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https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#1
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/28331145/modified-marionette-technique-for-laparoscopic-colorectal-surgery
#2
Seiichi Shinji, Hayato Kan, Takeshi Yamada, Michihiro Koizumi, Aya Yamagishi, Yasuyuki Yokoyama, Goro Takahashi, Takuma Iwai, Keisuke Hara, Kohki Takeda, Keiichiro Ohta, Eiji Uchida
INTRODUCTION: Single-port laparoscopic surgery has some technical limitations with respect to control of the forceps inserted through the single-access site, which results in increased internal collisions due to coaxial alignment of the instruments, as well as and decreased range of motion and visualization. To overcome these limitations, we employ a "modified marionette technique" as a way to carry out laparoscopic colorectal surgery. Materials and Surgical Technique: The procedures for the modified marionette technique are performed as follows: An Internal Organ Retractor (IOR)™ and an atraumatic clip designed to firmly grasp tissue, with 1-0 nylon thread, are inserted through a 12-mm trocar and secured in place where adequate visualization and traction for cutting with a radio knife is required...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28327921/the-superior-cerebellar-artery-aneurysm-a-posterior-circulation-aneurysm-with-favorable-microsurgical-outcomes
#3
Ana Rodríguez-Hernández, Brian P Walcott, Harjus Birk, Michael T Lawton
BACKGROUND: Superior cerebellar artery (SCA) aneurysms are usually grouped with aneurysms that arise from the upper basilar artery or more broadly, the posterior circulation. However, the SCA aneurysm has distinctive anatomy that facilitates safe surgical management, notably few associated perforating arteries, and excellent exposure in the carotid-oculomotor triangle. OBJECTIVE: To demonstrate the outcomes of patients treated with microsurgery in a continuous surgical series...
January 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28321460/complication-risk-factors-in-anterior-choroidal-artery-aneurysm-treatment
#4
Arthur André, Anne-Laure Boch, Federico Di Maria, Aurélien Nouet, Nader Sourour, Stéphane Clémenceau, Joseph Gabrieli, Vincent Degos, Chiheb Zeghal, Jacques Chiras, Philippe Cornu, Frédéric Clarençon
OBJECT: The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment. METHODS: We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%)...
March 20, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28320428/a-topology-based-method-to-mitigate-the-dosimetric-uncertainty-caused-by-the-positional-variation-of-the-boost-volume-in-breast-conservative-radiotherapy
#5
Peng-Yi Lee, Chih-Yuan Lin, Shang-Wen Chen, Chun-Ru Chien, Chun-Nan Chu, Hsiu-Ting Hsu, Ji-An Liang, Ying-Jun Lin, An-Cheng Shiau
BACKGROUND: To improve local control rate in patients with breast cancer receiving adjuvant radiotherapy after breast conservative surgery, additional boost dose to the tumor bed could be delivered simultaneously via the simultaneous integrated boost (SIB) modulated technique. However, the position of tumor bed kept changing during the treatment course as the treatment position was aligned to bony anatomy. This study aimed to analyze the positional uncertainties between bony anatomy and tumor bed, and a topology-based approach was derived to stratify patients with high variation in tumor bed localization...
March 20, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28319208/posterior-mandibular-ridge-resorption-associated-with-different-retentive-systems-for-overdentures-a-7-year-retrospective-preliminary-study
#6
Moustafa Abdou Elsyad, Shahinaz Sayed Mohamed, Ahmad Fathalla Shawky
PURPOSE: This retrospective study compared posterior mandibular residual ridge resorption with two different retentive mechanisms for overdentures after 7 years. MATERIALS AND METHODS: A convenience sample of 18 edentulous men was assigned to one of two equal groups. Two implants were placed in the mandibular canine areas for each patient using the conventional two-stage surgical protocol, and the implants were splinted with a round bar 3 months later. New mandibular overdentures were then connected to the bars with clips (clip-retained overdentures, CR group) or resilient liners (resilient liner-retained overdentures, RR group)...
March 20, 2017: International Journal of Prosthodontics
https://www.readbyqxmd.com/read/28303205/aneurysm-of-azygos-anterior-cerebral-artery-associated-with-falcine-meningioma-case-report-and-review-of-the-literature
#7
Lucas C Meguins, Raquel C T Hidalgo, Antônio R Spotti, Dionei F de Morais
BACKGROUND: The azygos anterior cerebral artery (ACA) is an uncommon intracranial vascular anomaly of the circle of Willis. Identification of aneurysm from azygos ACA with anterior falcine meningioma is an extremely rare association. The aim of the present study is to report the case of an adult female with a ruptured aneurysm from azygos ACA in association with an anterior falcine meningioma. CASE DESCRIPTION: A 65-year-old female was admitted in the Emergency Department reporting sudden onset of severe headache...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28291453/a-sutureless-vascular-closure-device-for-emergent-bovine-xenograft-implantation
#8
Joseph F Knapp, Matt Maxwell, Cassidy Briggs, Erin T Shaw, Milton V Marshall, David Cheung
A novel vascular staple (C-staple) was developed that does not enter the vasculature lumen during anastomoses. The objective of this study was to demonstrate C-staple safety when used with a bovine xenograft and compare efficacy of the C-staple procedure with Anastoclip surgical clips or suturing when used with a bovine xenograft. Eight sheep had an acute comparison between suturing and C-staples using both common carotid arteries. Sixteen sheep had xenograft placement in the left carotid artery, eight with C-staples and eight with Anastoclips in a chronic study...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286089/conventional-surgery-for-early-and-late-symptomatic-mitral-valve-stenosis-after-mitraclip-%C3%A2-intervention-an-institutional-experience-with-four-consecutive-patients
#9
Anthony Alozie, Liliya Paranskaya, Bernd Westphal, Alexander Kaminski, Gustav Steinhoff, Mohammad Sherif, Hüseyin Ince, Alper Öner
BACKGROUND: Surgical mitral valve repair is the gold standard for treatment of mitral regurgitation. Recently, the transcatheter treatment of mitral regurgitation with the MitraClip(®) device (Abbot Vascular Structural Heart, Menlo Park, CA) has demonstrated promising results in treating patients not amenable for surgical correction of mitral valve regurgitation. Most patients reported in the literature requiring surgical bailout after MitraClip treatment presented with residual or recurrent mitral valve regurgitation...
February 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28285011/arthroscopic-assisted-exploration-of-the-axillary-nerve-through-a-posterior-open-approach-a-novel-technique
#10
Andrés A Maldonado, Robert J Spinner, Allen T Bishop, Alexander Y Shin, Bassem T Elhassan
INTRODUCTION: Previous studies have described a segment of the axillary nerve (AN) that cannot be surgically explored through standard open surgical approaches (blind zone). This study aimed to evaluate the feasibility of combining the standard posterior approach to the AN by using an arthroscope to visualize all segments of the AN. MATERIAL AND METHODS: Four fresh-frozen shoulders in two adult human torsos were included in the study. A standard posterior approach was performed on each shoulder, and a dry arthroscopy was performed through the surgical opening in an attempt to visualize all the segments of the AN...
February 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28281190/ruptured-dissecting-aneurysms-of-the-a1-segment-of-the-anterior-cerebral-artery-three-case-reports-and-a-review-of-the-literature
#11
REVIEW
Takafumi Mitsuhara, Fusao Ikawa, Toshikazu Hidaka, Yasuharu Kurokawa, Ushio Yonezawa
Dissecting aneurysms in the anterior cerebral artery (ACA), although rare, can cause ischemic and/or hemorrhagic stroke. Hemorrhagic dissecting aneurysms in the A1 portion of the ACA are often associated with a poor prognosis. We retrospectively investigated three rare cases of hemorrhagic dissecting aneurysms in the A1 portion. Dissecting aneurysms were diagnosed by carotid angiography or computed tomography angiography to visualize morphological changes in the vessel. All patients presented with diffuse subarachnoid hemorrhage...
March 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28278561/the-role-of-surgical-clips-in-the-evaluation-of-interfractional-uncertainty-for-treatment-of-hepatobiliary-and-pancreatic-cancer-with-postoperative-radiotherapy
#12
Jin Suk Bae, Dong Hyun Kim, Won Taek Kim, Yong Ho Kim, Dahl Park, Yong Kan Ki
Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy...
March 10, 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/28272703/the-study-of-endogenous-hepatocyte-growth-factor-in-the-pathogenesis-of-intracranial-aneurysms
#13
L-L Yu, Y-J Liu, Z-H Wang, L Shi, L-X Liu
OBJECTIVE: Inflammation as a significant influence factor plays an important role in the formation and rupture of intracranial aneurysms. However, based on plenty of related studies, it is believed that the hepatocyte growth factor (HGF) is able to prevent vascular inflammation. This paper, therefore, explored the role and mechanism of endogenous HGF in the pathogenesis of intracranial aneurysms. MATERIALS AND METHODS: 16 blood samples were collected from the intracranial aneurysms and the lumens of the femoral artery of 16 patients...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28265392/hybrid-procedure-combining-clip-on-wrapping-and-stent-placement-for-ruptured-supraclinoid-blood-blister-like-aneurysm-of-the-internal-carotid-artery
#14
Hirokazu Nagasaki, Michihisa Narikiyo, Gota Nagayama, Seiya Nagao, Yoshifumi Tsuboi, Chisaku Kambayashi
Blood blister-like aneurysms of the supraclinoid portion of the internal carotid artery are rare, fragile, and thin-walled lesions with a higher rate of rebleeding. Our case underwent a hybrid procedure combining direct surgical and endovascular approach.
March 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28264247/pterional-or-subfrontal-access-for-proximal-vascular-control-in-anterior-interhemispheric-approach-for-ruptured-pericallosal-artery-aneurysms-at-risk-of-premature-rupture
#15
Jaechan Park
OBJECTIVE: Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. METHODS: A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28258847/percutaneous-edge-to-edge-mitral-valve-repair-for-the-treatment-of-acute-mitral-regurgitation-complicating-myocardial-infarction-a-single-centre-experience
#16
Marianna Adamo, Salvatore Curello, Ermanna Chiari, Claudia Fiorina, Giuliano Chizzola, Marco Magatelli, Elisa Locantore, Giovanni Cuminetti, Carlo Lombardi, Aldo Manzato, Marco Metra, Federica Ettori
BACKGROUND: Limited evidence is available about MitraClip therapy in patients with acute mitral regurgitation (MR) complicating myocardial infarction (MI). METHODS AND RESULTS: Among 80 consecutive patients undergoing MitraClip treatment, 5 (6.3%) had been admitted for acute MI complicated by severe MR. Mean age was 73±6years and 3 were males. At the time of admission they were in cardiogenic shock (80%) or pulmonary oedema (20%), with severe MR, left ventricular dysfunction and pulmonary hypertension...
May 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28256168/multidisciplinary-management-for-the-treatment-of-proximal-posterior-inferior-cerebellar-artery-aneurysms
#17
Kwang-Chun Cho, Yong Bae Kim, Sang Hyun Suh, Jin Yang Joo, Chang-Ki Hong
OBJECTIVES: Aneurysms of the proximal posterior inferior cerebellar artery (PICA) are rare. The management of proximal PICA aneurysms is challenging with either surgical or endovascular treatment. We report our successful experience of treating PICA aneurysms with a multimodal approach. METHODS: Of 2382 treated aneurysms, 22 aneurysms in 21 patients (male:female 8:13, mean age 48.9 years) were enrolled from March 1998 to December 2015. We treated the aneurysms with a multimodal approach and performed angiography to examine aneurysm regrowth at the 12 months follow-up...
March 3, 2017: Neurological Research
https://www.readbyqxmd.com/read/28254535/keyhole-approach-for-clipping-intracranial-aneurysm-comparison-of-supraorbital-and-pterional-keyhole-approach
#18
Qing Lan, Hengzhu Zhang, Qing Zhu, Ailin Chen, Yanming Chen, Liang Xu, Zhongyong Wang, Liqun Yuan, Shihai Liu
OBJECTIVE: The aim of this research was to compare the functional outcome and safety between supraorbital keyhole approach (SKA) and pterional keyhole approach (PKA) for clipping intracranial aneurysms. METHODS: This is a retrospective study involving 318 patients with a total 365 aneurysms who underwent keyhole surgery, comprising 195 cases in SKA group and 123 cases in PKA group. The outcome measures include Glasgow Outcome Scale (GOS), complete clipping rate, adverse events incidence, operation view angle, working distance, and surgical incision condition...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28251324/middle-cerebral-artery-aneurysm-rupture-in-a-neonate-with-interrupted-aortic-arch-case-report
#19
Joaquin Hidalgo, James Charles Dickerson, Brandon Burnsed, Ali Luqman, James Mason Shiflett
INTRODUCTION: Arterial cerebral aneurysms in the neonatal population are rare, and while the association of interrupted aortic arch and intracranial aneurysm has been reported in the adult and pediatric population (three cases each), to date, it has not been reported in the neonate. CASE REPORT: We report the case of a 26-day-old girl who presented with a generalized seizure 2 weeks after undergoing congenital heart surgery. Head CT revealed diffuse SAH with a 1...
March 1, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28250903/endoscopic-closure-instead-of-surgery-to-close-an-ileal-pouch-fistula-with-the-over-the-scope-clip-system
#20
Yao Wei, Jian-Feng Gong, Wei-Ming Zhu
An ileal pouch fistula is an uncommon complication after an ileal pouch anal anastomosis. Most patients who suffer from an ileal pouch fistula will need surgical intervention. However, the surgery can be invasive and has a high risk compared to endoscopic treatment. The over-the-scope clip (OTSC) system was initially developed for hemostasis and leakage closure in the gastrointestinal tract during flexible endoscopy. There have been many successes in using this approach to apply perforations to the upper gastrointestinal tract...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
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