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  • SAGE Publications  (22)
  • 1
    Online Resource
    Online Resource
    Safety and efficacy of dual antiplatelet drugs for stent-assisted embolization on risk of stroke and prognosis in patients with ruptured intracranial aneurysms: One center results of CIAP-5 clinical trial
    SAGE Publications ; 2024
    In:  Interventional Neuroradiology
    Details
    In: Interventional Neuroradiology, SAGE Publications
    Abstract: Although stent-assisted coiling embolization (SAC) has been associated with a higher risk of ischemic and hemorrhagic complications, the use of SAC continues to rise for treating ruptured intracranial aneurysms (RIAs). This study aims to assess the safety and effectiveness of dual antiplatelet therapy (DAPT) in the context of RIAs. Methods We conducted a retrospective analysis at a single center, involving patients with aneurysmal subarachnoid hemorrhage (aSAH) between May 1, 2017 and December 31, 2021. Patients were categorized into two groups: the SAC group and the non-SAC (NSC) group. Patients in the SAC group received DAPT. We compared modified Rankin Scale (mRS) score, along with hemorrhagic and ischemic complications, between the two groups to evaluate the safety and efficacy of DAPT for SAC. Results The study included a total of 541 patients, of whom 38 (7.0%) experienced hemorrhagic complications and 48 (8.9%) developed ischemic complications. Additionally, 99 (18.3%) and 84 (15.5%) had poor clinical outcomes at discharge and 6 months, respectively. However, no statistically significant differences were observed between the two groups. Our analysis revealed that aneurysm location in the posterior circulation was a significant risk factor for an unfavorable prognosis when antiplatelet drugs were used following SAC ( p = 0.025). Conclusions Administering antiplatelet drugs after SAC for RIAs has demonstrated both safety and effectiveness. However, caution should be exercised when considering this treatment strategy for RIAs located in the posterior circulation due to the potentially elevated risk.
    Type of Medium: Online Resource
    ISSN: 1591-0199 , 2385-2011
    URL: Article
    DOI: 10.1177/15910199231219212
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2024
    detail.hit.zdb_id: 2571161-1
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  • 2
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    Remote limb ischemic conditioning treatment for intracranial atherosclerotic stenosis patients
    SAGE Publications ; 2016
    In:  International Journal of Stroke Vol. 11, No. 7 ( 2016-10), p. 831-838
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 11, No. 7 ( 2016-10), p. 831-838
    Abstract: The recurrence rate of ischemic stroke remains high among symptomatic intracranial atherosclerotic stenosis patients with either ischemic stroke or transient ischemic attack. The aim of our study is to evaluate whether remote limb ischemic conditioning (RLIC) prevents cerebral ischemic events in symptomatic intracranial atherosclerotic stenosis patients. Methods Symptomatic intracranial atherosclerotic stenosis patients with either ischemic stroke or transient ischemic attack will be recruited from more than 60 hospitals in China to participate in a randomized, double-blind, parallel-controlled clinical trial that will compare the efficacy and safety of RLIC for the prevention of recurrent stroke. Following randomization, patients allocated to the RLIC group ( n = 1500) will receive RLIC once daily for 12 months, with treatment consisting of five cycles of 5 min of pressure treatment at 200 mm Hg, followed by 5 min of reperfusion. The sham group ( n = 1500) will be treated identically, with the exception of pressure treatment at 60 mm Hg. Results The primary endpoint will be an ischemic stroke event during the study period. Secondary endpoints will include composite fatal and nonfatal stroke, fatal and nonfatal myocardial infarction, and transient ischemic attack. Patients will be assessed periodically over a approximate 3-year study period using the modified Rankin Scale, National Institutes of Health Stroke Scale, and Barthel Activities of Daily Living Index. Conclusion We predict that RLIC treatment for 12 months will safely reduce the ischemic stroke recurrence rate.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/1747493016654489
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2211666-7
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  • 3
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    Basilar Artery Occlusion Chinese Endovascular Trial: Protocol for a prospective randomized controlled study
    SAGE Publications ; 2022
    In:  International Journal of Stroke Vol. 17, No. 6 ( 2022-07), p. 694-697
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 17, No. 6 ( 2022-07), p. 694-697
    Abstract: There are no randomized trials examining the best treatment for acute basilar artery occlusion in the 6–24-hour time window. Aims To assess the safety and efficacy of thrombectomy for stroke due to basilar artery occlusion in patients randomized within 6–24 h from symptom onset or time last seen well. Sample size For an estimated difference of 20% in proportions of the primary outcome between the two groups, 318 patients will be included for 5% significance and 90% power with a planned interim analysis after two-thirds of the sample size (212 patients) have achieved the 90 days follow-up. Methods and design A prospective, multi-center, randomized, controlled, open-label and blinded-endpoint trial. The randomization employs a 1:1 ratio of mechanical thrombectomy with the detachable Solitaire thrombectomy device and best medical therapy (BMT) vs. BMT alone. Study outcomes The primary outcome will be the proportion of patients achieving modified Rankin Scale (mRS) 0–3 at 90 days. Key secondary outcomes are: dramatic early favorable response, dichotomized mRS score (0–2 vs. 3–6 and 0–4 vs. 5–6) at 90 days, ordinal (shift) mRS analysis at 90 days, infarct volume at 24 h, vessel recanalization at 24 h in both treatment arms, and successful recanalization in the thrombectomy arm according to the modified thrombolysis in cerebral infarction (mTICI) classification defined as mTICI 2 b or 3. Safety variables are mortality at 90 days, symptomatic intracranial hemorrhage rates at 24 h, and procedure-related complications. Discussion Results from this trial will indicate whether mechanical thrombectomy is superior to medical management alone in achieving favorable outcomes in subjects with acute stroke caused by basilar artery occlusion presenting within 6–24 h from symptom onset. Trial registration: URL: http://www.clinicaltrials.gov . ClinicalTrials.gov Identifier: NCT02737189.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930211040923
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2211666-7
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  • 4
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    Plasminogen deficiency causes reduced angiogenesis and behavioral recovery after stroke in mice
    SAGE Publications ; 2021
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 41, No. 10 ( 2021-10), p. 2583-2592
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    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 41, No. 10 ( 2021-10), p. 2583-2592
    Abstract: Plasminogen is involved in the process of angiogenesis; however, the underlying mechanism is unclear. Here, we investigated the potential contribution of plasmin/plasminogen in mediating angiogenesis and thereby contributing to functional recovery post-stroke. Wild-type plasminogen naive (Plg +/+ ) mice and plasminogen knockout (Plg −/− ) mice were subjected to unilateral permanent middle cerebral artery occlusion (MCAo). Blood vessels were labeled with FITC-dextran. Functional outcomes, and cerebral vessel density were compared between Plg +/+ and Plg −/− mice at different time points after stroke. We found that Plg −/− mice exhibited significantly reduced functional recovery, associated with significantly decreased vessel density in the peri-infarct area in the ipsilesional cortex compared with Plg +/+ mice. In vitro, cerebral endothelial cells harvested from Plg −/− mice exhibited significantly reduced angiogenesis assessed using tube formation assay, and migration, as evaluated using Scratch assays, compared to endothelial cells harvested from Plg +/+ mice. In addition, using Western blots, expression of thrombospondin (TSP)-1 and TSP-2 were increased after MCAo in the Plg −/− group compared to Plg +/+ mice, especially in the ipsilesional side of brain. Taken together, our data suggest that plasmin/plasminogen down-regulates the expression level of TSP-1 and TSP-2, and thereby promotes angiogenesis in the peri-ischemic brain tissue, which contributes to functional recovery after ischemic stroke.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1177/0271678X211007958
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2039456-1
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  • 5
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    Multipotent Mesenchymal Stromal Cells Increase tPA Expression and Concomitantly Decrease PAI-1 Expression in Astrocytes through the Sonic Hedgehog Signaling Pathway after Stroke ( in vitro Study)
    SAGE Publications ; 2011
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 31, No. 11 ( 2011-11), p. 2181-2188
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 31, No. 11 ( 2011-11), p. 2181-2188
    Abstract: Multipotent mesenchymal stromal cells (MSCs) increase tissue plasminogen activator (tPA) activity in astrocytes of the ischemic boundary zone, leading to increased neurite outgrowth in the brain. To probe the mechanisms that underlie MSC-mediated activation of tPA, we investigated the morphogenetic gene, sonic hedgehog (Shh) pathway. In vitro oxygen and glucose deprivation and coculture of astrocytes and MSCs were used to mimic an in vivo ischemic condition. Both real-time-PCR and western blot showed that MSC coculture significantly increased the Shh level and concomitantly increased tPA and decreased plasminogen activator inhibitor 1 (PAI-1) levels in astrocytes. Inhibiting the Shh signaling pathway with cyclopamine blocked the increase of tPA and the decrease of PAI-1 expression in astrocytes subjected to MSC coculture or recombinant mouse Shh (rm-Shh) treatment. Both MSCs and rm-Shh decreased the transforming growth factor- β1 level in astrocytes, and the Shh pathway inhibitor cyclopamine reversed these decreases. Both Shh-small-interfering RNA (siRNA) and Glil-siRNA downregulated Shh and Gli1 (a key mediator of the Shh transduction pathway) expression in cultured astrocytes and concomitantly decreased tPA expression and increased PAI-1 expression in these astrocytes after MSC or rm-Shh treatment. Our data indicate that MSCs increase astrocytic Shh, which subsequently increases tPA expression and decreases PAI-1 expression after ischemia.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1038/jcbfm.2011.116
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2039456-1
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  • 6
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    Network dynamic defense system based on holographic transformation
    SAGE Publications ; 2020
    In:  International Journal of Distributed Sensor Networks Vol. 16, No. 5 ( 2020-05), p. 155014772091874-
    Details
    In: International Journal of Distributed Sensor Networks, SAGE Publications, Vol. 16, No. 5 ( 2020-05), p. 155014772091874-
    Abstract: Aimed at the problem of the boundary defense easily being out of availability caused by the static network structure, a novel dynamic enterprise network defense system based on holographic transformation is designed and implemented. To increase the uncertainty of network structure and the position of target nodes, the network view is dynamically changed by constantly transforming endpoint information. Virtual endpoint mutation and hopping period selection are achieved by the hopping address generation module. It takes the advantages of anti-collision and good randomicity of the Chinese national SM3 hash algorithm. The full-cycle hopping period is managed and controlled by the hopping period management mechanism based on the ciphertext policy attribute-based broadcast holographic transformation. Experiments show that the system achieves expected security goals and has good interactivity and high stability.
    Type of Medium: Online Resource
    ISSN: 1550-1477 , 1550-1477
    URL: Article
    DOI: 10.1177/1550147720918749
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2192922-1
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  • 7
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    Endovascular treatment of V3 segment vertebro-vertebral arteriovenous fistula with Willis covered stent: Case report and literature review
    SAGE Publications ; 2019
    In:  Interventional Neuroradiology Vol. 25, No. 1 ( 2019-02), p. 97-101
    Details
    In: Interventional Neuroradiology, SAGE Publications, Vol. 25, No. 1 ( 2019-02), p. 97-101
    Abstract: A 46-year-old male presented to our hospital suffering from right mastoid pulsatile tinnitus secondary to traffic trauma. Digital subtraction angiography was remarkable for a vertebro-vertebral arteriovenous fistula fed by the right vertebral artery at the C1 level. Dual platelet therapy was administrated before and after the operation, then a Willis covered stent was deployed at the orifice of the fistula. Post-operative angiography showed proper stent localization but some contrast agent leaking from the fistula. Angiography performed 6 months post-operatively demonstrated no leak from the fistula and the patency of the right vertebral artery. This case demonstrated that an intracranial covered stent could be used as an alternative, successful treatment for vertebro-vertebral arteriovenous fistula.
    Type of Medium: Online Resource
    ISSN: 1591-0199 , 2385-2011
    URL: Article
    DOI: 10.1177/1591019918796607
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2571161-1
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  • 8
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    Secondary Release of Exosomes from Astrocytes Contributes to the Increase in Neural Plasticity and Improvement of Functional Recovery after Stroke in Rats Treated with Exosomes Harvested from MicroRNA 133b-Overexpressing Multipotent Mesenchymal Stromal Cells
    SAGE Publications ; 2017
    In:  Cell Transplantation Vol. 26, No. 2 ( 2017-02), p. 243-257
    Details
    In: Cell Transplantation, SAGE Publications, Vol. 26, No. 2 ( 2017-02), p. 243-257
    Abstract: We previously demonstrated that multipotent mesenchymal stromal cells (MSCs) that overexpress microRNA 133b (miR-133b) significantly improve functional recovery in rats subjected to middle cerebral artery occlusion (MCAO) compared with naive MSCs and that exosomes generated from naive MSCs mediate the therapeutic benefits of MSC therapy for stroke. Here we investigated whether exosomes isolated from miR-133b-overexpressing MSCs (Ex-miR-133b + ) exert amplified therapeutic effects. Rats subjected to 2 h of MCAO were intra-arterially injected with Ex-miR-133b + , exosomes from MSCs infected by blank vector (Ex-Con), or phosphate-buffered saline (PBS) and were sacrificed 28 days after MCAO. Compared with the PBS treatment, both exosome treatment groups exhibited significant improvement of functional recovery. Ex-miR-133b + treatment significantly increased functional improvement and neurite remodeling/brain plasticity in the ischemic boundary area compared with the Ex-Con treatment. Treatment with Ex-miR-133b + also significantly increased brain exosome content compared with Ex-Con treatment. To elucidate mechanisms underlying the enhanced therapeutic effects of Ex-miR-133b + , astrocytes cultured under oxygen- and glucose-deprived (OGD) conditions were incubated with exosomes harvested from naive MSCs (Ex-Naive), miR-133b downregulated MSCs (Ex-miR-133b − ), and Ex-miR-133b + . Compared with the Ex-Naive treatment, Ex-miR-133b + significantly increased exosomes released by OGD astrocytes, whereas Ex-miR-133b − significantly decreased the release. Also, exosomes harvested from OGD astrocytes treated with Ex-miR-133b + significantly increased neurite branching and elongation of cultured cortical embryonic rat neurons compared with the exosomes from OGD astrocytes subjected to Ex-Con. Our data suggest that exosomes harvested from miR-133b-overexpressing MSCs improve neural plasticity and functional recovery after stroke with a contribution from a stimulated secondary release of neurite-promoting exosomes from astrocytes.
    Type of Medium: Online Resource
    ISSN: 0963-6897 , 1555-3892
    URL: Article
    DOI: 10.3727/096368916X693031
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2020466-8
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  • 9
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    Application of deblur technology for improving the clarity of digital subtractive angiography
    SAGE Publications ; 2022
    In:  Interventional Neuroradiology
    Details
    In: Interventional Neuroradiology, SAGE Publications
    Abstract: Digital subtraction angiography (DSA) is most commonly used in vessel disease examinations and treatments. We aimed to develop a novel deep learning-based method to deblur the large focal spot DSA images, so as to obtain a clearer and sharper cerebrovascular DSA image. Methods The proposed network cascaded several residual dense blocks (RDBs), which contain dense connected layers and local residual learning. Several loss functions for image restoration were investigated. Our training set consisted of 52 paired images of angiography with more than 350,000 cropped patches. The testing set included 10 body phantoms and 80 clinical images of different types of diseases for subjective evaluation. All test images were acquired using a large focal spot, and phantom images were simultaneously acquired using a micro focal spot as ground-truth. Peak-to-noise ratio (PSNR) and structural similarity (SSIM) were determined for quantitative analysis. The deblurring results were compared with the original data, and the image quality was subjectively evaluated and graded by two clinicians. Results For quantitative analysis of phantom images, the average PSNR/SSIM based on the deep-learning approach (35.34/0.9566) was better than that of large focal spot images (30.64/0.9163). For subjective evaluation of 80 clinical patient images, image quality in all types of cerebrovascular diseases was also improved based on a deep-learning approach ( p  〈  0.001). Conclusions Deep learning-based focal spot deblur algorithm can efficiently improve DSA image quality for better visualization of blood vessels and lesions in the image.
    Type of Medium: Online Resource
    ISSN: 1591-0199 , 2385-2011
    URL: Article
    DOI: 10.1177/15910199221143168
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 10
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    Acute embolic occlusion of the right common iliac artery after revision total hip arthroplasty treated with catheter-directed thrombolysis and balloon angioplasty: A case report
    SAGE Publications ; 2015
    In:  SAGE Open Medical Case Reports Vol. 3 ( 2015-01-01), p. 2050313X1559483-
    Details
    In: SAGE Open Medical Case Reports, SAGE Publications, Vol. 3 ( 2015-01-01), p. 2050313X1559483-
    Abstract: A 63-year-old woman with atrial fibrillation presented clinical symptoms and signs of acute ischemia in the right lower extremity on the 17th postoperative day after revision total hip arthroplasty of the left hip for aseptic loosening of femoral component. Aspirin was discontinued 7 days before surgery. Both computed tomography angiography and digital subtraction angiography demonstrated complete occlusion of the right common iliac artery. An emergency catheter-directed thrombolysis with urokinase combined with balloon angioplasty was performed to obtain complete patency of the right common iliac artery. Results: The patient received anticoagulation and antiplatelet therapy postoperatively and was fine at the 2-year follow-up. Conclusions: This case demonstrated that catheter-directed thrombolysis combined with balloon angioplasty could be an efficacious, minimally invasive approach for the treatment of acute embolic occlusion of the common iliac artery. Preoperative anticoagulation for patients undergoing total hip arthroplasty with long-term use of aspirin for atrial fibrillation needs further investigation.
    Type of Medium: Online Resource
    ISSN: 2050-313X , 2050-313X
    URL: Article
    DOI: 10.1177/2050313X15594836
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2736953-5
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