title: Cerebrovascular disease in the era of left ventricular assist devices with continuous flow: risk factors, diagnosis, and treatment.
abstract: Cerebral infarction and hemorrhage are among the principal sources of morbidity and mortality associated with mechanical circulatory support. There has been particular concern with the recently reported increased rate of device thrombosis in continuous-flow left ventricular assist devices. The neurologic management of stroke among these patients has limited data to inform current clinical practices. In this investigation we review the available literature on stroke in patients with continuous-flow left ventricular assist devices, with a focus on treatment algorithms in the acute setting and for secondary stroke prevention.
authors.affiliation: Department of Neurology, Division of Stroke and Cerebrovascular Diseases, Columbia University, New York, New York. Electronic address: jzw2@columbia.edu.
authors.forename: Joshua Z
authors.initials: JZ
authors.lastname: Willey
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Demmer
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Columbia University, New York, New York.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Takayama
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University, New York, New York.
authors.forename: Paolo C
authors.initials: PC
authors.lastname: Colombo
authors.affiliation: Department of Neurology, Division of Stroke and Cerebrovascular Diseases, Columbia University, New York, New York.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Lazar
mesh_terms: D000465:Algorithms; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000628:therapy*
keywords: acute stroke; epidemiology; intracerebral hemorrhage; ischemic stroke; left ventricular assist device; stroke prevention