The Experts below are selected from a list of 294 Experts worldwide ranked by ideXlab platform
Louis R. Caplan - One of the best experts on this subject based on the ideXlab platform.
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Vertebral Artery Compression Syndrome.
Frontiers in Neurology, 2019Co-Authors: Qi Li, Wen-song Yang, Stephen M. Davis, Louis R. CaplanAbstract:Objective: We aim to propose the term “vertebral Artery Compression syndrome” to describe a group of patients with a variety of clinical symptoms caused by vertebral Artery Compression of the medulla or spinal cord. Methods: We conducted the prospective case study in a university teaching hospital. Eleven patients who fulfilled the diagnostic criteria of vertebral Artery Compression syndrome and 22 age- and sex- matched controls were recruited. Clinical presentation and radiological findings of patients with vertebral Artery Compression syndrome were assessed and recorded. The basilar Artery diameter was measured at the midpons level on T2 weighted MR images and compared between both groups. Results: Medullary Compression was observed in 10 of 11 patients.The most common clinical presentation is dizziness, vertigo, imbalance or ataxia followed by limb weakness. Cervical spinal cord Compression was observed in one patient who presented with neck pain and left leg weakness. The mean basilar Artery diameter was similar between patients and controls (3.95±0.41 mm vs 3.81±0.43mm). Conclusions: Vertebral Artery Compression of medulla and spinal cord may cause various clinical symptoms even in patients without basilar Artery dolichoectasia. Future studies are needed to further clarify the prevalence, natural history and treatment of this condition.
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vertebral Artery Compression of the medulla
JAMA Neurology, 2006Co-Authors: Sean I Savitz, Michael Ronthal, Louis R. CaplanAbstract:BACKGROUND: Intracranial arteries in the subarachnoid space may compress the brain parenchyma and cranial nerves. Most arterial compressive lesions have been attributed to dolichoectasia in the vertebral-basilar system, and prior reports have concentrated on the pressure effects of basilar Artery ectasia. Much less is known about vertebral Artery Compression of the medulla. OBJECTIVE: To describe a series of patients with vertebral arteries compressing the medulla oblongata. DESIGN: Prospective case studies. SETTING: Tertiary care center. PATIENTS: Nine symptomatic patients, 4 men and 5 women, between the ages of 32 and 79 years. MAIN OUTCOME MEASURES: Clinical phenomena, radiographic findings, treatment, and outcomes. RESULTS: We found that Compression most commonly occurs at the ventrolateral surface. The clinical features can be transient or permanent and are predominantly motor and cerebellar or vestibular, but a poor correlation exists between the clinical findings and the severity or extent of impingement. The vertebral arteries were angulated, tortuous, or dilated but not necessarily dolichoectatic to cause obvious indentation. Seven patients were treated with antiplatelets and anticoagulants or analgesics, whereas 2 underwent microvascular deCompression, resulting in temporary or no relief. One surgical patient developed cranial nerve complications. Among the medically treated patients, none had progression of deficits, and those with single episodes had no recurrence of symptoms. CONCLUSION: This study is the largest collection, to our knowledge, of patients with medullary vascular Compression. Further studies are needed to estimate its frequency, natural course, and preferred management.
Lucie Stepankova - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of transient ulnar Artery Compression to recanalize acute radial Artery occlusion after transradial catheterization
American Journal of Cardiology, 2011Co-Authors: Ivo Bernat, Olivier F Bertrand, Richard Rokyta, Martin Kacer, Jan Pesek, Jiri Koza, Michal Smid, Hana Bruhova, Gabriela Sterbakova, Lucie StepankovaAbstract:Radial Artery occlusion (RAO) can result from transradial catheterization. We compared the incidence of RAO with 2 heparin dosage regimens after transradial coronary angiography, and we evaluated the efficacy and safety of transient homolateral ulnar Artery Compression to achieve acute radial Artery recanalization. Patients referred for coronary angiography were randomized to very-low-dose heparin (2,000 IU) or low-dose heparin (5,000 IU). On sheath removal, hemostasis was obtained using the TR band with a plethysmography-guided patent hemostasis technique. In the case of RAO as assessed by duplex ultrasonography 3 to 4 hours after hemostasis, immediate 1-hour ulnar Artery Compression was applied. Hematomas >15 cm 2 were also assessed. We randomized 465 patients, 222 in the 2,000-IU group and 243 in the 5,000-IU group. The baseline and procedural characteristics were comparable in both groups. The incidence of initial RAO was 5.9% in the 2,000-IU group and 2.9% in the 5,000-IU group (p = 0.17), with a Compression time of 2.10 ± 0.78 hours and 2.25 ± 0.82 hours, respectively (p = 0.051). After ulnar Artery Compression, the final incidence of RAO was 4.1% in the 2,000-IU group and 0.8% in the 5,000-IU group (p = 0.03). The incidence of local hematoma was 2.3% and 3.7% in the 2,000- and 5,000-IU groups, respectively (p = 0.42). In conclusion, acute RAO after transradial catheterization can be recanalized by early 1-hour homolateral ulnar Artery Compression. This simple nonpharmacologic method was effective and safe in patients with very-low- and low-dose heparin. Nevertheless, the incidence of final RAO remained significantly lower after a higher anticoagulation level.
Ivo Bernat - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of transient ulnar Artery Compression to recanalize acute radial Artery occlusion after transradial catheterization
American Journal of Cardiology, 2011Co-Authors: Ivo Bernat, Olivier F Bertrand, Richard Rokyta, Martin Kacer, Jan Pesek, Jiri Koza, Michal Smid, Hana Bruhova, Gabriela Sterbakova, Lucie StepankovaAbstract:Radial Artery occlusion (RAO) can result from transradial catheterization. We compared the incidence of RAO with 2 heparin dosage regimens after transradial coronary angiography, and we evaluated the efficacy and safety of transient homolateral ulnar Artery Compression to achieve acute radial Artery recanalization. Patients referred for coronary angiography were randomized to very-low-dose heparin (2,000 IU) or low-dose heparin (5,000 IU). On sheath removal, hemostasis was obtained using the TR band with a plethysmography-guided patent hemostasis technique. In the case of RAO as assessed by duplex ultrasonography 3 to 4 hours after hemostasis, immediate 1-hour ulnar Artery Compression was applied. Hematomas >15 cm 2 were also assessed. We randomized 465 patients, 222 in the 2,000-IU group and 243 in the 5,000-IU group. The baseline and procedural characteristics were comparable in both groups. The incidence of initial RAO was 5.9% in the 2,000-IU group and 2.9% in the 5,000-IU group (p = 0.17), with a Compression time of 2.10 ± 0.78 hours and 2.25 ± 0.82 hours, respectively (p = 0.051). After ulnar Artery Compression, the final incidence of RAO was 4.1% in the 2,000-IU group and 0.8% in the 5,000-IU group (p = 0.03). The incidence of local hematoma was 2.3% and 3.7% in the 2,000- and 5,000-IU groups, respectively (p = 0.42). In conclusion, acute RAO after transradial catheterization can be recanalized by early 1-hour homolateral ulnar Artery Compression. This simple nonpharmacologic method was effective and safe in patients with very-low- and low-dose heparin. Nevertheless, the incidence of final RAO remained significantly lower after a higher anticoagulation level.
Sean I Savitz - One of the best experts on this subject based on the ideXlab platform.
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vertebral Artery Compression of the medulla
JAMA Neurology, 2006Co-Authors: Sean I Savitz, Michael Ronthal, Louis R. CaplanAbstract:BACKGROUND: Intracranial arteries in the subarachnoid space may compress the brain parenchyma and cranial nerves. Most arterial compressive lesions have been attributed to dolichoectasia in the vertebral-basilar system, and prior reports have concentrated on the pressure effects of basilar Artery ectasia. Much less is known about vertebral Artery Compression of the medulla. OBJECTIVE: To describe a series of patients with vertebral arteries compressing the medulla oblongata. DESIGN: Prospective case studies. SETTING: Tertiary care center. PATIENTS: Nine symptomatic patients, 4 men and 5 women, between the ages of 32 and 79 years. MAIN OUTCOME MEASURES: Clinical phenomena, radiographic findings, treatment, and outcomes. RESULTS: We found that Compression most commonly occurs at the ventrolateral surface. The clinical features can be transient or permanent and are predominantly motor and cerebellar or vestibular, but a poor correlation exists between the clinical findings and the severity or extent of impingement. The vertebral arteries were angulated, tortuous, or dilated but not necessarily dolichoectatic to cause obvious indentation. Seven patients were treated with antiplatelets and anticoagulants or analgesics, whereas 2 underwent microvascular deCompression, resulting in temporary or no relief. One surgical patient developed cranial nerve complications. Among the medically treated patients, none had progression of deficits, and those with single episodes had no recurrence of symptoms. CONCLUSION: This study is the largest collection, to our knowledge, of patients with medullary vascular Compression. Further studies are needed to estimate its frequency, natural course, and preferred management.
M Dooris - One of the best experts on this subject based on the ideXlab platform.
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localized pulmonary Artery Compression due to saphenous vein graft perforation during percutaneous coronary intervention
Canadian Journal of Cardiology, 2011Co-Authors: Rohan S Poulter, M DoorisAbstract:Saphenous vein graft interventions are recognised as high risk procedures for adverse outcomes. We present a case of a ruptured vein graft causing a focal hematoma that led to pulmonary Artery Compression and cardiogenic shock without the classical signs of tamponade. Multi-modality imaging revealed the aetiology and the hematoma resolved after the patient received cardio-pulmonary resuscitation during attempted percutaneous drainage. Localized pulmonary Artery Compression is a rare complication of percutaneous coronary interventions (PCI). Its recognition and management are discussed, with the importance of early detection and urgent invasive management emphasized.
