Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Dec 2015
Meta AnalysisEfficacy and Safety of Edoxaban in Nonvalvular Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials.
Edoxaban is a potential alternative to warfarin for preventing thromboembolism in atrial fibrillation. However, the efficacy and safety, and the optimal regimen of edoxaban are still controversial. This study compared the efficacy and safety of edoxaban and warfarin in nonvalvular atrial fibrillation, and the effects of different edoxaban dosages. ⋯ Edoxaban was noninferior to warfarin in terms of efficacy and superior to warfarin in terms of safety. The benefits of edoxaban were related to the dose; efficacy was better at 60 mg/day, but there was lower risk of bleeding at 30 mg/day.
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J Stroke Cerebrovasc Dis · Dec 2015
Endovascular Modalities for the Treatment of Cavernous Sinus Arteriovenous Fistulas: A Single-Center Experience.
Cavernous sinus (CS) fistulas are classified into traumatic and spontaneous. Traumatic carotid-cavernous fistulas (CCFs) are usually direct internal carotid artery (ICA) high-flow fistulas; whereas spontaneous CCFs are usually dural, low-flow fistulas and generally possess less severe symptoms than direct carotid-cavernous fistulas. ⋯ Coils are superior solid embolic agents used for the treatment of direct high-flow fistulas, while Onyx is more valuable in dural low-flow CCF. Onyx shortens the procedure time and decreases procedure cost. Onyx injection inside the CS proper through the transarterial or transvenous route may be safer than Onyx injected inside dural arteries supplying the CS. However, more cases are needed to determine this.
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J Stroke Cerebrovasc Dis · Dec 2015
Preliminary Prospective Study to Assess the Effect of Early Blood Urea Nitrogen/Creatinine Ratio-Based Hydration Therapy on Poststroke Infection Rate and Length of Stay in Acute Ischemic Stroke.
This study aimed to determine whether blood urea nitrogen (BUN)/creatinine (Cr)-based hydration therapy can decrease the rate of poststroke infection and length of stay (LOS) in the neurology ward. ⋯ The findings suggest that the BUN/Cr ratio needs to be corrected in a timely manner in patients with acute ischemic stroke. Providing prompt saline hydration therapy based on the daily BUN/Cr ratio might decrease the poststroke infection rate and shorten LOS.
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J Stroke Cerebrovasc Dis · Dec 2015
Effect of the Inhibition of Hydrogen Sulfide Synthesis on Ischemic Injury and Oxidative Stress Biomarkers in a Transient Model of Focal Cerebral Ischemia in Rats.
Hydrogen sulfide (H2S) plays multiple roles in the function of the central nervous system in physiological and pathological conditions, such as cerebral ischemia. Recent studies have reported controversial results about the role of H2S in cerebral ischemia. The aim of this study was to evaluate the effects of amino-oxyacetic acid (AOAA), an inhibitor of H2S synthesis, on ischemic injury in an experimental model of stroke. ⋯ The results showed that AOAA administered at a low dose has protective effects; however, at higher doses it did not exert any protective effect against cerebral ischemia and even worsened the ischemic injury. This finding suggests that H2S might be both beneficial and harmful in cerebral ischemic injury depending on its concentration in transient model of focal cerebral ischemia.