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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have successfully corrected interrupted aortic arch with ventricular septal defect by employing deep hypothermia and circulatory arrest, a median sternotomy incision, and a pulmonary arteriotomy. This simplified technique has the advantage of an abbreviated period of cerebral ischemia, with a relatively simple partitioning of the pulmonary artery.
J Thorac Cardiovasc Surg 1983 Aug
PMID:Pulmonary artery partition: new method for correction of interrupted aortic arch. 687 68

To study the involvement of endogenous endothelin (ET) in the development of cerebral ischemia, we measured by radioimmunoassay brain tissue content of immunoreactive (ir)-ET-1 in a model of focal cerebral ischemia in the rat. Permanent occlusion of the middle cerebral artery (OMCA) was accompanied after 24 h by a progressive but marked elevation of ir-ET-1 in the ipsilateral compared with the contralateral hemisphere (119% after 24 h; 184% after 48 h and 459% after 72 h). The pial vessels and the arteries of the circle of Willis did not respond with ir-ET-1 production. The increase in ir-ET-1 content in tissues was first observed in the caudate nucleus (after 24 h) and later in the cortex (after 48 h), which was more variably injured. Transient ischemia followed by recirculation led to a slight increase of ir-ET-1, which also appeared after 24 h of recirculation. This study demonstrates that during permanent OMCA, the tissue content of ir-ET-1 markedly and progressively increases, whereas less severe ischemia (transient) is accompanied by a modest elevation of ir-ET-1 levels. These results suggest that endogenous ir-ET-1 production is involved in the development and the severity of ischemic injury.
J Cardiovasc Pharmacol 1993
PMID:Elevated tissue endothelin content during focal cerebral ischemia in the rat. 750 72

The importance and the various effects of serotonin (5-HT) in cardiovascular diseases are reviewed, with particular emphasis on the involvement of 5-HT2 receptors as mediators of the biological responses of vessels and blood platelets to 5-HT. The importance of 5-HT in peripheral and cerebral ischemia is shown by the key role it plays in inducing vasoconstriction, platelet aggregation, vascular permeability, and cell proliferation. Of particular importance is the 5-HT-selective hypersensitivity developing in vessels/platelets shortly after acute ischemia or early in the development of chronic vascular diseases. The mechanisms of action of naftidrofuryl are described, showing that this drug offers a particularly interesting profile of having both metabolic and vascular effects. Naftidrofuryl improves glucose aerobic metabolism by an action on succinodehydrogenase and improves the blood supply and the ischemic damage of the vessel wall by blocking specifically 5-HT2 receptors. The latter property permits an inhibition of the deleterious, multiple effects of 5-HT at sites of vascular injury, without influencing the general circulatory bed. Therefore, naftidrofuryl appears to be an anticonstrictor and not, as previously thought, a vasodilator. As a consequence, naftidrofuryl has a targeted impact without vasodilator-linked side effects such as hypotension or the steal phenomenon.
J Cardiovasc Pharmacol 1994
PMID:Serotonin, 5-HT2 receptors, and their blockade by naftidrofuryl: a targeted therapy of vascular diseases. 751 75

Hypertension causes marked adaptive changes in the cerebral circulation. The excess risk of stroke associated with hypertension is eliminated in controlled trials of antihypertensive treatment. Such treatment may even prevent transient ischaemic attacks in the elderly. In rare cases, overzealous antihypertensive treatment may cause cerebral ischaemia, especially in the initial treatment of very severe hypertension. Headache may occasionally be caused by severe hypertension, which may also lead to the rare syndrome of acute hypertensive encephalopathy. Finally, the importance of white-matter lesions, or leukoaraiosis, in hypertension is not yet fully established.
J Cardiovasc Risk 1995 Feb
PMID:Cerebrovascular damage in hypertension. 760 37

Earlier results reported by the authors suggest that carotid endarterectomy can relieve symptoms of non-hemispheric ischemia in patients who present with hemodynamically significant carotid stenosis. Long-term follow-up of a subgroup of these patients is described. Some 61 patients with non-hemispheric ischemia who underwent carotid endarterectomy were reviewed. Indications for surgery and postoperative results (stroke, death, symptom relief) were determined by office visit or phone interview. Results in these patients were compared with those of an entire patient population who underwent endarterectomy performed by the authors. Mean (s.d.) follow-up was available for 42.3 (31.7) months. Perioperative stroke rate (4.9%), survival (85.3 and 64.9% at 3 and 5 years respectively) and stroke-free survival (77.1 and 63.4% at 3 and 5 years respectively) were not different from that entire cohort of 553 patients. During follow-up, 11 patients (18%) developed recurrent symptoms of non-hemispheric ischemia. Carotid endarterectomy is successful in providing long-term relief of symptoms of non-hemispheric ischemia in most patients with significant carotid bifurcation stenosis. Results in such patients are similar to those seen in patients with symptoms of anterior cerebral ischemia or with symptom-free stenoses.
Cardiovasc Surg 1994 Oct
PMID:Carotid endarterectomy for non-hemispheric ischaemia: long-term follow-up. 782 May 14

The aim of this study was to establish whether a preoperative evaluation of cerebral haemodynamic reserve, carried out by means of transcranial Doppler and single photoemission computed tomography with a provocative test (acetazolamide) is able to select those patients who require carotid shunting to avoid cerebral ischaemia during clamping. All patients were monitored during operation by means of somatosensitive evoked potentials. Those patients who required shunting because of abnormal evoked potentials were also those who had a poor cerebral reserve with a perfusion and velocity increase below 15%. Only one neurological deficit developed in patients who were not shunted.
Cardiovasc Surg 1994 Feb
PMID:Cerebral reserve and indications for shunting in carotid surgery. 791 43

A technique is presented for intraoperative management of an axilloaxillary by-pass graft when performing a median sternotomy for myocardial revascularization. This method allows continual perfusion of both upper extremities during the operation thereby preventing the potential complications of upper extremity or cerebral ischemia.
J Cardiovasc Surg (Torino) 1994 Jun
PMID:Technique for management of an axilloaxillary by-pass graft complicating a median sternotomy. 804 Jan 72

Late-appearing infection of prosthetic grafts continues to plague the vascular surgeon. Although generally caused by biofilm-producing coagulase-negative staphylococci, other Gram-positive, as well as Gram-negative, organisms may also be etiologic. Extra-anatomic revascularization with either simultaneous or staged removal of the entire contaminated prosthesis has emerged as the preferred method of management of the infected aortic prosthesis. In addition to the usual technical problems accompanying surgery for aortic graft infection, operation for prosthetic graft infection involving the ascending aorta and aortic arch introduces the potential problem of temporary cerebral ischemia. The successful management of a 64-year-old woman with late Staphylococcus aureus infection of an aortoinnominate-left subclavian bifurcation graft by graft excision and extra-anatomic revascularization, in whom intraoperative cerebral ischemia was circumvented by initial placement of a right femoroaxillary bypass graft is described here.
Cardiovasc Surg 1994 Feb
PMID:Prosthetic graft infection involving the thoracic aorta: graft excision and extra-anatomic revascularization. 804 31

With the publication of the results of clinical trials and acceptance of the role of carotid endarterectomy for treatment of carotid bifurcation disease, it will be up to the surgeons to set the standards for performance that are consistent with the expected outcome. This is a complex issue that will have to be addressed and monitored continually to ensure that patients obtain the optimal and expected results. It will be incumbent on the surgical community to not only set the standards but also to set up mechanisms to monitor the performance of surgeons involved in this procedure. From a scientific standpoint, a great deal of work needs to be done to identify those changes in the plaque that are responsible for the production of clinical events. At present, the only finding that is predictive of outcome is the degree of narrowing. Whereas it is the high-grade lesions that lead to events, the majority will remain benign and not lead to cerebral ischemia. To carry out such research it will be necessary to develop three-dimensional imaging methods that permit measurement of the fibrous cap and the materials beneath it. Since plaque cap rupture with embolization, and in some cases, thrombosis, are the primary causes of clinical events, it will be necessary to measure the cap thickness in symptom-free as well as symptomatic patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovasc Surg 1994 Apr
PMID:The future of carotid surgery: changes and problems to solve. 804 39

A total of 1780 patients without symptoms of cerebral ischemia undergoing coronary artery bypass grafting (CABG) were screened before surgery for carotid stenosis by pneumophlethysmography. An abnormal test was defined as a difference in ophthalmic artery pressures of > or = 5 mmHg or ophthalmic-brachial pressure index < or = 0.69. Some 99 patients (5.6%) had an abnormal ocular pneumoplethysmographic measurement (89 unilateral, ten bilateral). Of these, 26 patients underwent prophylactic carotid endarterectomy before CABG (group 1), while the remaining 73 patients had reconstruction without previous carotid endarterectomy (group 2). A total of 100 patients (group 3) with normal ocular pneumoplethysmographic results were used as controls. The three groups were comparable with respect to age, diabetes, hypertension, smoking and severity of coronary artery disease. Early (30-day) postoperative stroke rates were 0 and 4% (n = 3) for groups 1 and 2 respectively, and 0% for group 3 (P > 0.07). Early mortality rates after CABG for groups 1 and 2 were 4% (n = 1) and 1% (n = 1), respectively and 2% (n = 2) for groups 3 (P > 0.4). Late follow-up (mean 48 months) demonstrated stroke rates of 0% for group 1, and 10% and 4% for groups 2 and 3 (P > 0.08). The early mortality and stroke rates in the ten patients with bilateral abnormal ocular pneumoplethysmographic values were 0 and 0%. However, late strokes occurred significantly more often (43%) in patients with bilateral abnormal results compared with those with unilateral abnormal findings when both groups did not undergo carotid endarterectomy (P < 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovasc Surg 1994 Apr
PMID:Outcome of patients with abnormal ocular pneumoplethysmographic measurements undergoing coronary artery bypass grafting. 804 59


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