bluuebunny/crossref_metadata_2025_split huggingface dataset:
E-024 The Mindframe Capture LP 3 mm and 4 mm thrombectomy device. Early clinical results: Abstract E-024 Table 1
Authors: Söderman M , Holmin S , Andersson T , Kuntze Söderqvist Å , Turner R 
Published: July 2012

IntroductionMechanical thrombectomy is effective in restoring blood flow to the brain in patients with occlusion of large intracranial arteries. Most devices require a 0.021 or 0.027 microcatheter. However, in some instances s smaller microcatheter may be advantageous. We here report the early results with the Mindframe Capture LP 3 mm and 4 mm thrombectomy devices, designed to pass through a 0.010 microcatheter.Material and Methods16 patients (8M/8F) with large vessel occlusion and sizeable penumbra were admitted with the intention to treat with thrombectomy using either of the 3 mm or 4 mm Mindframe Capture LP devices. Mean NIHSS was 15. Seven had received previous i.v. rTPA.Technical resultsThrombectomy was unsuccessful because of impossible access in one case, non-embolic occlusion due to vessel dissection in two cases, very old uncooperative patient in one case and device related failure in one case. There were no device related complications. Clinical results are not yet available but will be presented at the meeting.ConclusionMindframe Capture LP 3 mm and 4 mm thrombectomy devices are efficient with a low risk for device related complications.Abstract E-024 Table 1012a2b3TICI at start16TICI final5118Competing interestsM Söderman: MINDFRAME INC, Rapid medical. S Holmin: None. T Andersson: MINDFRAME INC, Covidien, Stryker, Rapid Medical. Å Kuntze Söderqvist: None. R Turner: MINDFRAME INC.
E-047 Novel treatment of isolated P1 segment “blister” aneurysm with telescoping stents
Authors: Chang T , Bourgeois A , Kvamme P 
Published: July 2012

PurposeDissecting posterior cerebral artery aneurysms are rare lesions that pose difficult treatment options. The purpose of this case is to describe the complications of stenting of a posterior cerebral artery dissecting aneurysm, novel treatment of this complication, and outcomes.Materials and MethodsCase report and retrospective chart review of a 34-year-old female who was transferred to our institution from an outside hospital with a history of subarachnoid hemorrhage. Patient underwent endovascular stenting of a dissecting aneurysm of the P1 segment of the left posterior cerebral artery after the aneurysm failed to improve after 3 months of observation.ResultsFollowing flow modulation therapy consisting of three Enterprise Vascular Reconstruction devices placed across the aneurysm, initial post treatment angiogram showed excellent modulation of flow within the aneurysm. Patient represented 10 days later with nausea, slurred speech and gait disturbance. CTA showed narrowing of the right P1 segment with possible flow limiting stenosis. MRI showed a new right sided pontine infarct. Patient was treated with Heparin, Angiomax infusion, Rheopro infusion, asparin, and plavix. Symptoms resolved after 1 day of anticoagulation/thrombolytic therapy. Follow-up angiogram showed significant morphologic change at the posterior cerebral artery with straightening of the posterior cerebral artery and kinking of the basilar artery. Our belief is that the radial forces created by the use of multiple stents caused the morphologic changes to the basilar artery and posterior cerebral artery. This morphologic change then damaged the small perforating vessels arising from the basilar artery and resulted in a pontine infarct. Two-year clinical follow-up revealed no persistent neurologic defects with return of the patient to her baseline functional status.ConclusionFlow modulation therapy of a dissecting posterior cerebral artery aneurysm by stenting is a valid treatment option. Care must be taken when determining the location and number of stents to be used as increasing radial forces can result in morphologic alteration of the native vessels and, as in this case, infarct. While this patient experienced no lasting deficits, infarcts in this vascular distribution could have the potential for catastrophic effects.Competing interestsNone.
E-050 Stenting after SAMMPRIS: the case for VBI
Authors: Newman B , Khalessi A 
Published: July 2012

Intracranial atherosclerotic disease (ICAD) accounts for 10% of ischemic strokes. The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) proposed an expansive indication for intracranial stenting. The study terminated prematurely because aggressive medical management proved superior to percutaneous transluminal angioplasty and stenting with the use of the Wingspan system for secondary prevention of stroke. These results prompted the FDA's Neurological Devices Advisory Committee to consider revoking the Wingspan's humanitarian device exemption. The SAMMPRIS trial, however, did not distinguish PTAS risk profile based on collateral circulation and location of the lesion. We present a case series of patients with vertebrobasilar ischemia and progressive neurological deficits in the setting of an absent collateral circulation and ICAD-induced vertebrobasilar occlusion. We propose PTAS as a unique endovascular solution for lesions proximal to AICA and medical management or stand alone angioplasty for lesions distal to AICA due to risk of perforator stroke. We present three cases of patients with NIHSS > 15 and progressive obtundation with V4 ICAD who experienced dramatic reversal of their symptoms with PTAS. All are mRS 0 at 3 months. All patients were treated awake. We further present a fourth patient with basilar ICAD between the SCA and AICA managed conservatively after an initial decompensation with distal microcatheter access; plaque instability with lesion crossing portended poorly for subsequent PTAS due to perforator and AICA ostia proximity. The fourth patient, who was being managed for secondary stroke prevention analogous to SAMMPRIS, is mRS 0 at 3 months without PTAS. We thus distinguish between secondary stroke prevention and vertebrobasilar ischemia; the case series presents a framework based on location and collateral circulation for post-SAMMPRIS applications for PTAS.Competing interestsNone.
E-052 mechanical thrombectomy of the superior sagittal sinus using the penumbra device for cerebral venous thrombosis: a case report
Authors: Hnenny L , Fiorella D , Kelly M 
Published: July 2012

BackgroundCerebral venous thrombosis is a potentially devastating condition. Predisposing factors include hypercoagulable state, infection, pregnancy, oral contraceptive use and female sex. Symptoms may include headache, nausea, vomiting, and visual changes. Papilledema, focal neurologic deficits, strokes, and seizures may occur. Treatment consists of systemic anticoagulation and management of the underlying process. Acetazolamide and cerebrospinal fluid diversion are reserved for cases with refractory, severe intracranial hypertension. Recently, neurointerventional techniques have shown promise in the treatment of this condition.Case reportWe report the case of a 47-year-old male who presented with seizures and intracerebral hemorrhage. CT angiography showed near-complete occlusion of the superior sagittal sinus and occlusion of both transverse sinuses. Anticoagulation was initiated, but he continued to have seizures and his level of consciousness deteriorated. He was therefore taken to angiography and mechanical thrombectomy of his sagittal sinus was performed with the Penumbra device (Penumbra Inc., Alameda, California, USA). Flow was markedly improved in the superior sagittal sinus, and he recovered well post-operatively. He was discharged home on antiepileptic medication with no neurologic deficits.ConclusionMechanical thrombectomy is a viable option for revascularization of the dural venous sinuses in the setting of cerebral venous thrombosis.Competing interestsL Hnenny: None. D Fiorella: Codman and Shurtleff, Covidien ev3, NFocus Medical, Cordis, Micrus Endovascular. M Kelly: None.
E-067 Safety and efficacy of the starclose vascular closure device with use of large French femoral sheath
Authors: Sharma J , Kulhari A , Vargas E , Moradzadeh N , Jung R , Blackham K 
Published: July 2012

BackgroundLarge French (Fr) sheaths are commonly used to obtain optimum common femoral artery (CFA) access while performing acute stroke endovascular treatments. The StarClose Vascular Closure System (Abott Vascular) is currently indicated for the percutaneous closure of CFA access sheaths of 5 Fr or 6Fr procedural size. Limited data exists regarding off-label use of the StarClose device in patients who had 7–9 French CFA access.ObjectivesTo evaluate the safety and efficacy of the StarClose extravascular closure device in achieving post femoral artery catheterization hemostasis after placement of large Fr femoral sheath.MethodsRetrospective chart review was performed between 2009 and 2011 of 73 patients who underwent endovascular treatment for acute stroke who were closed with the StarClose device. The study included 39 females and 34 males with mean age 68.1 years. 86.4% (n=63) had hypertension, 26% (n=19) had diabetes mellitus, 75.34% (n=55) had dyslipidemia, 42.5% (n=31) had coronary artery disease, and 39.7% had (n=29) had atrial fibrillation. The primary endpoints were successful hemostasis and sheath related post procedure major and minor complication rates.ResultsA 5Fr (1.4%) sheath was used in 1 patient, 6Fr sheaths in 37 (58.7%) patients, 7Fr sheaths in 2 (2.7%) patients, 8Fr sheaths in 14 (19%) patients, and 9Fr sheaths in 19 (26%) patients during acute stroke interventions. Overall, successful hemostasis was achieved in 72 (99%) cases. One (0.95%) minor complication was observed post procedure in the patient with a 6Fr access size. The patient had intermittent minor bleeding from the groin site and was found to have a CFA pseudoaneursym. No mortality or significant morbidity was observed associated with groin site closure in this study.ConclusionThe StarClose vascular closure device is safe and effective in achieving hemostasis during acute stroke endovascular interventions while using large French procedural access sheaths.Competing interestsNone.
E-073 n-BCA salvage of a recanalized carotid sacrifice in a patient with a direct carotid cavernous fistula: Abstract E-073 Figure 1
Authors: Samarawickrama D , Somers S , Basu S , Jacobson P 
Published: July 2012

IntroductionCoil embolization sacrifice of the internal carotid artery (ICA) is an accepted method for management of a direct carotid cavernous fistula (CCF) when adequate collateral pathways exist. With well packed coils, the expected outcome is irreversible occlusion of the artery and cessation of flow in the fistula. We present a case of an ICA sacrifice, for CCF, that subsequently recanalized and was later salvaged with glue embolization.MethodsA 61-year-old female developed right eye chemosis and proptosis. Workup revealed a direct left ICA CCF. The cavernous left ICA was subsequently embolized with coils from distal to proximal across the fistula, resulting in angiographic occlusion. Her symptoms resolved over several days. The patient resumed Plavix following the procedure for pre-existing coronary artery disease. Two months after the procedure, the patient returned with recurrence of her original symptoms. Repeat angiography showed a recurrence of the fistula fed by backflow from the anterior communicating artery and the small left posterior communicating artery as well as from flow, albeit decreased, through a recanalized embolized left ICA. Attempts to access the distal left ICA to embolize the distal coil pack were unsuccessful. Next, n-BCA embolization of the CCF was performed through the coil mass from the proximal ICA with penetration to the sinus, reestablishing ICA occlusion and cessation of fistula flow into the cavernous sinus. Plavix was withheld following the procedure to assist in maturation of the occlusion.ResultsDuring a clinic visit a few weeks later, the patient reported stable complete resolution of symptoms, including normalization of intraocular pressures.ConclusionRecanalization of a well coiled internal carotid artery is rare. The use of Plavix following the coil embolization and the persistent backflow from the circle of Willis collaterals may have led to failure of occlusion. Nevertheless, this case shows that n-BCA embolization through the coil mass can salvage a failed sacrifice.Competing interestsNone.Abstract E-073 Figure 1
Gymnasium-based unsupervised exercise maintains benefits in oxygen uptake kinetics obtained following supervised training in type 2 diabetes
Authors: MacAnaney Oscar , O’Shea Donal , Warmington Stuart A. , Green Simon , Egaña Mikel 
Published: July 2012

Supervised exercise (SE) in patients with type 2 diabetes improves oxygen uptake kinetics at the onset of exercise. Maintenance of these improvements, however, has not been examined when supervision is removed. We explored if potential improvements in oxygen uptake kinetics following a 12-week SE that combined aerobic and resistance training were maintained after a subsequent 12-week unsupervised exercise (UE). The involvement of cardiac output (CO) in these improvements was also tested. Nineteen volunteers with type 2 diabetes were recruited. Oxygen uptake kinetics and CO (inert gas rebreathing) responses to constant-load cycling at 50% ventilatory threshold (VT), 80% VT, and mid-point between VT and peak workload (50% Δ) were examined at baseline (on 2 occasions) and following each 12-week training period. Participants decided to exercise at a local gymnasium during the UE. Thirteen subjects completed all the interventions. The time constant of phase 2 of oxygen uptake was significantly faster (p < 0.05) post-SE and post-UE compared with baseline at 50% VT (17.3 ± 10.7 s and 17.5 ± 5.9 s vs. 29.9 ± 10.7 s), 80% VT (18.9 ± 4.7 and 20.9 ± 8.4 vs. 34.3 ± 12.7s), and 50% Δ (20.4 ± 8.2 s and 20.2 ± 6.0 s vs. 27.6 ± 3.7 s). SE also induced faster heart rate kinetics at all 3 intensities and a larger increase in CO at 30 s in relation to 240 s at 80% VT; and these responses were maintained post-UE. Unsupervised exercise maintained benefits in oxygen uptake kinetics obtained during a supervised exercise in subjects with diabetes, and these benefits were associated with a faster dynamic response of heart rate after training.
Seasonal variation in vitamin D status in professional soccer players of the English Premier League
Authors: Morton James P. , Iqbal Zafar , Drust Barry , Burgess Darren , Close Graeme L. , Brukner Peter D. 
Published: July 2012

The prevalence of seasonal variation in vitamin D status was examined in 20 FA Premier League soccer players residing at a latitude of 53°N. Serum 25-hydroxyvitamin D (25(OH)D) levels decreased (P < 0.001) between August (104.4 ± 21.1 nmol·L–1, range 68–151) and December (51.0 ± 19.0 nmol·L–1, range 22–86), such that levels for 65% of the sample were insufficient (<50 nmol·L–1) in winter. Strategies to augment vitamin D3 availability may therefore be advantageous for UK soccer players so as to maintain muscle function.
Ingesting a high-dose carbohydrate solution during the cycle section of a simulated Olympic-distance triathlon improves subsequent run performance
Authors: McGawley Kerry , Shannon Oliver , Betts James 
Published: July 2012

The well-established ergogenic benefit of ingesting carbohydrates during single-discipline endurance sports has only been tested once within an Olympic-distance (OD) triathlon. The aim of the present study was to compare the effect of ingesting a 2:1 maltodextrin/fructose solution with a placebo on simulated OD triathlon performance. Six male and 4 female amateur triathletes (age, 25 ± 7 years; body mass, 66.8 ± 9.2 kg; peak oxygen uptake, 4.2 ± 0.6 L·min–1) completed a 1500-m swim time-trial and an incremental cycle test to determine peak oxygen uptake before performing 2 simulated OD triathlons. The swim and cycle sections of the main trials were of fixed intensities, while the run section was completed as a time-trial. Two minutes prior to completing every quarter of the cycle participants consumed 202 ± 20 mL of either a solution containing 1.2 g·min–1 of maltodextrin plus 0.6 g·min–1 of fructose at 14.4% concentration (CHO) or a sugar-free, fruit-flavored drink (PLA). The time-trial was 4.0% ± 1.3% faster during the CHO versus PLA trial, with run times of 38:43 ± 1:10 min:s and 40:22 ± 1:18 min:s, respectively (p = 0.010). Blood glucose concentrations were higher in the CHO versus PLA trial (p < 0.001), while perceived stomach upset did not differ between trials (p = 0.555). The current findings show that a 2:1 maltodextrin/fructose solution (1.8 g·min–1 at 14.4%) ingested throughout the cycle section of a simulated OD triathlon enhances subsequent 10-km run performance in triathletes.
A segmental evaluation of arterial stiffness before and after prolonged strenuous exercise
Authors: Phillips Aaron A. , Cote Anita T. , Foulds Heather J. , Charlesworth Sarah , Bredin Shannon S.D. , Burr Jamie F. , Ngai Shirley , Ivey Adam , Drury C. Taylor , Fougere Renee J. , Warburton Darren E.R. 
Published: July 2012

We aimed to investigate the effects of a single session of prolonged strenuous exercise (PSE) on arterial stiffness by measuring pulse wave velocity (PWV) before and after competition in an ultramarathon. A total of 20 routine ultramarathon competitors (UM) completed baseline and postrace evaluation of central PWV (cPWV), upper-limb PWV (uPWV), and lower-limb PWV (lPWV) using carotid artery – femoral artery, carotid artery – finger, and femoral artery – toe segments, respectively. Fourteen additional age- and gender-matched normally active participants (NA) took part in the identical baseline evaluation but did not participate in the race. Average ultramarathon completion time was 30 h 47 min. Mean arterial blood pressure was reduced after exercise (before exercise (pre), 92 ± 7 mm Hg; after exercise (post), 84 ± 7 mm Hg; P < 0.001), whereas heart rate was increased (pre, 57 ± 10 beats·min–1; post, 73 ± 12 beats·min–1; P < 0.001). Also, lPWV (pre, 11.8 ± 3.6 m·s–1; post, 9.6 ± 2.6 m·s–1; P < 0.05) and uPWV (pre, 5.0 ± 0.53 m·s–1; post, 4.4 ± 0.8 m·s–1; P < 0.01) were reduced after exercise. No change in cPWV occurred (pre, 4.1 ± 0.8 m·s–1; post, 3.9 ± 1.3 m·s–1; P = 0.55). At baseline, the NA group had significantly increased cPWV in comparison with the UM group (UM, 4.1 ± 0.8 m·s–1; NA, 7.4 ± 1.3 m·s–1; P < 0.001). Acute participation in PSE influenced peripheral but not central arterial stiffness. Those who routinely participate in PSE have reduced central arterial stiffness as compared with normally active, age- and gender-matched controls.
Relationship between physical activity, physical performance, and iron status in adult women
Authors: Crouter Scott E. , DellaValle Diane M. , Haas Jere D. 
Published: July 2012

Iron deficiency affects approximately 16% of US females 18–45 years old. Iron is a key component of heme-containing proteins, which are essential for oxygen transport throughout the body. With low iron levels, performance and intense physical activity may be compromised. Thus, the purpose of this study was to examine the relationship between iron status, physical performance, and physical activity in 18- to 45-year-old females. Participants (N = 109) were screened for iron status using a venous blood sample, had their height and mass measured, and self-reported their physical activity level. The screening was used to match iron-depleted nonanemic females (hemoglobin, Hgb > 120 g·L–1; serum ferritin, sFer < 20 µg·L–1) to females with normal iron levels. After participant matching, they had their body composition measured, performed three cycle ergometer tests (maximal, endurance, and efficiency), and wore an ActiGraph GT1M accelerometer for five consecutive days, except when sleeping or during water activities. The final sample consisted of 25 iron-depleted participants and 24 with normal iron levels. Key findings were as follows: (i) after controlling for fat-free mass and vigorous physical activity, iron-depleted females had a significantly lower [Formula: see text]O2at ventilatory threshold compared with those with normal iron levels (P < 0.05); and (ii) after controlling for age, iron-depleted females spent significantly more time in sedentary behaviors and significantly less time in light physical activity than those with normal iron levels (P < 0.05). The increased sedentary time in iron-depleted females may contribute to excess mass gain over time; however, further investigation is needed to confirm these results.
Effects of acute hypoxia on the oxygen uptake kinetics of older adults during cycling exercise
Authors: Zerbini Livio , Brighenti Alfredo , Pellegrini Barbara , Bortolan Lorenzo , Antonetti Tommaso , Schena Federico 
Published: July 2012

Pulmonary oxygen uptake, heart rate (HR), and deoxyhemoglobin (HHb) kinetics were studied in a group of older adults exercising in hypoxic conditions. Fourteen healthy older adults (aged 66 ± 6 years) performed 4 exercise sessions that consisted of (i) an incremental test to exhaustion on a cycloergometer while breathing normoxic room air (fractional inspired oxygen (FiO2) = 20.9% O2); (ii) an incremental test to exhaustion on a cycloergometer while breathing hypoxic room air (FiO2 = 15% O2); (iii) 3 repeated square wave cycling exercises at moderate intensity while breathing normoxic room air; and (iv) 3 repeated square wave cycling exercises at moderate intensity while breathing hypoxic room air. During all exercise sessions, pulmonary gas exchange was measured breath-by-breath; HHb was determined on the vastus lateralis muscle by near-infrared spectroscopy; and HR was collected beat-by-beat. The pulomary oxygen uptake kinetics became slower in hypoxia (31 ± 9 s) than in normoxia (27 ± 7 s) because of an increased mismatching between O2 delivery to O2 utilization at the level of the muscle. The HR and HHb kinetics did not change between hypoxia and normoxia,