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https://www.readbyqxmd.com/read/28813082/middle-cerebral-artery-aneurysms-aneurysm-angiographic-morphology-and-its-relation-to-pre-operative-and-intra-operative-rupture
#1
Iracema Araújo Estevão, Bruno Camporeze, Antonio Santos de Araujo, Breno Nery, Ápio Claudio Martins Antunes, Timothy R Smith, Paulo Henrique Pires de Aguiar
Objective: Correlate the middle cerebral artery bifurcation aneurysm morphology with the pre-operative and intra-operative risk of rupture. Methods: Forty patients with 46 middle cerebral artery bifurcation aneurysms were treated microsurgically by the same surgeon. Aneurysms were classified according to shape and the Fisher test was applied to analyze the effect of morphology on the pre-operative and intra-operative rupture. Results: Pre-operative and intra-operative ruptures were observed in 8/46 patients (17...
August 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28812257/robotic-assisted-microvascular-surgery-skill-acquisition-in-a-rat-model
#2
Nicholas S Clarke, Johnathan Price, Travis Boyd, Stefano Salizzoni, Kenton J Zehr, Alejandro Nieponice, Pietro Bajona
Microsurgery is a technically demanding field with long learning curves. Robotic-assisted microsurgery has the ability to decrease these learning curves. We, therefore, sought to assess the feasibility of robotic-assisted microvascular surgery in a rat model, and whether this could be translated into a worthwhile skills acquisition exercise for residents. Twenty-eight rats underwent microvascular anastomosis. Procedures were performed by a trained microvascular surgeon with no robotic experience (n = 14), or a trained robotic surgeon with no microvascular experience (n = 14)...
August 10, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28808603/aneurysm-treatment-practice-patterns-for-newly-appointed-dual-trained-cerebrovascular-endovascular-neurosurgeons-comparison-of-open-surgical-to-neuroendovascular-procedures-in-the-first-2-years-of-academic-practice
#3
Bowen Jiang, Matthew T Bender, Bima Hasjim, Frank P K Hsu, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon, Li-Mei Lin
BACKGROUND: The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. METHODS: We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon's practice. RESULTS: A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#4
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28803176/an-easy-efficient-and-mobile-way-for-training-microsurgical-skills-during-busy-life-of-neurosurgical-residency-and-resource-challenged-environment
#5
Antti Huotarinen, Mika Niemelä, Behnam Rezai Jahromi
BACKGROUND: Residents life is more than hectic, it is hard to find place and time for training basic and advanced microsurgical skills. Surgical instruments, sutures can be purchased (or loaned from department) but the most expensive and space occupying device is microscope. In developing countries microscopes are used where the need is most; in operation rooms. Furthermore conventional microscope is not portable. For all mentioned reasons availability of microscope for training microsurgery is very limited...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#6
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28799880/a-morphometric-survey-of-the-parasellar-region-in-more-than-2700-skulls-emphasis-on-the-middle-clinoid-process-variants-and-implications-in-endoscopic-and-microsurgical-approaches
#7
Akshay Sharma, Gabrielle E Rieth, Joseph E Tanenbaum, James S Williams, Nakao Ota, Srikant Chakravarthi, Sunil Manjila, Amin Kassam, Bulent Yapicilar
OBJECTIVE The middle clinoid process (MCP) is a bony projection that extends from the sphenoid bone near the lateral margin of the sella turcica. The varied prevalence and morphological features of the MCP in populations stratified by age, race, and sex are unknown; however, the knowledge of its anatomy and preoperative recognition on CT scans can aid greatly in complication avoidance and management. The aim of this study was to further illustrate the surgical anatomy of the parasellar region and to quantify the incidence of MCP and caroticoclinoid rings (CCRs) in dried preserved human anatomical specimens...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28797974/a-portable-training-model-for-deep-bypass-surgery
#8
Jiwook Ryu, Seok Keun Choi, Yeongu Chung, Sung Ho Lee, Bi-O Jeong
INTRODUCTION: Deep bypass surgery remains a challenging operative procedure. For novice trainees, there is a high barrier to improving the microsurgical skills needed for this procedure because of the relatively low number of cases and the high cost of microsurgical instruments. Here, the authors introduce a training model that includes highly accessible devices and does not require a microscope. MATERIALS AND METHODS: The surgical environment consisted of two 15...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28792429/glabrous-flow-through-flaps-for-simultaneous-resurfacing-revascularization-and-reinnervation-of-digits
#9
Chao Chen, Liwen Hao, Wenhai Sun, Zengtao Wang, Zihai Ding, Shizhen Zhong
INTRODUCTION: Composite injuries of the volar surfaces of fingers are frequently associated with digital vessel and nerve damage. Flow-through glabrous flaps can provide esthetic tissue coverage as well as revascularization, and using a neurovascular flap, allows primary reconstruction of the digital nerve. METHODS: Between June 2010 and August 2014, we prospectively studied the use of Microsurgical flow-through glabrous flaps to achieve simultaneously digital revascularization and soft tissue coverage in 13 fingers of 12 patients who experienced volar injuries, comprising 6 great toe fibular flaps, 3 medial plantar flaps, 1 pedis medialis flap, and 3 hypothenar flaps...
November 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28792187/editorial-comment-use-of-indocyanine-green-angiography-in-microsurgical-subinguinal-varicocelectomy-lessons-learned-from-our-initial-experience
#10
EDITORIAL
Marcello Cocuzza
No abstract text is available yet for this article.
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28782688/urine-f2-isoprostanes-concentration-as-a-poor-prognostic-factor-after-subarachnoid-haemorrhage
#11
Karol Wiśniewski, Michał Bieńkowski, Bartłomiej Tomasik, Marcin Braun, Ernest J Bobeff, Paweł P Liberski, Dariusz J Jaskólski
BACKGROUND: The role of isoprostanes in cerebral vasospasm (CVS) after aneurysmal subarachnoid haemorrhage (aSAH) has remained controversial. Recent studies have suggested that the level of isoprostanes in cerebral spinal fluid could play a role in aSAH patients outcomes. We have measured their concentration in urine as collection is simple and non-invasive. Due to their biological mechanism of action, it is essential to identify their role in aSAH patients. METHODS: A prospective analysis of clinical data and urine samples of 20 patients with aSAH who underwent microsurgical clipping of the aneurysmal neck between May 2016 and January 2017...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28781922/fluorescein-for-resection-of-high-grade-gliomas-a-safety-study-control-in-a-single-center-and-review-of-the-literature
#12
Natale Francaviglia, Domenico Gerardo Iacopino, Gabriele Costantino, Alessandro Villa, Pietro Impallaria, Francesco Meli, Rosario Maugeri
BACKGROUND: The importance of a complete resection of high-grade gliomas (HGGs) has been highlighted in scientific literature, in order to limit tumor recurrence and above all to improve disease-free survival rates. Several fluorescent biomarkers have been tested to improve intraoperative identification of residual tumor; 5-aminolevulinic acid (5-ALA) and fluorescein sodium (FS) are now starting to play a central role in glioma surgery. We performed a retrospective analysis on 47 patients operated for HGGs...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28780846/-clinical-analysis-of-lateral-supraorbital-microsurgical-approach-for-ruptured-anterior-circulation-aneurysm
#13
Q H Meng, J J Xu, S C Wei, R Yu, J Jiang, J Wang, C C Qu
Objective: To explore the safety and efficiency of lateral supraorbital (LSO) approach for the ruptured anterior circulation aneurysm. Methods: The clinical data of 23 patients with grade Ⅰ-Ⅲ ruptured anterior circulation aneurysm via LSO at the Second Hospital of Shandong University from February 2016 to December 2016 were retrospectively analyzed. The clinical data included their clinical manifestations, radiological finding, microsurgical techniques and follow-up results. Results: All patients were diagnosed as anterior circulation aneurysm by preoperative CT angiography (CTA) or Digital Subtraction Angiography (DSA)...
August 1, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28777036/endovascular-treatment-of-a-large-ruptured-middle-cerebral-artery-bifurcation-aneurysm-in-a-5-week-old-infant-case-report
#14
Kristopher A Lyon, Eliel N Arrey, Ali S Haider, Dhruve S Jeevan, Ethan A Benardete
Ruptured intracranial aneurysms are extremely rare in infants. The optimal treatment strategy is not well established. Both microsurgical and endovascular techniques and strategies have been tried, and in the literature there is a significant variability in outcome. The authors report the presentation and successful endovascular treatment of a large, ruptured, middle cerebral artery bifurcation aneurysm in a 5-week-old girl, one of only a few reported in the literature. Clinical and radiological findings at follow-up are also presented...
August 4, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28777024/quantitative-anatomical-comparison-of-the-ipsilateral-and-contralateral-interhemispheric-transcallosal-approaches-to-the-lateral-ventricle
#15
Evgenii Belykh, Kaan Yağmurlu, Ting Lei, Sam Safavi-Abbasi, Mark E Oppenlander, Nikolay L Martirosyan, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
OBJECTIVE The best approach to deep-seated lateral and third ventricle lesions is a function of lesion characteristics, location, and relationship to the ventricles. The authors sought to examine and compare angles of attack and surgical freedom of anterior ipsilateral and contralateral interhemispheric transcallosal approaches to the frontal horn of the lateral ventricle using human cadaveric head dissections. Illustrative clinical experiences with a contralateral interhemispheric transcallosal approach and an anterior interhemispheric transcallosal transchoroidal approach are also related...
August 4, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28774503/the-role-of-simulation-in-microsurgical-training
#16
Evgenios Evgeniou, Harriet Walker, Sameer Gujral
Simulation has been established as an integral part of microsurgical training. The aim of this study was to assess and categorize the various simulation models in relation to the complexity of the microsurgical skill being taught and analyze the assessment methods commonly employed in microsurgical simulation training. Numerous courses have been established using simulation models. These models can be categorized, according to the level of complexity of the skill being taught, into basic, intermediate, and advanced...
July 31, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28770484/high-resolution-mr-lymphangiography-for-planning-lymphaticovenous-anastomosis-treatment-a-single-centre-experience
#17
Maria Antonietta Mazzei, Francesco Gentili, Francesco Giuseppe Mazzei, Paolo Gennaro, Duccio Guerrieri, Andrea Nigri, Guido Gabriele, Elisabetta Weber, Alfonso Fausto, Giuseppe Botta, Luca Volterrani
PURPOSE: This article illustrates the feasibility of MR lymphangiography (MRL) for imaging lymphatic vessels in patients with lymphedema, its accuracy in distinguishing lymphatic vessels from veins, and its utility for planning Lymphaticovenous anastomosis (LVA) treatment. MATERIALS AND METHODS: We prospectively enrolled 30 patients (24 women, range 18-70, 17 cases of lower limb lymphedema, 6 cases of primary lymphedema). All the patients underwent MRL, using a 1...
August 2, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28767168/the-possibility-of-free-tissue-transfer-as-a-nutrient-flap-for-critical-ischemic-foot-a-case-report
#18
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28767031/microsurgical-vascular-manipulation-in-aneurysm-surgery-and-delayed-ischemic-injury
#19
Muhammad Omar Chohan, Andrew P Carlson, Cristina Murray-Krezan, Christopher L Taylor, Howard Yonas
BACKGROUND: The role of aggressive surgical manipulation with clot evacuation, arachnoid dissection, and papaverine-guided adventitial dissection of large vessels during ruptured aneurysm surgery in reducing vasospasm is controversial. Here we describe a single-institution experience in aneurysm surgery outcomes with and without aggressive surgery. METHODS: We performed retrospective analysis of all patients >18 years of age with subarachnoid hemorrhage (SAH) from anterior circulation aneurysms between 2008 and 2013 at the University of New Mexico Hospital...
July 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28766734/pressure-flow-pattern-of-varicocele-veins-and-its-correlation-with-testicular-blood-flow-and-semen-parameters
#20
K Ur Rehman, A B Qureshi, A Numan, H Zaneb, M S Yousaf, I Rabbani, H Rehman
The pressure pattern in varicocele veins of infertile patients and its correlation with semen quality and testicular blood flow was determined. Consecutive patients at andro-urology clinic of a teaching hospital undergoing microsurgical varicocelectomy were included. Their semen quality and testicular blood flow were determined. Peak systolic velocity (PSV) and resistive index (RI) of subcapsular and intraparenchymal branches of testicular artery were noted by colour Doppler ultrasonography. During surgery before ligation of varicocele veins, intravenous pressures of internal spermatic (ISV) and external spermatic (ESV) veins were determined at baseline and after Valsalva manoeuvre...
August 2, 2017: Andrologia
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