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cerebral dissecting aneurysm

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https://www.readbyqxmd.com/read/28710081/use-of-a-next-generation-multi-durometer-long-guide-sheath-for-triaxial-access-in-flow-diversion-experience-in-95-consecutive-cases
#1
Li-Mei Lin, Matthew T Bender, Geoffrey P Colby, Narlin B Beaty, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Intracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED). METHODS: We retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28664015/central-hypoventilation-syndrome-complicated-with-lateral-medullary-infarction-after-endovascular-treatment-of-the-vertebral-artery-dissecting-aneurysm-a-case-report
#2
Katsuhiro Tanaka, Hideki Kanamaru, Atsunori Morikawa, Kenji Kawaguchi
Lateral medullary infarction rarely leads to central hypoventilation syndrome (CHS). CHS is a life-threatening disorder characterized by hypoventilation during sleep. We report the first case of CHS as a complication of lateral medullary infarction after endovascular treatment. A 65-year-old man presented twice with severe headache. Computed tomography revealed subarachnoid hemorrhage and cerebral angiography showed a right vertebral dissecting aneurysm involving the posterior inferior cerebellar artery. After emergent endovascular patent artery occlusion, he developed Wallenberg syndrome and experienced apnea and a conscious disturbance episode due to CHS on postoperative days 6 and 16...
October 2016: NMC Case Rep J
https://www.readbyqxmd.com/read/28651554/validation-of-an-international-classification-of-disease-ninth-revision-coding-algorithm-to-identify-decompressive-craniectomy-for-stroke
#3
Hormuzdiyar H Dasenbrock, David J Cote, Yuri Pompeu, Viren S Vasudeva, Timothy R Smith, William B Gormley
BACKGROUND: Although International Classification of Disease, Ninth Revision, Clinical Modification (ICD9-CM) coding is the basis of administrative claims data, no study has validated an ICD9-CM algorithm to identify patients undergoing decompressive craniectomy for space-occupying supratentorial infarction. METHODS: Patients who underwent decompressive craniectomy for stroke at our institution were retrospectively identified and their associated ICD9-CM codes were extracted from billing data...
June 26, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28647420/increased-prevalence-of-cerebrovascular-disease-in-hospitalized-patients-with-ehlers-danlos-syndrome
#4
Sarasa T Kim, Harry Cloft, Kelly D Flemming, David F Kallmes, Giuseppe Lanzino, Waleed Brinjikji
BACKGROUND AND PURPOSE: Small studies have suggested that Ehlers-Danlos syndrome (EDS) is associated with a number of cerebrovascular complications. We sought to determine whether a clinical diagnosis of EDS 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 EDS to controls without such a diagnosis...
August 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28647036/supra-aortic-interventions-for-endovascular-exclusion-of-the-entire-aortic-arch
#5
REVIEW
Terézia B Andrási, Marius Grossmann, Dieter Zenker, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVE: Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. METHODS: Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28622069/spontaneous-coronary-artery-dissection-in-a-woman-with-a-past-medical-history-of-subarachnoid-hemorrhage-a-case-report
#6
Jean Bardon, Fabien Picard, Franck Barbou, Olivier Varenne, Benoît Vivien
Spontaneous coronary artery dissection (SCAD) is an uncommon disease. We report the case of a 50 year-old woman with a past medical history of aneurysmal subarachnoid hemorrhage, presenting with acute chest pain and diffuse ST segment elevation on ECG. Coronary angiogram revealed a SCAD of the left anterior descending coronary artery. The association between cerebral aneurysms and SCAD should trigger providers concern for fibromuscular dysplasia. We hereby report on a rare and atypical case involving the relationship between fibromuscular dysplasia and SCAD...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28602923/successful-hybrid-neurovascular-surgery-for-a-ruptured-basilar-artery-dissecting-aneurysm-in-a-patient-with-jeopardized-collateral-circulation-associated-with-aortitis-syndrome-case-report
#7
Kazuaki Yamamoto, Takahisa Mori, Tsuyoshi Watanabe, Tomonori Iwata, Gakuji Gondo, Masahiko Tanaka, Satoshi Tanaka
BACKGROUND: Dissecting aneurysms of the basilar artery (BA) are rare lesions and the management of them has been controversial and challenging. The treatment becomes much more difficult when the patient has a disorder such as aortitis syndrome, which makes cerebral arteries occluded and tortuous. The authors describe a case of a ruptured BA dissecting aneurysm associated with aortitis syndrome, successfully treated with hybrid neurovascular surgery. CASE DESCRIPTION: A 64-year-old woman with a medical history of aortitis syndrome developed a severe headache and was diagnosed with a subarachnoid hemorrhage from a BA dissecting aneurysm...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28594797/-single-centre-experience-with-implantation-of-the-e-vita-open-plus-hybrid-stent-graft
#8
B N Kozlov, D S Panfilov, V V Saushkin, M S Kuznetsov, G G Nasrashvili, A V Andriianova, V M Shipulin
Hybrid technologies appear to have been gaining ground in surgery of the thoracic aorta. The present study was aimed at assessing the immediate clinical outcomes of surgical treatment of diseases of the thoracic aorta by means of the 'E-vita open plus' hybrid stent graft. The 'E-vita open plus' hybrid stent graft was implanted to 18 patients. All operations were carried out in the conditions of moderate hypothermia. The brain was protected by unilateral cerebral perfusion through the brachiocephalic trunk. The duration of artificial circulation averagely amounted to 265...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28591766/elective-frozen-elephant-trunk-procedure-using-the-e-vita-open-plus-prosthesis-in-94-patients-a-multicentre-french-registry
#9
Jean-Philippe Verhoye, Reda Belhaj Soulami, Olivier Fouquet, Vito Giovanni Ruggieri, Adrien Kaladji, Jacques Tomasi, Michel Sellin, Fadi Farhat, Amedeo Anselmi
OBJECTIVES: Our goal was to evaluate the operative outcomes of the frozen elephant trunk technique using the E-Vita Open Plus ® hybrid prosthesis in chronic aortic arch diseases and report clinical and radiological outcomes at the 1-year follow-up. METHODS: As determined from a prospective multicentre registry, 94 patients underwent frozen elephant trunk procedures using the E-Vita Open Plus hybrid device for the treatment of chronic aortic conditions, including 50% chronic aortic dissections, 40% degenerative aneurysms and 10% miscellaneous indications...
June 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28565990/transcirculation-pipeline-embolization-device-deployment-a-rescue-technique
#10
Edison P Valle-Giler, Elias Atallah, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
The Pipeline embolization device (PED) has become a very important tool in the treatment of nonruptured cerebral aneurysms. However, a patient's difficult anatomy or vascular stenosis may affect the device delivery. The purpose of this article was to describe an alternate technique for PED deployment when ipsilateral anatomy is not amenable for catheter navigation. A 44-year-old woman with a symptomatic 6-mm right superior hypophyseal artery aneurysm and a known history of right internal carotid artery dissection presented for PED treatment of her aneurysm...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28555327/navigation-guided-clipping-of-a-de-novo-aneurysm-associated-with-superficial-temporal-artery-middle-cerebral-artery-bypass-combined-with-indirect-pial-synangiosis-in-a-patient-with-moyamoya-disease
#11
Daiki Aburakawa, Miki Fujimura, Kuniyasu Niizuma, Hiroyuki Sakata, Hidenori Endo, Teiji Tominaga
De novo aneurysms associated with superficial temporal artery (STA)-middle cerebral artery (MCA) bypass are an extremely rare complication of direct revascularization surgery for moyamoya disease (MMD). The basic pathology of MMD includes fragility of the intracranial arterial wall characterized by medial layer thinness and waving of the internal elastic lamina. However, the incidence of newly formed aneurysms at the site of anastomosis currently remains unknown. Among 317 consecutive direct/indirect combined revascularization surgeries performed for MMD, we encountered a 52-year-old woman manifesting a de novo aneurysm adjacent to the site of anastomosis 11 years after successful STA-MCA bypass with encephalo-duro-myo-synangiosis (EDMS)...
July 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#12
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28456915/reversible-cerebral-vasoconstriction-syndrome-recognition-and-treatment
#13
REVIEW
Cecilia Cappelen-Smith, Zeljka Calic, Dennis Cordato
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare but increasingly recognized disorder with over 500 cases published in the literature. The condition is characterized by recurrent severe thunderclap headaches with or without other neurological symptoms and diffuse segmental narrowing of the cerebral arteries which is reversible within 3 months. RCVS may occur spontaneously but in over 50% of cases, it is associated with various other conditions, including vasoactive medications or illicit drugs and the post-partum state...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28456735/aneurysms-of-the-proximal-segment-of-the-anterior-cerebral-artery-a-new-classification-system-with-corresponding-therapeutic-options
#14
Xinmin Ding, Peyton L Nisson, Whitney S James, Michael T Lawton, Shaohua Ren, Lu Jia, Honging Ji
OBJECTIVE: This study aims to establish a new classification system for proximal anterior cerebral artery (A1) aneurysms and to offer treatment strategies, based on the lessons learned by studying the case reports of 41 patients with A1 aneurysms. METHODS: A total of 2332 consecutive patients with intracranial aneurysms were treated at a single medical center between June 2005 and May 2015. Forty-one patients with 42 A1 aneurysms were treated by surgical clipping or endovascular coiling...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28413555/dissecting-intracranial-aneurysm-in-pregnancy-a-rare-association
#15
Manasi Mehrotra, Anant Mehrotra, Anup Nair, Arun Srivastava, Rabi Narayan Sahu, Mandakini Pradhan, Raj Kumar
We report a case of dissecting aneurysm of the right posterior cerebral artery presenting with sudden onset headache and altered behavior during labor. A 26-year-old P1001 with uncomplicated antenatal period, except history of headache off and on since 32 weeks of pregnancy, developed sudden onset headache and altered behavior during 3(rd) stage of labor. She had vaginal delivery and a live born male baby was delivered with good Apgar score. The CT was suggestive of subarachnoid hemorrhage and DSA was suggestive of dissecting aneurysm of the right P2 segment with hypoplasia of right P1 segment and A1 segment of posterior and anterior cerebral artery, respectively...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28383849/-myocardial-infarction-on-spontaneous-coronary-dissection-caused-by-fibromuscular-dysplasia
#16
L Jackers, L Davin, B Falque, M Magnée, L Piérard
Spontaneous Coronary Artery Dissection (SCAD) is a non-traumatic and non-iatrogenic separation of the coronary arterial wall. Although uncommon, it should be suspected in any young patient with acute myocardial infarction especially without risk factor of cardiovascular disease. Early coronary angiography is essential in the diagnosis of SCAD. Fibromuscular dysplasia is a rare cause of SCAD, particularly encountered in young women. This is a nonatherosclerotic and noninflammatory vascular disease. Fibromuscular dysplasia may cause stenosis, aneurysm, dissection and / or occlusion of arteries...
October 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28355763/-late-reoperations-after-repaired-stanford-type-a-aortic-dissection
#17
F H Huang, L P Li, C H Su, W Qin, M Xu, L M Wang, Y S Jiang, Z B Qiu, L Q Xiao, C Zhang, H W Shi, X Chen
Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#18
Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, Rolando Del Maestro
OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#19
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28288887/transapical-endovascular-repair-of-thoracic-aortic-pathology
#20
Takashi Murakami, Shinsuke Nishimura, Mitsuharu Hosono, Yoshitsugu Nakamura, Etsuji Sohgawa, Yukimasa Sakai, Toshihiko Shibata
BACKGROUND: Alternative access for thoracic endovascular aortic repair (TEVAR) has been explored for patients with unsuitable femoral and iliac access, but few cases of transapical access have been described. We report our experience with transapical access for various aortic pathologies. METHODS: We reviewed 6 cases undergoing transapical access for endovascular repair of thoracic aortic pathology between December 2013 and August 2015. Five patients had an aortic arch aneurysm and 1 patient presented with Stanford type A subacute aortic dissection...
March 10, 2017: Annals of Vascular Surgery
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