; and 90+ years, 894%/413%. Conclusions The ageing population in Austria will result in the number of patients increasing considerably from 2012 to 2075, to 182%, 180%, or 208% (relative to 100% in 2012) according to the ageing, main, and growth scenarios, respectively; the corresponding value among those aged 80+ years is 315%, 290%, or 347%. These figures demonstrated the importance of improving pri¬mary preventive measures. The results of this study should provide a basis for discussions among health-care professionals and economists to face the future large financial burden of ischemic stroke on the Austrian health system.

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