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cerebral dissecting aneurysm

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https://www.readbyqxmd.com/read/29789153/adjunct-retrograde-cerebral-perfusion-provides-superior-outcomes-compared-with-hypothermic-circulatory-arrest-alone-a-meta-analysis
#1
David H Tian, Justin Weller, Shaheen Hasmat, Aung Oo, Paul Forrest, Hosen Kiat, Tristan D Yan
OBJECTIVE: Retrograde cerebral perfusion is becoming less frequently used as a method of neuroprotection during aortic surgery. The present meta-analysis aims to compare outcomes after arch surgery with hypothermic circulatory arrest versus hypothermic circulatory arrest + retrograde cerebral perfusion. METHODS: Electronic searches were performed using 7 databases from their inception to September 2016. Relevant comparative studies that included patient groups who underwent aortic arch surgery using hypothermic circulatory arrest with continuous retrograde cerebral perfusion or hypothermic circulatory arrest alone were identified, and data were extracted by 2 independent researchers...
April 21, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29788334/microsurgical-resection-of-ruptured-large-left-temporo-occipital-arteriovenous-malformation-3-dimensional-operative-video
#2
Chun-Yu Cheng, Rakshith Shetty, Laligam N Sekhar
A 59-yr-old man presented with intraventricular hemorrhage and was found to have a large temporo-occipital arteriovenous malformation (AVM), Spetzler-Martin grade 4. The preoperative intra-arterial digital subtraction angiography (IADSA) showed the AVM was 4 × 4 cm2, had superficial and deep venous drainage, and was fed by multiple branches of the posterior cerebral artery and middle cerebral artery. Preoperative embolization was done in 4 stages. He underwent a left temporo-occipital craniotomy, mastoidectomy, and retrosigmoid craniotomy with a posterior temporal approach...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#3
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29741225/prediction-of-vascular-abnormalities-on-ct-angiography-in-patients-with-acute-headache
#4
Imanda M E Alons, Ben F J Goudsmit, Korné Jellema, Marianne A A van Walderveen, Marieke J H Wermer, Ale Algra
OBJECTIVES: Patients with acute headache increasingly undergo CT-angiography (CTA) to evaluate underlying vascular causes. The aim of this study is to determine clinical and non-contrast CT (NCCT) criteria to select patients who might benefit from CTA. METHODS: We retrospectively included patients with acute headache who presented to the emergency department of an academic medical center and large regional teaching hospital and underwent NCCT and CTA. We identified factors that increased the probability of finding a vascular abnormality on CTA, performed multivariable regression analyses and determined discrimination with the c-statistic...
May 9, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#5
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29725567/one-stage-stent-assisted-coil-embolization-for-rupture-side-unknown-bilateral-vertebral-artery-dissecting-aneurysms-in-an-acute-stage-a-case-report
#6
Mio Terashima, Yoichi Miura, Fujimaro Ishida, Naoki Toma, Tomohiro Araki, Shinichi Shimosaka, Kenji Kanamaru, Hidenori Suzuki
Bilateral vertebral artery dissecting aneurysms (VADAs) with subarachnoid hemorrhage (SAH) are rare and their management is still challenging. In this report, we successfully performed one-stage stent-assisted coil embolization (SAC) for bilateral VADAs with SAH in an acute stage, because the ruptured side could not be diagnosed. A 47-year-old woman presented with a sudden onset of headache without laterality, and left-side dominant SAH with bilateral VADAs was noted on computed tomography (CT) scans. The size of aneurysmal dome and neck was similar between the two VADAs, and a bleb was observed only on the right VADA...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29721358/mirror-image-of-bilateral-daca-aneurysm-with-its-successful-surgical-management
#7
Saraj K Singh, Kapil Jain, Vijendra K Jain, Arun Saroha
Background: Among various locations of intracranial aneurysms reported in the literature, two different aneurysms situated symmetrically opposite on bilateral distal anterior cerebral arteries (DACA) are very rare. Case Description: Here, we report a rare case of mirror image distal anterior cerebral aneurysm in a middle-aged male patient. The patient presented with severe headache and loss of consciousness. Angiography was done which suggested mirror imaging of two aneurysms located over both DACA...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29707342/aortic-arch-repair-under-moderate-hypothermic-circulatory-arrest-with-or-without-antegrade-cerebral-perfusion-based-on-the-extent-of-repair
#8
Sung Jun Park, Bo Bae Jeon, Hee Jung Kim, Joon Bum Kim
Background: For aortic-arch repair, moderate hypothermic circulatory arrest (HCA) have shown favorable outcomes over conventional deep HCA when coupled with antegrade cerebral perfusion (ACP); however, recent studies have shown that ACP may not be essential when circulatory arrest time is less than 30 minutes. This study aims to evaluate the stratified arch repair strategy of moderate HCA with or without ACP based on the extent of procedure. Methods: Consecutive 138 patients (63 female; mean age, 60...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29701554/long-term-results-of-middle-cerebral-artery-aneurysm-clipping-in-the-barrow-ruptured-aneurysm-trial
#9
Michael A Mooney, Elias D Simon, Scott Brigeman, Peter Nakaji, Joseph M Zabramski, Michael T Lawton, Robert F Spetzler
OBJECTIVE A direct comparison of endovascular versus microsurgical treatment of ruptured middle cerebral artery (MCA) aneurysms in randomized trials is lacking. As endovascular treatment strategies continue to evolve, the number of reports of endovascular treatment of these lesions is increasing. Herein, the authors report a detailed post hoc analysis of ruptured MCA aneurysms treated by microsurgical clipping from the Barrow Ruptured Aneurysm Trial (BRAT). METHODS The cases of patients enrolled in the BRAT who underwent microsurgical clipping for a ruptured MCA aneurysm were reviewed...
April 27, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29701386/simplified-technique-for-aortic-arch-replacement-in-patients-at-high-risk-for-frozen-elephant-trunk
#10
Álvaro Laranjeira Santos, António Cruz Tomás, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Surgical approach of multisegmental pathology of the thoracic aorta, namely aortic arch / descending aorta is challenging. The Frozen Elephant Trunk (FET) has good results, with acceptable risk. However, in the subgroup of patients (pts) older than 75 years and with important comorbidities, the surgical risk is very high. OBJECTIVES: Review short-term results of this original, simplified and potentially hybrid technique developed in our Department for this subgroup of patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#11
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29682071/intraoperative-rupture-cerebral-aneurysm-and-computational-flow-dynamics
#12
Ilya Senko, Anton Shatokhin, Ishu Bishnoi, Yasuhiro Yamada, Riki Tanaka, Daisuke Suyama, Tukasa Kawase, Yoko Kato
Intraoperative aneurysmal rupture (IAR) is the most fearsome complication of aneurysm surgery. IAR associates with high morbidity and mortality. In recent years, we have many studies regarding using computational fluid dynamics (CFD) in aneurysm surgery. CFD helps in calculating the velocity of blood flowing in the aneurysm sac, the pressure in the aneurysm sac, and wall shear stress (WSS). CFD also helps in predicting nature of aneurysm wall and thus may warn about different intraoperative microscopy findings in aneurysms...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29644398/stent-placement-in-patients-with-acute-subarachnoid-haemorrhage-when-is-it-justified
#13
Andrew G Murchison, Victoria Young, Tanja Ddjurdjevic, Martino Cellerini, Rufus Corkill, Wilhelm Küker
PURPOSE: Endovascular stents are widely used for the elective treatment of cerebral aneurysms. Acute stenting is performed in the management of dissections, pseudo-aneurysms, broad-based aneurysms or as a 'bail out' measure after coil migration. The purpose of this study is to review the safety of using stents in acute subarachnoid haemorrhage. METHODS: The stent registry of our institution was reviewed for procedures in patients with acute subarachnoid haemorrhage...
April 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29628950/safety-assessment-of-endovascular-treatment-of-cerebral-aneurysms-in-patients-with-fibromuscular-dysplasia
#14
Matthew T Bender, Christopher Hurtado, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Li-Mei Lin, Alexander L Coon, Geoffrey P Colby
Background: The prevalence of cerebral aneurysms is increased in fibromuscular dysplasia (FMD). The presence of FMD may serve as discouragement to elective endovascular aneurysm treatment. Outcomes of endovascular intervention for aneurysms through vessels affected by FMD have not been reported. Methods: A prospectively maintained database of patients undergoing intracranial embolization was reviewed for patients with FMD who underwent endovascular aneurysm treatment...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29618068/occipital-artery-to-posterior-cerebral-artery-bypass-using-descending-branch-of-the-lateral-circumflex-femoral-artery-graft-for-treatment-of-fusiform-unruptured-posterior-cerebral-artery-aneurysm-3-dimensional-operative-video
#15
Kristine Ravina, Ian A Buchanan, Robert C Rennert, Ben A Strickland, Joseph N Carey, Jonathan J Russin
Posterior cerebral artery (PCA) aneurysms can be technically challenging lesions due to the intricacy of perforating branches and the relationship to cranial nerves and the brainstem. Fusiform aneurysms of the perimesencephalic segment of the PCA are a rare finding which does not favor direct clip occlusion or reconstruction. In such cases, proximal parent vessel occlusion is an option for aneurysm treatment. Extracranial-intracranial (EC-IC) bypass can be used to revascularize beyond the lesion when considering proximal occlusion...
April 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29611032/thoracoabdominal-aortic-replacement-in-patients-aged-50-and-younger
#16
REVIEW
Kenji Minatoya, Yosuke Inoue, Yoshimasa Seike, Atsushi Omura, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVE: Open repair of a thoracoabdominal aortic aneurysm (TAAA) has been regarded as one of the most invasive procedures in cardiovascular surgery. Conversely, endovascular technology currently enables the repair of the thoracoabdominal aorta, and this approach is less invasive. However, the long-term durability of this method of endovascular repair remains unknown. This investigation retrospectively analyzed the long-term durability of thoracoabdominal aorta repair in patients aged 50 and younger...
April 2, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29608702/flow-diversion-of-posterior-circulation-cerebral-aneurysms-a-single-institution-series-of-59-cases
#17
Matthew T Bender, Geoffrey P Colby, Bowen Jiang, Li-Mei Lin, Jessica K Campos, Risheng Xu, Erick M Westbroek, Chau D Vo, David A Zarrin, Justin M Caplan, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Posterior circulation cerebral aneurysms are at higher risk of rupture and are more symptomatic than those in the anterior circulation. Existing treatments carry significant morbidity. Early reports of flow diversion for posterior circulation aneurysms have suggested high complication and low occlusion rates. OBJECTIVE: To report safety and efficacy of flow diversion with the pipeline embolization device (ev3, Medtronic Inc, Dublin, Ireland) for aneurysms located throughout the posterior circulation...
March 28, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29605278/rare-case-of-diffuse-spinal-arachnoiditis-following-a-complicated-vertebral-artery-dissection
#18
Elias Atallah, Sophia Dang, Sage Rahm, James Feghali, Chalouhi Nohra, Stavropoula Tjoumakaris, Robert H Rosenwasser, Hekmat Zarzour, Nabeel Herial, Michael Reid Gooch, Pascal Jabbour
Spinal arachnoiditis (SA) is an extremely rare and delayed complication of subarachnoid hemorrhage (SAH). Little is known about its underlying pathogenesis and subsequent clinical course. A middle-aged patient presented with the worst headache of her life and a grade 3 SAH of the basal-cisterns and posterior fossa was identified on Computed Tomography scans (CT). Angiography revealed a ruptured dissecting aneurysm of the left vertebral artery (VA-V4), as well as an unruptured left Anterior Cerebral Artery (ACA-A1) aneurysm...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29581340/arterial-wall-imaging-in-pediatric-stroke
#19
Nomazulu Dlamini, Ivanna Yau, Prakash Muthusami, David J Mikulis, Jorina Elbers, Mahmoud Slim, Rand Askalan, Daune MacGregor, Gabrielle deVeber, Manohar Shroff, Mahendranath Moharir
BACKGROUND AND PURPOSE: Arteriopathy is common in childhood arterial ischemic stroke (AIS) and predicts stroke recurrence. Currently available vascular imaging techniques mainly image the arterial lumen rather than the vessel wall and have a limited ability to differentiate among common arteriopathies. We aimed to investigate the value of a magnetic resonance imaging-based technique, namely noninvasive arterial wall imaging (AWI), for distinguishing among arteriopathy subtypes in a consecutive cohort of children presenting with AIS...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29507781/adenosine-to-facilitate-the-clipping-of-cerebral-aneurysms-literature-review
#20
REVIEW
Virendra R Desai, Alejandro L Rosas, Gavin W Britz
Cerebral aneurysms have a high mortality rate when ruptured. Endovascular techniques have improved substantially in treating this pathology. However, surgical clip ligation remains the preferred option for some aneurysms. Various techniques are used intraoperatively to assist the surgeon in dissecting the aneurysmal dome free of surrounding tissue and placing a clip around the neck safely and effectively so that no nearby perforating vessels are affected and no residual remains. These techniques include temporary clip ligation, endovascular balloon occlusion and cardiac standstill...
December 2017: Stroke and Vascular Neurology
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