TY - JOUR AU - Marton, Annamária AU - Blényesi, Eszter AU - Török, Katalin AU - Balogh, Gábor AU - Gubucz, István AU - Nardai, Sándor AU - Lenzsér, Gábor AU - Nagy, Csaba Balázs AU - Bajzik, Gábor AU - Tollár, József AU - Repa, Imre AU - Nagy, Ferenc AU - Vajda, Zsolt TI - Treatment of In-stent Restenosis of the Internal Carotid Artery Using Drug-eluting Balloons JF - CLINICAL NEURORADIOLOGY J2 - CLIN NEURORADIOL VL - 34 PY - 2024 IS - 1 SP - 147 EP - 154 PG - 8 SN - 1869-1439 DO - 10.1007/s00062-023-01343-6 UR - https://m2.mtmt.hu/api/publication/34133554 ID - 34133554 N1 - Department of Neurology, Somogy County Moritz Kaposi Teaching Hospital, Kaposvár, Hungary Department of Surgery, Somogy County Moritz Kaposi Teaching Hospital, Kaposvár, Hungary Neurovascular and Interventional Unit, Somogy County Moritz Kaposi Teaching Hospital, Kaposvár, Hungary Export Date: 3 April 2024 Correspondence Address: Vajda, Z.; Neurovascular and Interventional Unit, Hungary; email: vajdus@gmail.com Chemicals/CAS: acetylsalicylic acid, 493-53-8, 50-78-2, 53663-74-4, 53664-49-6, 63781-77-1; clopidogrel, 113665-84-2, 120202-66-6, 90055-48-4, 94188-84-8, 120202-65-5, 120202-67-7, 894353-16-3, 744256-69-7; heparin, 37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5, 9041-08-1 Tradenames: Elutax, Aachen Resonance, Germany; Multiplate, roche deutschland holding gmbh, Germany; SOMATOM Definition Flash, Siemens, Germany Manufacturers: Aachen Resonance; Aachen Resonance, Germany; roche deutschland holding gmbh; roche deutschland holding gmbh, Germany; Siemens; Siemens, Germany LA - English DB - MTMT ER - TY - JOUR AU - Marton, Annamária AU - Nagy, Csaba Balázs AU - Lenzsér, Gábor AU - Nardai, Sándor AU - Gubucz, István AU - Bajzik, Gábor AU - Nagy, Ferenc AU - Vajda, Zsolt TI - Akut ischaemiás stroke neurointervenciós kezelése: kaposvári tapasztalatok JF - IDEGGYÓGYÁSZATI SZEMLE PROCEEDINGS / CLINICAL NEUROSCIENCE PROCEEDINGS J2 - IDEGGYÓGY SZEMLE PROC VL - 7 PY - 2022 IS - 3 SP - 156 EP - 157 PG - 2 SN - 2498-6240 UR - https://m2.mtmt.hu/api/publication/33062483 ID - 33062483 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Spántler, Dóra AU - Csécsei, Péter AU - Böröcz, Katalin AU - Berki, Tímea AU - Zavori, Laszlo AU - Schwarcz, Attila AU - Lenzsér, Gábor AU - Molnár, Tihamér TI - Serum Periostin May Help to Identify Patients with Poor Collaterals in the Hyperacute Phase of Ischemic Stroke JF - DIAGNOSTICS J2 - DIAGNOSTICS VL - 12 PY - 2022 IS - 8 PG - 11 SN - 2075-4418 DO - 10.3390/diagnostics12081942 UR - https://m2.mtmt.hu/api/publication/33050416 ID - 33050416 N1 - Department of Anaesthesiology and Intensive Care and Department of Neurosurgery, Medical School, University of Pecs, Pecs, 7624, Hungary Department of Neurosurgery, Medical School, University of Pecs, Pecs, 7624, Hungary Department of Immunology and Biotechnology, Medical School, University of Pecs, Pecs, 7624, Hungary Salisbury NHS Foundation Trust, Salisbury, SP2 8BJ, United Kingdom Export Date: 13 November 2023 Correspondence Address: Csecsei, P.; Department of Neurosurgery, Hungary; email: csecseipeti@yahoo.com AB - Background: Periostin is a glycoprotein that mediates cell functions in the extracellular matrix and appears to be a promising biomarker in neurological damage, such as ischemic stroke (IS). We aimed to measure serum periostin levels in the hyperacute phase of ischemic stroke to explore its predictive power in identification of patients with poor collaterals (ASPECT < 6). Methods: We prospectively enrolled 122 patients with acute ischemic stroke within the first 6 h after onset. The early ischemic changes were evaluated by calculating ASPECT score on admission using a native CT scan. An unfavorable outcome was defined as the modified Rankin Scale (mRS) > 2 at 90 days follow-up. Blood samples were collected on admission immediately after CT scan and periostin serum concentrations were determined by ELISA. Results: The admission concentration of serum periostin was significantly higher in patients with unfavorable outcome than in patients with favorable outcome (615 ng/L, IQR: 443–1070 vs. 390 ng/L, 260–563, p < 0.001). In a binary logistic regression model, serum periostin level was a significant predictor for ASPECT < 6 status on admission, within 6 h after stroke onset (OR, 5.911; CI, 0.990–0.999; p = 0.015). Conclusion: Admission periostin levels can help to identify patients who are not suitable for neurointervention, especially if advanced neuroimaging is not available. LA - English DB - MTMT ER - TY - JOUR AU - Abada, Alan AU - Csécsei, Péter AU - Ezer, Erzsébet AU - Lenzsér, Gábor AU - Hegyi, Péter AU - Szolics, Alex AU - Mérei, Ákos AU - Szentesi, Andrea Ildikó AU - Molnár, Tihamér TI - General Anesthesia-Related Drop in Diastolic Blood Pressure May Impact the Long-Term Outcome in Stroke Patients Undergoing Thrombectomy JF - JOURNAL OF CLINICAL MEDICINE J2 - J CLIN MED VL - 11 PY - 2022 IS - 11 PG - 10 SN - 2077-0383 DO - 10.3390/jcm11112997 UR - https://m2.mtmt.hu/api/publication/32843086 ID - 32843086 N1 - Department of Anesthesiology and Intensive Care, Medical School, University of Pecs, Pecs, 7624, Hungary Centre for Translational Medicine, Semmelweiss University, Budapest, 1085, Hungary Department of Neurosurgery, Medical School, University of Pecs, Pecs, 7624, Hungary Department of Radiology, Örebro University Hospital, Örebro, 70281, Sweden Export Date: 13 November 2023 Correspondence Address: Csecsei, P.; Department of Neurosurgery, Hungary; email: csecsei.peter@pte.hu AB - Background: Several factors affect the efficacy of endovascular thrombectomy (EVT); however, the anesthesia-related factors have not been fully explored. We aimed to identify independent predictors of outcome by analyzing procedural factors based on a multicentric stroke registry. Methods: Data of consecutive patients with acute ischemic stroke (AIS) were extracted from the prospective STAY ALIVE stroke registry. Demographic, clinical, and periprocedural factors including hemodynamic values were analyzed in patients undergoing thrombectomy with either general anesthesia (GA) or conscious sedation (CS). Independent predictors of outcome both at 30 and 90 days based on the modified Rankin Scale (mRS: 0–2 as favorable outcome) were also explored. Results: A total of 199 patients (GA: 76 (38%) vs. CS: 117 (59%); in addition, six patients were converted from CS to GA) were included. The minimum value of systolic, diastolic, and mean arterial pressure was significantly lower in the GA compared to the CS group, and GA was associated with a longer onset to EVT time and a higher drop in all hemodynamic variables (all, p < 0.001). A higher drop in diastolic blood pressure (DBP) was even independently associated with a poor 90-day outcome (p = 0.024). Conclusion: A GA-related drop in DBP may independently predict a poor long-term outcome in stroke patients undergoing thrombectomy. LA - English DB - MTMT ER - TY - JOUR AU - Kalmár, Péter János AU - Tárkányi, Gábor AU - Karádi, Nozomi Zsófia AU - Bosnyák, Edit AU - Nagy, Csaba Balázs AU - Csécsei, Péter AU - Lenzsér, Gábor AU - Büki, András AU - Janszky, József Vladimír AU - Szapáry, László TI - A mechanikus thrombectomiát megelőző intravénás thrombolysis szerepe az akut agyi nagyérelzáródások kezelésében JF - IDEGGYOGYASZATI SZEMLE / CLINICAL NEUROSCIENCE J2 - IDEGGYOGY SZEMLE VL - 75 PY - 2022 IS - 1-2 SP - 23 EP - 29 PG - 7 SN - 0019-1442 DO - 10.18071/isz.75.0023 UR - https://m2.mtmt.hu/api/publication/32647101 ID - 32647101 AB - The efficacy of intravenous thrombolysis (IVT) is moderate in the proximal vascular segments of intracranial arteries, as opposed to mecha-nical thrombectomy (MT). In the management of acute ischemic stroke (AIS) caused by large vessel occlusions (LVO), IVT prior to MT is highly recommended based on the latest guidelines, but the necessity of IVT has been questioned by the latest studies of the past years. The aim of our study was to investigate and compare the efficacy and safety of direct mechanical thrombectomy (dMT) and combined therapy (CT) for patients who suffered an AIS with LVO and were treated in our department.We investigated patients with AIS caused by LVO who were admitted up to 4.5 hours after symptom onset and underwent MT in our department between November 2017 and August 2019. Patients' data were collected in our stroke register. Patients enrolled in our study were divided into two groups depending on whether dMT or CT was used. Our primary outcome was the 30- and 90- day functional outcome measured by modified Rankin Scale (mRS). Mortality at 30- and 90- day, successful recanalization rates, and symptomatic intracranial hemorrhage were considered as secondary outcomes.A total of 142 patients (age: 68.3 ± 12.6 years, 53.5% female) were enrolled in our study, including 81 (57.0%) dMT cases, and 61 (43.0%) patients who received CT. The vascular risk factors and comorbidities were significantly higher in the dMT-treated group. At day 30, the rate of favorable functional outcomes was 34.7% in dMT vs. 43.6% among those who received CT (p = 0.307), by day 90 this ratio changed to 40.8% vs. 46.3% (p = 0.542). Mortality rates at day 30 were 22.2% and 23.6% (p = 0.851), and at day 90 33.8% and 25.9% (p = 0.343). The rate of effective recanalization was 94.2% for dMT-treated patients and 98.0% for CT-treated patients (p = 0.318). Symptomatic intracranial hemorrhage was detected in 2.5% of dMT-treated patients and 3.4% of CT-treated group (p = 0.757).Our results suggest that CT is associated with a moderately better outcome compared to dMT. IVT prior to MT did not increase the risk of symptomatic intracranial hemorrhages. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Nagy, Csaba Balázs AU - Héger, Júlia AU - Balogh, Gábor AU - Gubucz, István AU - Nardai, Sándor AU - Lenzsér, Gábor AU - Bajzik, Gábor AU - Fehér, Máté AU - Moizs, Mariann AU - Repa, Imre AU - Nagy, Ferenc AU - Vajda, Zsolt TI - Endovascular Recanalization of Tandem Internal Carotid Occlusions Using the Balloon-assisted Tracking Technique JF - CLINICAL NEURORADIOLOGY J2 - CLIN NEURORADIOL VL - 32 PY - 2022 IS - 2 SP - 375 EP - 384 PG - 10 SN - 1869-1439 DO - 10.1007/s00062-021-01078-2 UR - https://m2.mtmt.hu/api/publication/32228684 ID - 32228684 AB - Tandem occlusive lesions are responsible for up to 20% of acute ischemic stroke cases and are associated with poor prognosis if complete recanalization cannot be achieved. Endovascular recanalization might be challenging due to difficulties in the safe passage of the occluded plaque at the origin of the internal carotid artery (ICA). The balloon-assisted tracking technique (BAT), where a partially deflated balloon is exposed out of the catheter tip to facilitate its passage through stenosed or spastic arterial segments was introduced by interventional cardiologists and the applicability of the technique has been recently proposed in the field of neurointervention as well. Here we describe our experience using the BAT technique in the endovascular recanalization of tandem occlusive lesions.Procedures were performed from June 2013 to December 2020 in a single center. Baseline clinical and imaging data, procedural and follow-up details and clinical outcomes were retrospectively collected.In this study 107 patients, median age 66 years, median admission NIHSS 14 and median ASPECTS 8 were included. Successful recanalization of the ICA using the BAT technique was achieved in 100 (93%) and successful intracranial revascularization in 88 (82%) patients. There were no complications attributable to the BAT technique. Intraprocedural complications occurred in 9 (8%) patients. Emergent stenting was performed in 40 (37%) at the end of the procedure. Postprocedural adverse events (intracerebral hemorrhage [ICH], malignant infarction) occurred in 6 (5%) patients. Good clinical outcome at 3 months (modified Rankin scale [mRS] 0-2) was 54 (50%) and mortality 26 (24%). Delayed stent placement during follow-up occurred in 21 cases.Application of BAT technique in tandem occlusions appears feasible, safe, and efficient. Further evaluation of this technique is awaited. LA - English DB - MTMT ER - TY - JOUR AU - Schranz, Dániel AU - Molnár, Tihamér AU - Erdő-Bonyár, Szabina AU - Simon, Diána AU - Berki, Tímea AU - Závori, László AU - Szolics, Alex AU - Büki, András AU - Lenzsér, Gábor AU - Csécsei, Péter TI - Fatty Acid-Binding Protein 3 and CXC-Chemokine Ligand 16 are Associated with Unfavorable Outcome in Aneurysmal Subarachnoid Hemorrhage JF - JOURNAL OF STROKE AND CEREBROVASCULAR DISEASES J2 - J STROKE CEREBROVASC DIS VL - 30 PY - 2021 IS - 11 PG - 7 SN - 1052-3057 DO - 10.1016/j.jstrokecerebrovasdis.2021.106068 UR - https://m2.mtmt.hu/api/publication/32165067 ID - 32165067 N1 - * Megosztott szerzőség AB - Aneurysmal subarachnoid hemorrhage (aSAH) is associated with activation of the inflammatory cascade contributing to unfavorable outcome and secondary complications, such as delayed cerebral ischemia (DCI). Both fatty acid-binding protein 3 (FABP3) and CXC-chemokine ligand 16 (CXCL-16) have been linked to vascular inflammation and cellular death. The authors aimed to assess the 30-day prognostic value of serum levels of FABP3 and CXCL-16 and explore their associations with DCI in aSAH patients.A total of 60 patients with aSAH were prospectively enrolled. Sampling for markers was done at 24 hours after the index event. FABP3 and CXCL-16 serum concentrations were determined by MilliPlex multiplex immunoassay method. The primary endpoint was unfavorable outcome at Day 30 based on the modified Rankin Scale.Both FABP3 and CXCL-16 levels were significantly elevated in patients with unfavorable outcome compared to those with favorable outcome after aSAH (FABP3: 2133 pg/mL, IQR: 1053-4567 vs. 3773, 3295-13116; p<0.003 and CXCL-16: 384 pg/mL, 313-502 vs. 498, 456-62, p<0.001). The area under the curve (AUC) for serum CXCL-16 levels as a predictor of unfavorable outcome at Day 30 was 0.747 (95% CI =0.622-0.871; p<0.001). Based on binary logistic regression analysis, serum CXCL-16 with a cut-off level >446.7 ng/L independently predicted Day 30 unfavorable outcome with a sensitivity of 81% and a specificity of 62%. Neither CXCL-16 nor FABP3 showed a significant correlation with DCI.Early FABP3 and CXCL-16 levels are significantly associated with poor 30-day outcome in patients with aSAH. LA - English DB - MTMT ER - TY - CHAP AU - Alan, Abada AU - Csécsei, Péter AU - Ezer, Erzsébet AU - Alex, Szolics AU - Lenzsér, Gábor AU - Nagy, Csaba Balázs AU - Hegyi, Péter AU - Tárkányi, Gábor AU - Mérei, Ákos AU - Szentesi, Andrea Ildikó AU - Molnár, Tihamér ED - Csiszár, Beáta ED - Hankó, Csilla ED - Kajos, Luca Fanni ED - Mező, Emerencia TI - General anesthesia related drop of diastolic blood pressure may impact the long-term outcome in stroke patients undergoing thrombectomy - a retrospective single-center analysis T2 - Medical Conference for PhD Students and Experts of Clinical Sciences 2021 PB - University of Pécs, Doctoral Student Association CY - Pécs SN - 9789634296539 PY - 2021 SP - 42 EP - 42 PG - 1 UR - https://m2.mtmt.hu/api/publication/32130143 ID - 32130143 LA - English DB - MTMT ER - TY - JOUR AU - Kalmár, Péter János AU - Tárkányi, Gábor AU - Nagy, Csaba Balázs AU - Csécsei, Péter AU - Lenzsér, Gábor AU - Bosnyák, Edit AU - Karadi, Zsofia Nozomi AU - Annus, Ádám AU - Szegedi, István AU - Büki, András AU - Szapáry, László TI - Comparing Endovascular Treatment Methods in Acute Ischemic Stroke Due to Tandem Occlusion Focusing on Clinical Aspects JF - LIFE-BASEL J2 - LIFE-BASEL VL - 11 PY - 2021 IS - 5 PG - 10 SN - 2075-1729 DO - 10.3390/life11050458 UR - https://m2.mtmt.hu/api/publication/32029068 ID - 32029068 LA - English DB - MTMT ER - TY - JOUR AU - Abada, Alan AU - Csécsei, Péter AU - Ezer, Erzsébet AU - Szólics, Alex AU - Lenzsér, Gábor AU - Nagy, Csaba Balázs AU - Hegyi, Péter AU - Vajda, Petra AU - Tárkányi, Gábor AU - Molnár, Tihamér TI - Az általános anesztéziával összefüggő diasztolés vérnyomásesés negatív hatása a thrombectomián átesett stroke betegek hosszútávú kimenetelére JF - FOCUS MEDICINAE J2 - FOCUS MEDICINAE VL - 23 PY - 2021 IS - 1 SP - 26 EP - 32 PG - 7 SN - 1419-0478 UR - https://m2.mtmt.hu/api/publication/31964049 ID - 31964049 LA - Hungarian DB - MTMT ER -