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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stenosis of extracranial vertebral artery (VA) is not an infrequent lesion, and it can pose a significant clinical problem. However, the standard treatment for a significant VA stenosis has still not been established. Here in this study, we report our experiences of VA stenting in 25 patients (age 56.2 +/- 15.2 years, male 76%). The patients had comorbidities as follows: DM (36%), hypertension (64%), Takayasu's (12%) and Behcet's diseases (4%). There were combined involvement of other vessels such as the coronary artery (72%), carotid artery (36%), subclavian artery (32%) and the contralateral vertebral artery (24%). Indications for stenting were prior stroke or symptoms related to vertebrobasilar ischemia in 11 patients, and an asymptomatic but angiographically significant stenosis (> 70% stenosis) in 14 patients. Twenty-three balloon-expandable stents and two self-expandable stents were deployed. A drug-eluting coronary stent and distal balloon protection device were each used in one case. A technically successful procedure was achieved in all patients. The baseline reference diameter was 4.7 +/- 1.3 mm, minimal luminal diameter (MLD) 1.0 +/- 0.6 mm (diameter stenosis 77.8 +/- 12.5%) and lesion length 6.4 +/- 3.9 mm. After stenting and adjuvant dilation, the MLD was increased to 4.5 +/- 0.9 mm (diameter stenosis 3.1 +/- 17.9%). There were no procedure-related complications. During the further follow-up period of 25 (3-49) months, no stroke or death occurred. Restenosis was observed in 4 (30.8%) of 13 eligible patients. In conclusion, VA stenting is feasible with a high degree of technical success, and this treatment is associated with a relatively low incidence of procedure-related complications. However, a relative high rate of in-stent restenosis remains as a problem to be resolved.
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PMID:Percutaneous interventional treatment of extracranial vertebral artery stenosis with coronary stents. 1534 3

For categorizing the presenting neurological symptoms in Takayasu's arteritis (TA) and correlating to the imaging findings of cerebral angiography, we retrospectively reviewed the angiographies of 27 patients presented with stroke, transient ischemic attack (TIA), visual disturbance, and/or dizziness. Neurological manifestations of TA resulted from decreased blood flow due to a steno-occlusive lesion and/or shifting of blood flow, thromboembolism, or hypertension. The pattern analysis of neurological manifestations related to specific arterial involvement is mandatory in understanding neurological manifestations of this systemic disease.
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PMID:Correlation of neurological manifestations of Takayasu's arteritis with cerebral angiographic findings. 1575 61

Takayasu arteritis (TA) is an inflammatory arteritis involving large vessels, predominantly the aorta and its main branches. Angina pectoris or myocardial infarction may occur in 3-5% of patients. Symptomatic coronary artery disease may be in rare case the first sign of TA. We describe a case of a young woman in whom acute myocardial infarction and cardiogenic shock and stroke were the initial presentations of TA.
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PMID:Unusual presentation of Takayasu arteritis. 1706 87

Takayasu's disease is a non specific, chronic, inflammatory panarteritis. It affects the aorta, its chief collaterals and the pulmonary arteries. Clinical manifestations depend on the site and the severity of the occlusive vascular lesion. We report a case observed in a young woman who presented ischemic stroke as the inaugural sign of Takayasu's disease.
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PMID:[Ischemic stroke caused by Takayasu's arteritis]. 1727 41

Takayasu arteritis (TA) is an uncommon disease of young women, characterized by granulomatous vasculitis of medium and large arteries. In addition to constitutional symptoms, it causes various clinical morbidities, such as arm claudication, decreased arterial pulses, carotidynia and hypertension. The incidence rate of TA has wide variation in different geographical areas. It was calculated to be 0.12 cases/100,000/ year in Sweden, 0.22 in Kuwait, 0.26 in USA, and probably higher in Japan. Neurological involvement is reported in only a minority of patients and occurrence of neurological syndromes as the first manifestation of disease has been rarely reported. We present clinical, laboratory and imaging findings of a 50 years old lady with TA, who was initially presented by clinical manifestations mimicking a stroke. Of particular importance is the occurrence of intracranial arterial stenosis in the patient, which is a relatively rare condition. The rarity of the disease and especially such a presentation can cause considerable delay in the diagnosis and treatment.
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PMID:Stroke as the first manifestation of Takayasu arteritis. 1756 29

Takayasu arteritis (TA) is a chronic inflammatory disease involving the aorta and its principal branches, leading to narrowing and occlusion of the vessels. Since the clinical manifestations depend on the location and severity of the lesions, stroke may be the initial presentation of the disease. Here we report the case of a young man with TA and complete thrombotic occlusion of the right common carotid artery who underwent surgical intervention at our institution. His postoperative computed tomography angiogram performed after 3 months revealed also total occlusion of the left anterior descending coronary artery from its proximal portion.
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PMID:Carotid and coronary artery occlusion in a patient with Takayasu arteritis. 1879 39

Takayasu's arteritis is a rare disease that causes arterial inflammation with resulting stenosis or aneurysm of affected vessels. It primarily affects young females and has a predilection for the aorta, its primary branches, and the pulmonary arteries. Patients may present with symptoms of organ ischemia, such as stroke or claudication, or with signs of arterial stenosis, such as absent pulses or asymmetric blood pressures. Most patients require chronic immunosuppressive therapy to control inflammation. The foundation of therapy is glucocorticoids, which are often used in combination with other immunosuppressive agents, such as methotrexate, azathioprine, or mycophenolate mofetil. The goal of systemic therapy is to induce and maintain disease remission, often defined as the absence of new arterial lesions, lack of systemic symptoms, and ability to taper prednisone to less than 10 mg/d. Promising results have been seen with the use of agents directed against tumor necrosis factor in patients who have failed to maintain remission with standard therapies. Revascularization procedures such as percutaneous transluminal angioplasty (PTA) or bypass grafting are reserved for patients who have critical organ ischemia or severe extremity claudication. Bypass grafting has a lower restenosis rate than PTA and is the preferred method of restoring blood flow to affected organs. Frequent laboratory testing is recommended to monitor for drug toxicity and signs of disease relapse. At each clinic visit, physicians should auscultate for bruits over primary arterial branches and evaluate for asymmetry between arm and leg blood pressures. Biannual radiographic imaging with magnetic resonance or CT angiography is helpful to examine for evidence of new aortic aneurysms or arterial stenoses.
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PMID:Takayasu's arteritis. 1832 19

Takayasu's arteritis is a chronic inflammatory disease of the aorta and its main branches, and a well known cause of stroke. Pathogenesis of ischaemic stroke has been attributed to intracranial vasculitic involvement or emboli from either stenoocclusive extracranial vessels or cardiac disease such as aortic regurgitation. We present a patient with Takayasu's arteritis and recurrent cerebral infarctions associated with intracranial atherosclerosis. We postulate that the intracranial atherosclerotic process is an important mechanism in Takayasu's arteritis-related ischaemic stroke.
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PMID:Takayasu's disease presenting with atherothrombotic ischaemic stroke. 1894 42

Takayasu's arteritis is a chronic inflammatory vasculitis, involving mainly the aorta and its main branches and the pulmonary arteries, with characteristic of stenotic and occasionally dilated lesions. Neurologic manifestations of Takayasu's arteritis range from simple headache to catastrophic neurologic impairments, including visual loss, stroke and transient ischemic attack. However, spinal cord compression has never been described as a complication of Takayasu's arteritis. We describe a case of Takayasu's arteritis complicated by spinal cord compression due to thoracolumbar inflammatory epiduritis.
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PMID:An unusual clinical manifestation of Takayasu's arteritis: spinal cord compression. 1907 May 27

We report a 68-year-old woman who was incidentally diagnosed as having an occlusion in the right internal carotid artery on magnetic resonance angiography. On ultrasound, the right common carotid artery showed narrow and tortuous lumens, which suggest the uneven thickening of the arterial wall in the nonactive stage of Takayasu's arteritis. Although macaroni-like diffuse and circumferential thickening of the arterial wall is a known ultrasonographic finding of Takayasu's arteritis, the tortuous sign also appears to be characteristic as an ultrasonographic finding of the healed arteritis in aged patients.
J Stroke Cerebrovasc Dis
PMID:Tortuous carotid artery lumens in Takayasu's arteritis. 1971 27


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