ABSTRACT
Takotsubo syndrome (TS) is characterized with a reversible disorder of left ventricular contractility. At present time, it is established that various factors, both psycho-emotional and clinical, can trigger this disease. Notably, according to current opinions, coronary atherosclerosis may accompany TS and not be its exclusion criteria as it was previously thought. This article presents a clinical case of TS relapse in a female patient aged 83 years at 5 years following the first episode associated with progression of coronary atherosclerosis.
Subject(s)
Coronary Artery Disease , Takotsubo Cardiomyopathy , Aged, 80 and over , Coronary Angiography , Coronary Artery Disease/complications , Coronary Artery Disease/diagnosis , Electrocardiography , Female , Heart Ventricles , Humans , Takotsubo Cardiomyopathy/complications , Takotsubo Cardiomyopathy/diagnosisABSTRACT
OBJECTIVE: Based on a retrospective analysis, to evaluate technical results and functional outcomes at discharge after endovascular thrombectomy (EVT) in anterior circulation out of 6-hours «therapeutic window¼ in patients with stroke. MATERIAL AND METHODS: The retrospective analysis of EVT in 594 acute stroke patients (303 male, 291 female, median age 69 years) with the anterior circulation large vessel occlusion was performed. EVT was carried out before 6 hrs in 550, later in 44 patients. Time to artery puncture was defined as a cut point. Patients were included in the study if they met the criterion for 0-6 hours «therapeutic window¼. RESULTS: No significant differences in functional outcomes at discharge assessed with the Rankin scale (mRs 0-2 29.8% and 20.5% p<0.19; mRs 3-5 38.7% and 38.6% p<0.99; mRs 6 31.5% and 40.9% p<0.2) and the rates of intracranial haemorrhage, haemorrhagic transformation and symptomatic haemorrhagic transformation (4% and 0% p<0.17; 20.9% and 29.5% p<0.49; 10.1% and 11.4% p<0.78) were observed in patients exposed to EVT before 6 hrs and later. CONCLUSION: EVT in anterior circulation stroke over 6 hrs «therapeutic window¼ based on the criterion for 0-6 hrs provides comparable functional outcomes at discharge without the increase in the frequency of intracranial haemorrhages, haemorrhagic and symptomatic haemorrhagic transformations.
Subject(s)
Brain Ischemia , Endovascular Procedures , Stroke , Aged , Cerebrovascular Circulation , Female , Humans , Male , Retrospective Studies , Russia , Thrombectomy , Treatment OutcomeABSTRACT
Transcatheter aortic valve implantation (TAVI) has become the standard treatment for advanced age and high risk patients with severe aortic stenosis. The incidence of life-threatening complications during TAVI has significantly decreased over the last decade due to advanced current surgical experience. However, there is a risk of perioperative life-threatening complications which can require emergency hemodynamic support. Veno-arterial extracorporeal membrane oxygenation (ECMO) may represent an effective strategy for immediate hemodynamic stabilization until further treatment of the underlying complication. It is presented case report of TAVI under ECMO performed at the Kemerovo Research Institute for Complex Issues of Cardiovascular Diseases. Emergency ECMO represents a feasible strategy for stabilization until further treatment of life-threatening complications during TAVI.
Subject(s)
Aortic Valve Stenosis/surgery , Aortic Valve/surgery , Extracorporeal Membrane Oxygenation , Transcatheter Aortic Valve Replacement/methods , Feasibility Studies , Heart Valve Prosthesis , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Treatment OutcomeABSTRACT
AIM: To assess technical results and close functional outcomes of acute ischemic stroke (AIS) in patients treated with endovascular thrombecomy (ET) in regional vascular centers (RVC) of St-Petersburg. MATERIAL AND METHODS: Retrospective analysis of 183 patients with AIS, including 143 patients with AIS due to a large intracranial vessel occlusion in anterior (AC) and 25 patients in posterior cerebral (PC) circulation, 15 with isolated extracranial carotid occlusion treated in 6 RVC in 2017 was performed. All patients underwent ET. RESULTS AND CONCLUSION: Effective reperfusion (mTICI 2b-3) was achieved in 71.5% (71.3% AC, 72% PC). On discharge, 35,7% patients had good (mRs 0-2) functional outcome (37.1% AC, 28% PC). The incidence of symptomatic intracranial hemorrhage (according to ECASS II criteria) was 10.7% (9.1% AC, 20% PC), the mortality was 29.2% (22.4% AC, 68% PC).). The results of our study show the possibility of effective and safe application of ET in patients with AIS in the anterior and posterior cerebral circulation in regional vascular centers of St.-Petersburg.
