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cerebral dissecting aneurysm

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https://www.readbyqxmd.com/read/29146726/endovascular-rescue-treatment-through-stent-positioning-after-surgical-clipping-of-intracranial-aneurysms-complicated-by-parent-artery-obstruction
#1
Giovanni Vitale, Giacomo Talenti, Joseph Gabrieli, Giacomo Cester, Alessandro Della Puppa, Francesco Causin
During aneurysm clipping, ischemic complications may occur and require a rescue treatment, usually surgical. We present two such cases that required urgent rescue treatment, performed through an endovascular route. Our first case presented with a non-ruptured right posterior inferior cerebellar artery (PICA) aneurysm. After permanent clip positioning, occlusion of the PICA occurred. An unsuccessful attempt of clip repositioning was performed. We therefore positioned a stent obtaining complete flow restoration...
November 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29142493/cervical-arterial-fibromuscular-dysplasia-in-a-biethnic-population-a-retrospective-study-in-the-u-s-mexican-border
#2
Ihtesham A Qureshi, Gustavo J Rodriguez, Tatiana Chacon-Quesada, Gavito-Higuera Jose, Salvador Cruz-Flores, Alberto Maud
Background  There have been studies trying to characterize Fibromuscular Dysplasia (FMD); however, most of them are based in mainly non-Hispanic sample. The objective of this study is to better understand the epidemiology and clinical characteristics of craniocervical FMD in the Hispanic population. Methods  We retrospectively reviewed the cerebral angiograms performed in our center in a period of 3.5 years under any indication looking for angiographic patterns of FMD. Exclusion criteria consisted of cases in which the first angiogram was done when the patients were younger than 18 years...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#3
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29118800/septoplasty-scepter-balloon-angioplasty-for-vasospasm-after-aneurysmal-subarachnoid-hemorrhage
#4
Bradley A Gross, Daniel A Tonetti, Gregory M Weiner, David M Panczykowski, William J Ares, Cynthia L Kenmuir, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Introduction: Balloon angioplasty can be a requisite approach for the treatment of symptomatic and/or severe vasospasm. Dual-lumen microcatheter balloons have multiple potential advantages for this indication including accommodating a 0.014-inch wire and the potential to deliver superselective vasodilators directly via the microcatheter prior to angioplasty. Methods: The authors reviewed a 3-year institutional experience with the Scepter XC balloon (Microvention, Tustin, CA, USA) in the treatment of postaneurysmal subarachnoid hemorrhage vasospasm, focusing on treatment methods, angiographic, and clinical results...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118799/optional-endovascular-therapy-of-dissecting-posterior-cerebral-artery-aneurysm
#5
Mohamed Wael Osman, Krzysztof Kadziolka, Laurent Peirot
BACKGROUND: Posterior cerebral artery aneurysms are uncommon, with an occurrence rate of less than 1% of intracranial aneurysms. They have various shapes, including saccular and fusiform. Dissecting aneurysms may occur in distal posterior cerebral artery and they may affect the whole artery. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. SUMMARY: Posterior cerebral artery aneurysms are uncommon...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29114312/a-case-of-high-dose-adenosine-usage-for-anterior-communicating-artery-aneurysm-clip-ligation-what-is-the-dose-limit-for-a-resistant-response
#6
Shahid M Nimjee, David L McDonagh, Abhishek Agrawal, Gavin W Britz
Intraoperative adenosine is used to induce asystole to facilitate clip ligation of intracranial aneurysms. Typically, 5-10 mg doses are used per administration and approximately 30 mg is used for a given case. An obvious concern with using adenosine is that the patient can remain in asystole or that prolonged hypotension can result in cerebral or cardiovascular ischemia. The upper limit of adenosine administration remains unclear. We present a case of a patient with a large anterior communicating artery aneurysm requiring large doses of adenosine, far exceeding previously reported cases...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29097336/a-case-of-subarachnoid-hemorrhage-caused-by-tuberculous-aneurysm
#7
Wei Liu, Chuanfeng Li, Xianming Liu, Zhiming Xu, Lu Kong
In this paper, we report a case of intracranial tuberculum with adjacent intracerebral inflammatory aneurysm, and include a brief discussion of the developmental mechanism of these pathologies. A 28-year-old man presented with sudden onset of severe headache. He was diagnosed with h pulmonary tuberculosis 8 year ago, and had been treated with anti-tuberculosis medications for 6 months. Head computed tomography (CT) showed a small hematoma in the left Sylvian fissure with subarachnoid hemorrhage. Cerebral digital subtraction angiograph (DSA) was performed and no aneurysm was found...
October 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29030048/increased-prevalence-of-cerebrovascular-disease-in-hospitalized-patients-with-marfan-syndrome
#8
Sarasa T Kim, Harry Cloft, Kelly D Flemming, David F Kallmes, Giuseppe Lanzino, Waleed Brinjikji
BACKGROUND AND PURPOSE: Small studies have suggested that Marfan syndrome is associated with a number of cerebrovascular complications. We sought to determine whether a clinical diagnosis of Marfan syndrome is associated with a higher prevalence of cerebrovascular diseases than the general population by performing a case-control study of hospitalized patients in the Nationwide Inpatient Sample (NIS). METHODS: Using the 2000-2012 NIS, we performed a case-control study matching cases of Marfan syndrome to controls without such a diagnosis...
October 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29029292/minimizing-retraction-by-pia-arachnoidal-10-0-sutures-in-intrasulcal-dissection
#9
Kutluay Uluc, Ulas Cikla, Deniz B Morkan, Alperen Sirin, Azam S Ahmed, Kyle Swanson, Mustafa K Baskaya
BACKGROUND: In contemporary microneurosurgery reducing retraction-induced injury to the brain is essential. Self-retaining retractor systems are commonly used to improve visualization and decrease the repetitive microtrauma, but sometimes self-retaining retractor systems can be cumbersome and the force applied can cause focal ischemia or contusions. This may increase the morbidity and mortality. Here, we describe a technique of retraction using 10-0 sutures in the arachnoid. OBJECTIVE: To evaluate the imaging and clinical results in patients where 10-0 suture retraction was used to aid the surgical procedure...
September 19, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28994832/carotid-endarterectomy-for-treatment-of-carotid-in-stent-restenosis-long-term-follow-up-results-and-surgery-experiences-from-one-single-centre
#10
Le-Bao Yu, Wei Yan, Qian Zhang, Ji-Zong Zhao, Yan Zhang, Rong Wang, Jun-Shi Shao, Dong Zhang
OBJECTIVE: Few studies have reported the surgical treatment of carotid in-stent restenosis (ISR), more data and longer follow-up are needed. We describe the surgical treatment of ISR by standard carotid endarterectomy (CEA) with stent removal, including long-term follow-up in 10 patients from our centre. METHODS: Ten patients from our centre who underwent CEA with stent removal for ISR were retrospectively analysed, including nine symptomatic and one asymptomatic ISR of at least 70% with mean age 67...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28984522/the-v3-segment-of-the-vertebral-artery-as-a-robust-donor-for-intracranial-to-intracranial-interpositional-bypasses-technique-and-application-in-5-patients
#11
Ali Tayebi Meybodi, Arnau Benet, Michael T Lawton
The V3 segment of the vertebral artery (VA) has been studied in various clinical scenarios, such as in tumors of the craniovertebral junction and dissecting aneurysms. However, its use as a donor artery in cerebral revascularization procedures has not been extensively studied. In this report, the authors summarize their clinical experience in cerebral revascularization procedures using the V3 segment as a donor. A brief anatomical description of the relevant techniques is also provided.
October 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28977379/single-centre-experience-with-the-frozen-elephant-trunk-technique-in-251-patients-over-15%C3%A2-years
#12
Malakh Shrestha, Andreas Martens, Tim Kaufeld, Erik Beckmann, Sebastian Bertele, Heike Krueger, Julia Neuser, Felix Fleissner, Fabio Ius, Firas Abd Alhadi, Jasmin Hanke, Jan D Schmitto, Serghei Cebotari, Matthias Karck, Axel Haverich, Ajay Chavan
OBJECTIVES: Our goal was to present our 15-year experience (2001-2015) with the frozen elephant trunk (FET) technique. METHODS: A total of 251 patients (82 with aortic aneurysms, 96 with acute aortic dissection type A, 4 with acute type B dissections, 52 with chronic aortic dissection type A, 17 with chronic type B dissection and 67 redo cases) underwent FET implantation with either the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 31) or the Vascutek Thoraflex hybrid (n = 154) prosthesis...
November 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28973685/microsurgery-simulator-of-cerebral-aneurysm-clipping-with-interactive-cerebral-deformation-featuring-a-virtual-arachnoid
#13
Naoyuki Shono, Taichi Kin, Seiji Nomura, Satoru Miyawaki, Toki Saito, Hideaki Imai, Hirofumi Nakatomi, Hiroshi Oyama, Nobuhito Saito
BACKGROUND: A virtual reality simulator for aneurysmal clipping surgery is an attractive research target for neurosurgeons. Brain deformation is one of the most important functionalities necessary for an accurate clipping simulator and is vastly affected by the status of the supporting tissue, such as the arachnoid membrane. However, no virtual reality simulator implementing the supporting tissue of the brain has yet been developed. OBJECTIVE: To develop a virtual reality clipping simulator possessing interactive brain deforming capability closely dependent on arachnoid dissection and apply it to clinical cases...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28962962/a-patient-with-a-recurrent-anterior-cerebral-artery-dissecting-aneurysm-after-stent-assisted-coil-embolization-successfully-treated-with-a3-a3-anastomosis
#14
Yoshiharu Takahashi, Hidenori Endo, Toshiki Endo, Miki Fujimura, Kuniyasu Niizuma, Teiji Tominaga
BACKGROUND: With recent advances in endovascular devices and techniques, the use of endovascular treatment has been reported for intracranial dissecting aneurysms. However, the efficacy of this endovascular approach for intracranial dissection is still unknown. We report the case of a patient with a recurrent anterior cerebral artery (ACA) dissecting aneurysm after endovascular treatment. CASE DESCRIPTION: A 67-year-old woman underwent stent-assisted coil embolization for a ruptured ACA dissecting aneurysm of the left A2 segment...
September 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28939539/falxuplication-a-novel-method-for-wrap-clipping-a-fusiform-aneurysm-a-technical-note
#15
Martin M Mortazavi, Tania Hassanzadeh, Kianoush Khalili, Sajid S Suriya, M Asif Taqi, Salman A Fard, R Shane Tubbs
BACKGROUND: Various techniques have been used for wrap-clipping a ruptured, fusiform intracranial aneurysm. However, there is no available literature on use of the falx cerebri for wrap-clipping. OBJECTIVE: We present a review of the literature with an illustrative case, with a ruptured fusiform pericallosal artery aneurysm firmly attached to the lower edge of the falx cerebri and not amenable to endovascular intervention. METHODS: While the firm attachment between the inferior falx and the fusiform aneurysm was maintained, a section of the lower thinner part of the falx cerebri firmly attached to the aneurysm was dissected and wrapped around the fusiform aneurysm, stabilized with a fenestrated clip...
September 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28919562/operative-management-of-distal-anterior-cerebral-artery-aneurysms-through-a-mini-anterior-interhemispheric-approach
#16
Alejandro Monroy, Edgar Nathal, Albert L Rhoton
BACKGROUND: Distal anterior cerebral artery (DACA) aneurysms, also referred to as pericallosal artery aneurysms, are present in 1.5 to 9% of all intracranial aneurysms. This study aims to describe the importance of the microsurgical anatomy of the DACA and demonstrate the surgical nuances for handling DACA aneurysms, with a minimally invasive surgical technique METHODS: We retrospectively and descriptively analyzed a series of aneurysm cases performed at the National Institute of Neurology and Neurosurgery-Mexico City...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28885101/association-between-the-maximal-distance-of-atrial-septal-protrusion-and-cryptogenic-stroke
#17
Keisuke Tokunaga, Masahiro Yasaka, Takahiro Kuwashiro, Seiji Gotoh, Asako Nakamura, Go Takaguchi, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Yasushi Okada
Background and purpose Previous studies have suggested that atrial septal aneurysm is a potential risk factor for cerebral embolism. However, the association between the level of atrial septal protrusion and cerebral embolism is still unclear. The purpose of the present study was to assess the association between the maximal distance of atrial septal protrusion and cryptogenic stroke. Methods A total of 588 consecutive acute ischemic stroke patients (70 ± 11 (mean ± SD) years, 401 men) who underwent transesophageal echocardiography were enrolled...
December 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28868317/aorto-cutaneous-fistula-and-false-aneurysm-of-the-ascending-aorta-five-years-after-its-prosthetic-replacement-for-stanford-type-a-acute-aortic-dissection
#18
Pierre Demondion, Dorian Verscheure, Pascal Leprince
Aorto-cutaneous fistula and false aneurysm of the ascending aorta in patients who previously underwent Stanford Type A acute aortic dissection are rare and severe complications. Surgical correction remains a demanding challenge. In a case of false aneurysm rupture during redo sternotomy, selective cannulation of the right axillary and left carotid arteries allowed an efficient method of cerebral perfusion.
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28845874/-the-frozen-elephant-trunk-technique-for-the-treatment-of-complex-lesions-of-the-thoracic-aorta
#19
Luca Di Marco, Davide Pacini, Alessandro Leone, Antonio Pantaleo, Giacomo Murana, Roberto Di Bartolomeo
The treatment of patients with extensive disease of the thoracic aorta represents a formidable challenge for the cardiovascular surgeon. The beginning of thoracic aortic endovascular aortic arch repair has promoted the development of different hybrid approaches as the frozen elephant trunk (FET) strategy, which includes classic arch replacement and antegrade stenting of the descending thoracic aorta. It represents an interesting approach for patients with extensive disease of the thoracic aorta, and its application has significantly increased over recent years...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28838113/indocyanine-green-videoangiography-for-surgery-of-a-ruptured-dissecting-aneurysm-in-the-precommunicating-anterior-cerebral-artery-a-technical-case-report
#20
Yasunori Nagai, Masanori Goto, Hiroki Toda, Namiko Nishida, Naoya Yoshimoto, Koichi Iwasaki
BACKGROUND AND IMPORTANCE: Indocyanine green videoangiography (ICG-VA) is an important intraoperative adjunct for saccular aneurysm surgery, but its efficacy in surgery for dissecting aneurysms has rarely been reported. The authors describe the usefulness of preclipping ICG-VA in a rare case of a ruptured dissecting aneurysm located at the precommunicating (A1) segment of the anterior cerebral artery. CLINICAL PRESENTATION: A 52-year-old woman, with no history of connective tissue diseases or vascular disorders, presented with sudden headache and convulsion...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
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