GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Endovascular Treatment of Acute Ischemic Stroke With the Penumbra System in Routine Practice: COMPLETE Registry Results
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Stroke Vol. 53, No. 3 ( 2022-03), p. 769-778
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. 3 ( 2022-03), p. 769-778
    Abstract: The purpose of the COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D Revascularization Device) registry was to evaluate the generalizability of the safety and efficacy of the Penumbra System (Penumbra, Inc, Alameda) in a real-world setting. Methods: COMPLETE was a global, prospective, postmarket, multicenter registry. Patients with large vessel occlusion–acute ischemic stroke who underwent mechanical thrombectomy using the Penumbra System with or without the 3D Revascularization Device as frontline approach were enrolled at 42 centers (29 United States, 13 Europe) from July 2018 to October 2019. Primary efficacy end points were successful postprocedure angiographic revascularization (modified Thrombolysis in Cerebral Infarction ≥2b) and 90-day functional outcome (modified Rankin Scale score 0–2). The primary safety end point was 90-day all-cause mortality. An imaging core lab determined modified Thrombolysis in Cerebral Infarction scores, Alberta Stroke Program Early CT Scores, clot location, and occurrence of intracranial hemorrhage at 24 hours. Independent medical reviewers adjudicated safety end points. Results: Six hundred fifty patients were enrolled (median age 70 years, 54.0% female, 49.2% given intravenous recombinant tissue-type plasminogen activator before thrombectomy). Rate of modified Thrombolysis in Cerebral Infarction 2b to 3 postprocedure was 87.8% (95% CI, 85.3%–90.4%). First pass and postprocedure rates of modified Thrombolysis in Cerebral Infarction 2c to 3 were 41.5% and 66.2%, respectively. At 90 days, 55.8% (95% CI, 51.9%–59.7%) had modified Rankin Scale score 0 to 2, and all-cause mortality was 15.5% (95% CI, 12.8%–18.3%). Conclusions: Using Penumbra System for frontline mechanical thrombectomy treatment of patients with large vessel occlusion–acute ischemic stroke in a real-world setting was associated with angiographic, clinical, and safety outcomes that were comparable to prior randomized clinical trials with stringent site and operator selection criteria. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03464565.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.121.034268
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Cerebral Blood Flow in a Healthy Circle of Willis and Two Intracranial Aneurysms: Computational Fluid Dynamics Versus Four-Dimensional Phase-Contrast Magnetic Resonance Imaging
    ASME International ; 2014
    In:  Journal of Biomechanical Engineering Vol. 136, No. 4 ( 2014-04-01)
    Details
    In: Journal of Biomechanical Engineering, ASME International, Vol. 136, No. 4 ( 2014-04-01)
    Abstract: Computational fluid dynamics (CFD) opens up multiple opportunities to investigate the hemodynamics of the human vascular system. However, due to numerous assumptions the acceptance of CFD among physicians is still limited in practice and validation through comparison is mandatory. Time-dependent quantitative phase-contrast magnetic resonance imaging PC-MRI measurements in a healthy volunteer and two intracranial aneurysms were carried out at 3 and 7 Tesla. Based on the acquired images, three-dimensional (3D) models of the aneurysms were reconstructed and used for the numerical simulations. Flow information from the MR measurements were applied as boundary conditions. The four-dimensional (4D) velocity fields obtained by CFD and MRI were qualitatively as well as quantitatively compared including cut planes and vector analyses. For all cases a high similarity of the velocity patterns was observed. Additionally, the quantitative analysis revealed a good agreement between CFD and MRI. Deviations were caused by minor differences between the reconstructed vessel models and the actual lumen. The comparisons between diastole and systole indicate that relative differences between MRI and CFD are intensified with increasing velocity. The findings of this study lead to the conclusion that CFD and MRI agree well in predicting intracranial velocities when realistic geometries and boundary conditions are provided. Due to the considerably higher temporal and spatial resolution of CFD compared to MRI, complex flow patterns can be further investigated in order to evaluate their role with respect to aneurysm formation or rupture. Nevertheless, special care is required regarding the vessel reconstruction since the geometry has a major impact on the subsequent numerical results.
    Type of Medium: Online Resource
    ISSN: 0148-0731 , 1528-8951
    URL: Article
    DOI: 10.1115/1.4026108
    Language: English
    Publisher: ASME International
    Publication Date: 2014
    SSG: 31
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Does Device Selection Impact Recanalization Rate and Neurological Outcome? : An Analysis of the Save ChildS Study
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. 4 ( 2020-04), p. 1182-1189
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 4 ( 2020-04), p. 1182-1189
    Abstract: The recent Save ChildS study provides multicenter evidence for the use of mechanical thrombectomy in children with large vessel occlusion arterial ischemic stroke. However, device selection for thrombectomy may influence rates of recanalization, complications, and neurological outcomes, especially in pediatric patients of different ages. We, therefore, performed additional analyses of the Save ChildS data to investigate a possible association of different thrombectomy techniques and devices with angiographic and clinical outcome parameters. Methods— The Save ChildS cohort study (January 2000–December 2018) analyzed data from 27 European and United States stroke centers and included all pediatric patients ( 〈 18 years), diagnosed with arterial ischemic stroke who underwent endovascular recanalization. Patients were grouped into first-line contact aspiration (A Direct Aspiration First Pass Technique [ADAPT]) and non-ADAPT groups as well as different stent retriever size groups. Associations with baseline characteristics, recanalization rates (modified Treatment in Cerebral Infarction), complication rates, and neurological outcome parameters (Pediatric National Institutes of Health Stroke Scale after 24 hours and 7 days; modified Rankin Scale and Pediatric Stroke Outcome Measure at discharge, after 6 and 24 months) were investigated. Results— Seventy-three patients with a median age of 11.3 years were included. Currently available stent retrievers were used in 59 patients (80.8%), of which 4×20 mm (width×length) was the most frequently chosen size (36 patients =61%). A first-line ADAPT approach was used in 7 patients (9.6%), and 7 patients (9.6%) were treated with first-generation thrombectomy devices. In this study, a first-line ADAPT approach was neither associated with the rate of successful recanalization (ADAPT 85.7% versus 87.5% No ADAPT) nor with the complication rate or the neurological outcome. Moreover, there were no associations of stent retriever sizes with rates of recanalization, complication rates, or outcome parameters. Conclusions— Our study suggests that neurological outcomes are generally good regardless of any specific device selection and suggests that it is important to offer thrombectomy in eligible children regardless of technique or device selection. Registration— URL: https://www.drks.de/ ; Unique identifier: DRKS00016528.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.119.028221
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Is Accurate Lumen Segmentation More Important than Outlet Boundary Condition in Image-Based Blood Flow Simulations for Intracranial Aneurysms?
    Springer Science and Business Media LLC ; 2023
    In:  Cardiovascular Engineering and Technology
    Details
    In: Cardiovascular Engineering and Technology, Springer Science and Business Media LLC
    Abstract: Image-based blood flow simulations are increasingly used to investigate the hemodynamics in intracranial aneurysms (IAs). However, a strong variability in segmentation approaches as well as the absence of individualized boundary conditions (BCs) influence the quality of these simulation results leading to imprecision and decreased reliability. This study aims to analyze these influences on relevant hemodynamic parameters within IAs. Methods As a follow-up study of an international multiple aneurysms challenge, the segmentation results of five IAs differing in size and location were investigated. Specifically, five possible outlet BCs were considered in each of the IAs. These are comprised of the zero-pressure condition (BC1), a flow distribution based on Murray’s law with the exponents n = 2 (BC2) and n = 3 (BC3) as well as two advanced flow-splitting models considering the real vessels by including circular cross sections (BC4) or anatomical cross sections (BC5), respectively. In total, 120 time-dependent blood flow simulations were analyzed qualitatively and quantitatively, focusing on five representative intra-aneurysmal flow and five shear parameters such as vorticity and wall shear stress. Results The outlet BC variation revealed substantial differences. Higher shear stresses (up to Δ9.69 Pa), intrasaccular velocities (up to Δ0.15 m/s) and vorticities (up to Δ629.22 1/s) were detected when advanced flow-splitting was applied compared to the widely used zero-pressure BC. The tendency of outlets BCs to over- or underestimate hemodynamic parameters is consistent across different segmentations of a single aneurysm model. Segmentation-induced variability reaches Δ19.58 Pa, Δ0.42 m/s and Δ957.27 1/s, respectively. Excluding low fidelity segmentations, however, (a) reduces the deviation drastically ( 〉 43%) and (b) leads to a lower impact of the outlet BC on hemodynamic predictions. Conclusion With a more realistic lumen segmentation, the influence of the BC on the resulting hemodynamics is decreased. A realistic lumen segmentation can be ensured, e.g., by using high-resolved 2D images. Furthermore, the selection of an advanced outflow-splitting model is advised and the use of a zero-pressure BC and BC based on Murray’s law with exponent n = 3 should be avoided.
    Type of Medium: Online Resource
    ISSN: 1869-408X , 1869-4098
    URL: Article
    DOI: 10.1007/s13239-023-00675-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2543111-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Geometric uncertainty in intracranial aneurysm rupture status discrimination: a two-site retrospective study
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 11 ( 2022-11), p. e063051-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 11 ( 2022-11), p. e063051-
    Abstract: Assessing the risk associated with unruptured intracranial aneurysms (IAs) is essential in clinical decision making. Several geometric risk parameters have been proposed for this purpose. However, performance of these parameters has been inconsistent. This study evaluates the performance and robustness of geometric risk parameters on two datasets and compare it to the uncertainty inherent in assessing these parameters and quantifies interparameter correlations. Methods Two datasets containing 244 ruptured and unruptured IA geometries from 178 patients were retrospectively analysed. IAs were stratified by anatomical region, based on the PHASES score locations. 37 geometric risk parameters representing four groups (size, neck, non-dimensional, and curvature parameters) were assessed. Analysis included standardised absolute group differences (SADs) between ruptured and unruptured IAs, ratios of SAD to median relative uncertainty (MRU) associated with the parameters, and interparameter correlation. Results The ratio of SAD to MRU was lower for higher dimensional size parameters (ie, areas and volumes) than for one-dimensional size parameters. Non-dimensional size parameters performed comparatively well with regard to SAD and MRU. SAD was higher in the posterior anatomical region. Correlation of parameters was strongest within parameter (sub)groups and between size and curvature parameters, while anatomical region did not strongly affect correlation patterns. Conclusion Non-dimensional parameters and few parameters from other groups were comparatively robust, suggesting that they might generalise better to other datasets. The data on discriminative performance and interparameter correlations presented in this study may aid in developing and choosing robust geometric parameters for use in rupture risk models.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-063051
    DOI: 10.1136/bmjopen-2022-063051.supp1
    DOI: 10.1136/bmjopen-2022-063051.supp2
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Experimental investigation of intravascular OCT for imaging of intracranial aneurysms
    Springer Science and Business Media LLC ; 2016
    In:  International Journal of Computer Assisted Radiology and Surgery Vol. 11, No. 2 ( 2016-2), p. 231-241
    Details
    In: International Journal of Computer Assisted Radiology and Surgery, Springer Science and Business Media LLC, Vol. 11, No. 2 ( 2016-2), p. 231-241
    Type of Medium: Online Resource
    ISSN: 1861-6410 , 1861-6429
    URL: Article
    DOI: 10.1007/s11548-015-1275-1
    RVK:
    XA 49910
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2235881-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Multiple intracranial aneurysms: a direct hemodynamic comparison between ruptured and unruptured vessel malformations
    Springer Science and Business Media LLC ; 2018
    In:  International Journal of Computer Assisted Radiology and Surgery Vol. 13, No. 1 ( 2018-1), p. 83-93
    Details
    In: International Journal of Computer Assisted Radiology and Surgery, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2018-1), p. 83-93
    Type of Medium: Online Resource
    ISSN: 1861-6410 , 1861-6429
    URL: Article
    DOI: 10.1007/s11548-017-1643-0
    RVK:
    XA 49910
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2235881-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH)—phase II: rupture risk assessment
    Springer Science and Business Media LLC ; 2019
    In:  International Journal of Computer Assisted Radiology and Surgery Vol. 14, No. 10 ( 2019-10), p. 1795-1804
    Details
    In: International Journal of Computer Assisted Radiology and Surgery, Springer Science and Business Media LLC, Vol. 14, No. 10 ( 2019-10), p. 1795-1804
    Type of Medium: Online Resource
    ISSN: 1861-6410 , 1861-6429
    URL: Article
    DOI: 10.1007/s11548-019-01986-2
    RVK:
    XA 49910
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2235881-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Tocilizumab-associated posterior reversible encephalopathy syndrome in giant-cell arteritis – case report
    Springer Science and Business Media LLC ; 2021
    In:  BMC Neurology Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Neurology, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: We describe one of the first cases of a Posterior reversible encephalopathy syndrome (PRES) under tocilizumab as treatment of Giant cell arteritis (GCA). Case presentation A 65-year-old female with known GCA and treatment with Tocilizumab (TCZ) developed a convulsive epileptic seizure for the first time. MRI was suggestive of PRES and an associated left sided occipital hemorrhage. Extensive high blood pressure values were not detected. The patient recovered within a week and no further seizures occurred under anticonvulsive medication. Conclusion PRES during the treatment with Tocilizumab hasn’t been described in GCA so far. There are single reports of an association between TCZ and PRES in other entities. Thus, a link between interleukin-6 and the integrity of the vasculature could be considered. The clinical consequence should be a stringent blood pressure monitoring in the ambulant setting of patients receiving TCZ.
    Type of Medium: Online Resource
    ISSN: 1471-2377
    URL: Article
    DOI: 10.1186/s12883-021-02231-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041347-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Stent-induced vessel deformation after intracranial aneurysm treatment – A hemodynamic pilot study
    Elsevier BV ; 2019
    In:  Computers in Biology and Medicine Vol. 111 ( 2019-08), p. 103338-
    Details
    In: Computers in Biology and Medicine, Elsevier BV, Vol. 111 ( 2019-08), p. 103338-
    Type of Medium: Online Resource
    ISSN: 0010-4825
    URL: Article
    DOI: 10.1016/j.compbiomed.2019.103338
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 1496984-1
    SSG: 12
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...