The Experts below are selected from a list of 2259 Experts worldwide ranked by ideXlab platform
A V Khaw - One of the best experts on this subject based on the ideXlab platform.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:BACKGROUND: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. METHODS: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but <100%, and 3 = 100% collateral filling. We analyzed the association between the final infarct volume on CT 5 days after the intervention and the CTA-cs, successful reperfusion (Thrombolysis in Myocardial Infarction, TIMI, grades 2 and 3) and time to treatment in a prospective study approved by our institutional review board, with informed consent from all patients. RESULTS: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = -0.63; p < 0.001) and postinterventional TIMI grade (r = -0.403; p = 0.046) were inversely associated with final infarct volume. After multiple regression analysis, CTA-cs and reperfusion remained as independent predictors of final infarct volume whereas time to treatment and initial stroke severity did not. CONCLUSION: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:Background: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. Methods: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but Results: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = –0.63; p Conclusion: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
Wei Feng Shen - One of the best experts on this subject based on the ideXlab platform.
-
Reduced coronary Collateralization in type 2 diabetic patients with chronic total occlusion
BMC, 2018Co-Authors: Ying Shen, Feng Hua Ding, Rui Yan Zhang, Yang Dai, Xiao Qun Wang, Wei Feng ShenAbstract:Abstract Background The extent of coronary collateral formation is a primary determinant of the severity of myocardial damage and mortality after coronary artery occlusion. Type 2 diabetes mellitus (T2DM) represents an important risk factor for impaired collateral vessel growth. However, the mechanism of reduced coronary Collateralization in type 2 diabetic patients remains unclear. Methods With the reference to the recent researches, this review article describes the pathogenic effects of T2DM on collateral development and outlines possible clinical and biochemical markers associated with reduced coronary Collateralization in type 2 diabetic patients with chronic total occlusion (CTO). Results Diffuse coronary atherosclerosis in T2DM reduces pressure gradient between collateral donor artery and collateral recipient one, limiting collateral vessel growth and function. An interaction between advanced glycation end-products and their receptor activates several intracellular signaling pathways, enhances oxidative stress and aggravates inflammatory process. Diabetic condition decreases pro-angiogenic factors especially vascular endothelial growth factor and other collateral vessel growth related parameters. Numerous clinical and biochemical factors that could possibly attenuate the development of coronary collaterals have been reported. Increased serum levels of glycated albumin, cystatin C, and adipokine C1q tumor necrosis factor related protein 1 were associated with poor coronary Collateralization in type 2 diabetic patients with stable coronary artery disease and CTO. Diastolic blood pressure and stenosis severity of the predominant collateral donor artery also play a role in coronary collateral formation. Conclusions T2DM impairs collateral vessel growth through multiple mechanisms involving arteriogenesis and angiogenesis, and coronary collateral formation in patients with T2DM and CTO is influenced by various clinical, biochemical and angiographic factors. This information provides insights into the understanding of coronary pathophysiology and searching for potential new therapeutic targets in T2DM
-
impact of coronary collateral circulation on angiographic in stent restenosis in patients with stable coronary artery disease and chronic total occlusion
International Journal of Cardiology, 2017Co-Authors: Zhen Kun Yang, Ying Shen, Feng Hua Ding, Rui Yan Zhang, Qi Zhang, Jian Hu, Lin Lu, Wei Feng ShenAbstract:Abstract Objective This study aimed to evaluate the relationship between coronary Collateralization and in-stent restenosis (ISR) in stable coronary artery disease patients with chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. Methods The degree of coronary collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded according to Rentrop classification in 216 patients with stable angina undergoing successful DES based PCI for CTO. Univariable and multivariable logistic regression analyses were performed to assess the potential factors related to angiographic ISR during follow-up. Results Despite similar number of diseased coronary arteries, good Collateralization (Rentrop score 2 or 3) was more frequently associated with right coronary artery occlusion (60%), whereas poor collaterals (Rentrop score 0 or 1) occurred more often in left anterior descending artery occlusion (40%). Despite similar number of CTO intervened, stent length was longer in patients with good Collateralization (59±27mm vs 47±23mm, p =0.001). At mean 18months, the rate of ISR did not significantly differ between patients with good Collateralization and those with poor Collateralization (12.7% vs 20.2%, p =0.148). At multivariable analysis, age (OR 1.058, 95%CI 1.015–1.104, p =0.008), history of diabetes mellitus (OR 2.382, 95%CI 1.109–5.116, p =0.026) and reference CTO vessel diameter (OR 0.219, 95% CI 0.051–0.951, p =0.043) were independent risk factors for ISR while Rentrop collateral grade (OR 0.795, 95% CI 0.365–1.732, p =0.414) was not associated with ISR. Conclusions The occurrence of ISR after successful DES based PCI for CTO may be not influenced by coronary Collateralization.
-
RESEARCH ARTICLE Serum Cystatin C Reflects Angiographic Coronary Collateralization in Stable Coronary Artery Disease Patients with Chronic Total Occlusion
2016Co-Authors: Ying Shen, Feng Hua Ding, Rui Yan Zhang, Qi Zhang, Wei Feng ShenAbstract:Objective We investigated whether and to what extent cystatin C was associated with angiographic coronary Collateralization in patients with stable coronary artery disease and chronic total occlusion. Methods Serum levels of cystatin C and high-sensitive C-reactive protein (hsCRP) and glomerular fil-tration rate (GFR) were determined in 866 patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as poor (Rentrop score of 0 or 1) or good coronary Collateralization (Rentrop score of 2 or 3). Results In total, serum cystatin C was higher in patients with poor Collateralization than in those with good Collateralization (1.08 ± 0.32 mg/L vs. 0.90 ± 0.34 mg/L, P < 0.001), and correlated inversely with Rentrop score (adjusted Spearmen’s r =-0.145, P < 0.001). The prevalenc
-
cystatin c versus creatinine based definition of renal dysfunction for predicting poor coronary Collateralization in type 2 diabetic patients with stable coronary artery disease
Journal of diabetes & metabolism, 2014Co-Authors: Ying Shen, Feng Hua Ding, Rui Yan Zhang, Qi Zhang, Zhen Sun, Wei Feng ShenAbstract:Objective: Renal dysfunction represents a risk factor for poor coronary collateral growth. We investigated whether Glomerular Filtration Rate (GFR) estimated with the cystatin C-based formula (GFRCYS) is superior to that with the creatinine-based abbreviated Modification of Diet in Renal Disease (GFRMDRD) and the Chronic Kidney Disease Epidemiology Collaboration (GFREPI) equations for evaluating coronary Collateralization in type 2 diabetic patients with stable coronary artery disease. Methods: GFR was estimated with creatinine- and cystatin C- based equations in 302 diabetic and 127 nondiabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as poor (Rentrop score of 0 or 1) or good Collateralization (Rentrop score of 2 or 3). Results: In diabetic patients, GFRCYS correlated more closely with Rentrop score than GFRMDRD (Spearmen’s r=0.44 vs. Spearmen’s r=0.30, P=0.047) and GFREPI (Spearmen’s r=0.44 vs. Spearmen’s r=0.29, P=0.028), and area under the curve of GFRCYS was larger compared with that of GFRMDRD and GFREPI (0.78 vs. 0.68 and 0.66, P=0.001 and P<0.001) for predicting the presence of poor Collateralization, along with a net reclassification improvement of 15.0% and 20.1% (P=0.025 and P=0.002). After adjusting for possible confounding variables, a GFR<90 mL/min/1.73m2 estimated with the cystatin C- based formula was more independently associated with poor Collateralization (OR:6.21 vs. 2.86 and 2.36, P=0.042 and P=0.015). In contrast, GFRCYS, GFRMDRD, and GFREPI were similar for assessing coronary Collateralization in non-diabetic patients. Conclusions: Cystatin C-based definition of renal dysfunction indicates a potential better clinical utility than creatinine-based equations for predicting poor Cystatin collaterals in diabetic atherosclerotic patients.
A Angermaier - One of the best experts on this subject based on the ideXlab platform.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:BACKGROUND: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. METHODS: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but <100%, and 3 = 100% collateral filling. We analyzed the association between the final infarct volume on CT 5 days after the intervention and the CTA-cs, successful reperfusion (Thrombolysis in Myocardial Infarction, TIMI, grades 2 and 3) and time to treatment in a prospective study approved by our institutional review board, with informed consent from all patients. RESULTS: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = -0.63; p < 0.001) and postinterventional TIMI grade (r = -0.403; p = 0.046) were inversely associated with final infarct volume. After multiple regression analysis, CTA-cs and reperfusion remained as independent predictors of final infarct volume whereas time to treatment and initial stroke severity did not. CONCLUSION: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:Background: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. Methods: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but Results: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = –0.63; p Conclusion: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
Norbert Hosten - One of the best experts on this subject based on the ideXlab platform.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:BACKGROUND: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. METHODS: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but <100%, and 3 = 100% collateral filling. We analyzed the association between the final infarct volume on CT 5 days after the intervention and the CTA-cs, successful reperfusion (Thrombolysis in Myocardial Infarction, TIMI, grades 2 and 3) and time to treatment in a prospective study approved by our institutional review board, with informed consent from all patients. RESULTS: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = -0.63; p < 0.001) and postinterventional TIMI grade (r = -0.403; p = 0.046) were inversely associated with final infarct volume. After multiple regression analysis, CTA-cs and reperfusion remained as independent predictors of final infarct volume whereas time to treatment and initial stroke severity did not. CONCLUSION: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:Background: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. Methods: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but Results: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = –0.63; p Conclusion: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
Christof Kessler - One of the best experts on this subject based on the ideXlab platform.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:BACKGROUND: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. METHODS: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but <100%, and 3 = 100% collateral filling. We analyzed the association between the final infarct volume on CT 5 days after the intervention and the CTA-cs, successful reperfusion (Thrombolysis in Myocardial Infarction, TIMI, grades 2 and 3) and time to treatment in a prospective study approved by our institutional review board, with informed consent from all patients. RESULTS: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = -0.63; p < 0.001) and postinterventional TIMI grade (r = -0.403; p = 0.046) were inversely associated with final infarct volume. After multiple regression analysis, CTA-cs and reperfusion remained as independent predictors of final infarct volume whereas time to treatment and initial stroke severity did not. CONCLUSION: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.
-
ct angiographic Collateralization predicts final infarct volume after intra arterial thrombolysis for acute anterior circulation ischemic stroke
Cerebrovascular Diseases, 2011Co-Authors: A Angermaier, S Langner, M Kirsch, Christof Kessler, Norbert Hosten, A V KhawAbstract:Background: Final infarct volume after thrombolysis for acute ischemic stroke depends on time to, and degree of reperfusion and residual blood flow, which is influenced by leptomeningeal Collateralization. We evaluated the role of Collateralization in the ischemic territory as a predictor of infarct size. Methods: Twenty-five patients (17 women, 8 men, mean age: 67.6 ± 12.4 years) selected by non-contrast-enhanced CT and CT angiography (CTA) underwent intra-arterial thrombolysis (iaT) within 6 h after symptom onset (mean 4.1 ± 1.3 h) for middle cerebral and terminal internal carotid artery (MCA/ICA) stroke. CTA was evaluated for Collateralization using thick-slice coronal and axial maximum-intensity projection reconstructions according to a simple score, the CTA Collateralization score (CTA-cs): 0 = no collateral filling, 1 = ≤50%, 2 = >50% but Results: Reperfusion was achieved in 72%. Asymptomatic and symptomatic parenchymal hemorrhage occurred in 2 patients (8%) each and hemorrhagic transformation in 4 (16%). CTA-cs (r = –0.63; p Conclusion: The extent of Collateralization and reperfusion are independent predictors of final infarct volume in acute MCA/ICA stroke treated with iaT. Time to treatment and stroke severity had no independent effect on final infarct volume.