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Stehli J, Stub D, Htun N, Martin C, Dick R, Duffy S, Walton T. Long-Term Valve Durability of Patients Undergoing Transcatheter Aortic Valve Implantation in Australia. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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102
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Stehli J, Stub D, Htun N, Quine E, Martin C, Dick R, Walton T, Duffy S. Favourable Short-Term Outcome of Transcatheter Aortic Valve Implantation in Nonagenarians. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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103
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Peck K, Andrianopoulos N, Parfrey S, Roberts L, Duffy S, Sebastian M, Clark D, Brennan A, Oqueli E, Ajani A, Reid C, Freeman M, Teh A. Role of Routine Use of Beta Blockers After Percutaneous Coronary Intervention for Acute Coronary Syndrome. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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104
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Quine E, Duffy S, Walton A, Dick R, Htun N, Stehli J, Stub D. Comparison of Early Outcomes in Low-, Intermediate- and High-Risk Transcatheter Aortic Valve Implantation Patients. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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105
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Letchworth P, MacLaren E, Duffy S. Obstetric fistula: a paradigm shift is needed in research and prevention. BJOG 2017; 125:925-928. [PMID: 29281180 DOI: 10.1111/1471-0528.15110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 12/01/2022]
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106
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Brinjikji W, Duffy S, Burrows A, Hacke W, Liebeskind D, Majoie CBLM, Dippel DWJ, Siddiqui AH, Khatri P, Baxter B, Nogeuira R, Gounis M, Jovin T, Kallmes DF. Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review. J Neurointerv Surg 2017; 9:529-534. [PMID: 27166383 PMCID: PMC6697418 DOI: 10.1136/neurintsurg-2016-012391] [Citation(s) in RCA: 195] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 04/15/2016] [Accepted: 04/22/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Studying the imaging and histopathologic characteristics of thrombi in ischemic stroke could provide insights into stroke etiology and ideal treatment strategies. We conducted a systematic review of imaging and histologic characteristics of thrombi in acute ischemic stroke. MATERIALS AND METHODS We identified all studies published between January 2005 and December 2015 that reported findings related to histologic and/or imaging characteristics of thrombi in acute ischemic stroke secondary to large vessel occlusion. The five outcomes examined in this study were (1) association between histologic composition of thrombi and stroke etiology; (2) association between histologic composition of thrombi and angiographic outcomes; (3) association between thrombi imaging and histologic characteristics; (4) association between thrombi imaging characteristics and angiographic outcomes; and (5) association between imaging characteristics of thrombi and stroke etiology. A meta-analysis was performed using a random effects model. RESULTS There was no significant difference in the proportion of red blood cell (RBC)-rich thrombi between cardioembolic and large artery atherosclerosis etiologies (OR 1.62, 95% CI 0.1 to 28.0, p=0.63). Patients with a hyperdense artery sign had a higher odds of having RBC-rich thrombi than those without a hyperdense artery sign (OR 9.0, 95% CI 2.6 to 31.2, p<0.01). Patients with a good angiographic outcome had a mean thrombus Hounsfield unit (HU) of 55.1±3.1 compared with a mean HU of 48.4±1.9 for patients with a poor angiographic outcome (mean standard difference 6.5, 95% CI 2.7 to 10.2, p<0.001). There was no association between imaging characteristics and stroke etiology (OR 1.13, 95% CI 0.32 to 4.00, p=0.85). CONCLUSIONS The hyperdense artery sign is associated with RBC-rich thrombi and improved recanalization rates. However, there was no association between the histopathological characteristics of thrombi and stroke etiology and angiographic outcomes.
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107
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Gunning GM, McArdle K, Mirza M, Duffy S, Gilvarry M, Brouwer PA. Clot friction variation with fibrin content; implications for resistance to thrombectomy. J Neurointerv Surg 2017; 10:34-38. [PMID: 28044009 DOI: 10.1136/neurintsurg-2016-012721] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/01/2016] [Accepted: 12/12/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Despite significant advancements in the procedural efficacy of mechanical thrombectomy in patients with ischemic stroke in recent years, there still remains a portion of the population that does not achieve good recanalization. The reasons for this may be varied. We hypothesized that static friction between the clot and the vessel, or catheter wall might contribute to the difficulty in removing the clot. OBJECTIVE To determine if there is a relationship between clot composition and the resistance to sliding (friction) which might contribute to resistance to clot removal. METHODS As clot composition can vary significantly, we investigated five different types of clot in order to measure their respective frictional properties. To do this, a custom-made testing apparatus was created, consisting of various replaceable low-friction surfaces on which the clots could be placed. The surface was then gradually tilted until the clots began to slide; the angle at which this occurred is related to the coefficient of friction of the clots. The experiment was repeated on a bovine aortic surface in order to confirm the results. RESULTS We found that fibrin-rich clots (<20% red blood cell content) have a significantly higher coefficient of friction than clots with a red blood cell content >20%. This result was confirmed by repeating the experiment on a bovine aortic surface as a representation of the interaction between clots and the arterial wall. CONCLUSIONS The friction properties of clots were found to be related to the content ratio of fibrin to red blood cells. Future imaging techniques that could show fibrin and red blood cell content might help us to predict the 'stickiness' of a clot.
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108
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Dawson L, Dagan M, Walton A, Stub D, Duffy S, Shaw J. Significance of Iliac Vessel Disease and Coronary Artery Disease in Patients with Severe Aortic Stenosis being Considered for Transcatheter Aortic Valve Implantation. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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109
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Khialani B, Andrianopoulos N, Reid C, Sebastian M, Yip T, Clark D, Freeman M, Duffy S, Ajani A, Sharma A, Hiew C, Hutchison A. Outcomes After Percutaneous Coronary Intervention (PCI) in Patients with Prior Coronary Artery Bypass Grafts (CABG). Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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110
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Biswas S, Dinh D, Brennan A, Tacey M, Andrianopoulos N, Brien R, Duffy S, Harper R, Nadurata V, van Gaal W, Grigg L, Cox N, Clark D, Reid C, Lefkovits J, Stub D. Patient and Hospital Factors Predicting Prolonged Door-to-Balloon Time in STEMI Patients Undergoing Primary PCI. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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111
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Biswas S, Duffy S, Lefkovits J, Andrianopoulos N, Brennan A, Walton A, Shaw J, Chan W, Ajani A, Clark D, Freeman M, Hiew C, Oqueli E, Reid C, Stub D. Impact of Socioeconomic Status on Risk Factors, Treatment and Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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112
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Parfrey S, Andrianopoulos N, Roberts L, Teh A, Rajakariar K, Marceddo L, Clarke D, Ajani A, Sebastian M, Brennan A, Duffy S, Reid C, Oqueli E, Freeman M. CHA 2 DS 2 -VASc Score as a Predictor of Adverse Outcomes in Patients Undergoing Percutaneous Coronary Intervention (PCI). Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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113
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Yudi M, Hamilton G, Andrianopoulos N, Brennan A, Farouque O, Ajani A, Yeoh J, Sebastian M, Freeman M, Oqueli E, Reid C, Duffy S, Clark D. Trends and Clinical Outcomes of Patients with Established Coronary Artery Disease Presenting with Acute Coronary Syndromes. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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114
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Noaman S, Adrianopoulos N, Reid C, Sharma A, Chan W, brien O, Clark D, Freeman M, Ajani A, Brennan A, Yip T, Duffy S, Oqueli E. Clinical Outcomes of ST-Elevation Myocardial Infarction Secondary to Stent Thrombosis Treated by Percutaneous Coronary Intervention. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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115
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Noaman S, Andrianopoulos N, Brennan A, Reid C, Stub D, Biswas S, Walton A, Clark D, Ajani A, Freeman M, Sebastian M, Duffy S, Chan W. Clinical Outcomes of Cardiogenic Shock Complicating Acute Coronary Syndrome Treated with Percutaneous Coronary Intervention. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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116
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Bissessor N, Duffy S, Walton A. A Comparative Analysis of Low Risk TAVI Patients with Intermediate/High Risk with Outcomes at Two Years. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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117
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Brinjikji W, Michalak G, Kadirvel R, Dai D, Gilvarry M, Duffy S, Kallmes DF, McCollough C, Leng S. Utility of single-energy and dual-energy computed tomography in clot characterization: An in-vitro study. Interv Neuroradiol 2017; 23:279-284. [PMID: 28604189 DOI: 10.1177/1591019917694479] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background and purpose Because computed tomography (CT) is the most commonly used imaging modality for the evaluation of acute ischemic stroke patients, developing CT-based techniques for improving clot characterization could prove useful. The purpose of this in-vitro study was to determine which single-energy or dual-energy CT techniques provided optimum discrimination between red blood cell (RBC) and fibrin-rich clots. Materials and methods Seven clot types with varying fibrin and RBC densities were made (90% RBC, 99% RBC, 63% RBC, 36% RBC, 18% RBC and 0% RBC with high and low fibrin density) and their composition was verified histologically. Ten of each clot type were created and scanned with a second generation dual source scanner using three single (80 kV, 100 kV, 120 kV) and two dual-energy protocols (80/Sn 140 kV and 100/Sn 140 kV). A region of interest (ROI) was placed over each clot and mean attenuation was measured. Receiver operating characteristic curves were calculated at each energy level to determine the accuracy at differentiating RBC-rich clots from fibrin-rich clots. Results Clot attenuation increased with RBC content at all energy levels. Single-energy at 80 kV and 120 kV and dual-energy 80/Sn 140 kV protocols allowed for distinguishing between all clot types, with the exception of 36% RBC and 18% RBC. On receiver operating characteristic curve analysis, the 80/Sn 140 kV dual-energy protocol had the highest area under the curve for distinguishing between fibrin-rich and RBC-rich clots (area under the curve 0.99). Conclusions Dual-energy CT with 80/Sn 140 kV had the highest accuracy for differentiating RBC-rich and fibrin-rich in-vitro thrombi. Further studies are needed to study the utility of non-contrast dual-energy CT in thrombus characterization in acute ischemic stroke.
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Nanayakkara S, Stub D, Duffy S, Marasco S, Kaye D, Walton A. The Impact of Mild Mitral Regurgitation in Patients Undergoing Transcutaneous Aortic Valve Implantation (TAVI). Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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119
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Parfrey S, Andrianopoulos N, Teh A, Roberts L, Brennan A, Hiew C, Clark D, Duffy S, Ajani A, Reid C, New G, Freeman M. Safety of Early Discharge Following Percutaneous Coronary Intervention (PCI) for STEMI. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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120
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Yudi M, Andrianopoulos N, Farouque O, Ramchand J, Jones N, Theuerle J, Brennan A, Ajani A, Duffy S, Freeman M, Yip T, Sharma A, Reid C, Clark D. Pre-Treatment With Dual Anti-Platelet Therapy in STEMI – Does it Make Any Difference? Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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121
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Sharma A, MacFadyen R, Andrianopoulos N, Chan W, Brennan A, Papapostolou S, Duffy S, Clark D, Freeman M, Yip T, Ajani A, Reid C, Oqueli E. Identifying Attenuated Biological Ageing in Octogenarians: Do Conventional Population Risk Factors and Age Alone Inform Cardiovascular Outcomes in the Very Elderly. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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122
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Venkataraman P, Andrianopoulos N, Teh A, Roberts L, Duffy S, Brennan A, Ajani A, Clark D, Sebastian M, Reid C, Sajeev J, New G, Freeman M. Outcomes of Pre-Loading vs In-Lab Loading with Prasugrel and Ticagrelor in Patients With Acute Coronary Syndromes (ACS) Undergoing Percutaneous Coronary Intervention (PCI). Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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123
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Biswas S, Andrianopoulos N, Brennan A, Ajani A, Lefkovits J, Warren R, Duffy S, Clark D, Freeman M, Sebastian M, Reid C, Eccleston D. Long-Term Outcomes After PCI in Patients With Insulin-Treated vs. Non-Insulin Treated Diabetes Mellitus. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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124
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Yudi M, Andrianopoulos N, O’Brien J, Selkrig L, Clark D, Ajani A, Freeman M, Hiew C, Chan W, Reid C, Farouque O, Dart A, Duffy S. Predictors of Recurrent Acute Coronary Syndrome Hospitalisations and Unplanned Revascularisation Following Acute Myocardial Infarction. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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125
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Brennan A, Dinh D, Lefkovits J, Stub D, Brien R, Carruthers H, Andrianopoulos N, Duffy S, Dick R, Clark D, Hiew C, New G, Warren R, McNeil J, Reid C. Ensuring the Quality in Clinical Quality Registries – Design and Implementation of Rigorous Audit Activities in the Victorian Cardiac Outcomes Registry (VCOR). Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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