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Surgical clipping

Ira Seibel, Aline I Riechardt, Katharina Erb-Eigner, Alexander Böker, Dino Cordini, Jens Heufelder, Antonia M Joussen
PURPOSE: This study was performed to show long-term outcomes concerning metastasis rates and local recurrence rates after primary proton beam therapy in uveal melanoma with posterior extraocular extension (EOE) with the main focus on optic nerve invasion. DESIGN: Retrospective case series METHODS: All patients treated with primary proton beam therapy for choroidal or ciliary body melanoma with posterior EOE between July 1998 and August 2010 were included. EOE was either detected upon sonography at primary examination or during the surgical application of tantalum clips onto the sclera...
April 12, 2018: American Journal of Ophthalmology
Arslan Talat, Demetrios Tzimas, Juan Carlos Bucobo
No abstract text is available yet for this article.
April 9, 2018: Clinical Gastroenterology and Hepatology
Hideyuki Tomita, Katsuya Saito
Background: Vascular anomaly and aneurysmal formation of an anterior communicating artery (Acom) complex has often been reported. Because of such a complicated relationship between the vascular structure and aneurysms, Acom aneurysm is one of the most difficult aneurysms to treat among other common anterior circulation aneurysms. We experienced an extremely rare and difficult-to-treat case of ruptured Acom aneurysm with the combined vascular anomaly of the Acom fenestration and an accessory anterior cerebral artery (ACA)...
2018: Surgical Neurology International
Varun Naragum, Mohamad AbdalKader, Thanh N Nguyen, Alexander Norbash
The anterior communicating artery is a common location for intracranial aneurysms. Compared to surgical clipping, endovascular coiling has been shown to improve outcomes for patients with ruptured aneurysms and we have seen a paradigm shift favoring this technique for treating aneurysms. Access to the anterior cerebral artery can be challenging, especially in patients with tortuous anatomy or subarachnoid hemorrhage or in patients presenting with vasospasm. We present a technique for cannulating the anterior cerebral artery using a balloon inflated in the proximal middle cerebral artery as a rebound surface...
February 2018: Interventional Neurology
Lumarie Santiago, Rosalind P Candelaria, Monica L Huang
MR imaging is now routinely performed for breast cancer screening and staging. For suspicious MR imaging-detected lesions that are mammographically and sonographically occult, MR imaging-guided breast interventions, including biopsy, clip placement, and preoperative needle localization, have been developed to permit accurate tissue diagnosis and aid in surgical planning. These procedures are safe, accurate, and effective when performed according to key principles, including proper patient selection, use of appropriate technique, adequate preprocedure preparation and postprocedure patient care, and postprocedure imaging-pathology correlation...
May 2018: Magnetic Resonance Imaging Clinics of North America
Vijay Agarwal, Daniel L Barrow
We present the case of an 11-yr-old male who originally presented to an outside hospital with subarachnoid hemorrhage. He was discovered at that time to have a ruptured right A1-A2 junction anterior cerebral artery aneurysm just proximal to the anterior communicating artery. He underwent endovascular coiling at the outside center. While recovering at a rehabilitation center, he had a rehemorrhage and acute neurological decline. He was transferred to our service, where he underwent surgical exploration and clip reconstruction of what appeared to be a pseudoaneurysm...
March 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Angela F Caveney, Scott A Langenecker, Aditya S Pandey, Laura B Farah, J Alexis Ortiz, Nadia Huq, Runa Bhaumik, B Gregory Thompson, Bruno J Giordani, Donna Auer, Lewis B Morgenstern
BACKGROUND: Evaluation of differences in neuropsychological outcomes in patients undergoing surgical clipping (SC) vs endovascular coiling (EC) for unruptured cerebral aneurysms is essential in guiding patients seeking treatment of asymptomatic cerebral aneurysms. OBJECTIVE: To perform a prospective longitudinal analysis of neuropsychological outcomes in patients who underwent microsurgery or coiling for unruptured cerebral aneurysms. METHODS: SC (50 patients), EC (35 patients), and healthy controls (43 individuals) were included...
March 27, 2018: Neurosurgery
Priscilla Machado, John R Eisenbrey, Maria Stanczak, Barbara C Cavanaugh, Lisa M Zorn, Flemming Forsberg
The objective was to evaluate a commercial image processing technique (MicroPure, Canon Medical Systems, Tustin, CA, USA) for detection of microcalcifications in breast surgical specimens. Twenty women scheduled for surgical excision of an area with breast calcifications were enrolled, their surgical specimens underwent grayscale ultrasound (US) and MicroPure examination using an Aplio XG scanner (Canon). Four independent and blinded readers analyzed 54 US and 54 MicroPure digital clips to determine the number of calcifications and scored image quality and artifacts on a 10-point scale...
March 29, 2018: Ultrasound in Medicine & Biology
Abdullah Alshammari, Sreyoshi Fatima Alam, Mohammed Hussein Ahmed, Khaled AlKattan
INTRODUCTION: There has been a recent surge in bariatric surgery. Consequently, identification of new complications is imminent. Gastrobronchial fistula is one of the newly identified severe complications. The medical community is yet to come up with a consensus on management, which is further complicated by the lack of literature on par with its rarity. Therefore, we aim to contribute to a better understanding and add to the managerial approach. PRESENTATION OF CASE: We report a case of a 36-year-old female...
March 26, 2018: International Journal of Surgery Case Reports
Jiantao Wang, Jun Wu, Yong Cao, Zhisheng Kan, Shuo Wang
OBJECTIVE: To compare the pterional and frontolateral approach to determine the most effective route for paraclinoid aneurysm surgery. METHODS: Between June 2010 and December 2015, a total of 176 patients with paraclinoid aneurysm underwent surgical clipping, 96 through the pterional and 80 through the frontolateral approach. We analyzed the two groups and compared demographic, radiologic, and clinical variables including age, sex, aneurysm type,intraoperative rupture rates, operative time,anatomical obstacles,outcome and postoperative complications...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Spiessberger Alexander, Strange Fabio, Fandino Javier, Marbacher Serge
OBJECTIVE: Neck clipping remains a valuable treatment option for basilar apex aneurysms, especially in those with complex morphology, such as incorporation of branching vessels or large size, and young patient age. A number of approaches have proven to give effective exposure for various types of lesion morphologies. Our historic literature review from 1976 to the present systematically compares the outcomes and complications of the key surgical approaches in the treatment of basilar apex aneurysms...
March 27, 2018: World Neurosurgery
Lai Chuang Chee, Johari Adnan Siregar, Abdul Rahman Izani Ghani, Zamzuri Idris, Noor Azman A Rahman Mohd
Background: Ruptured cerebral aneurysm is a life-threatening condition that requires urgent medical attention. In Malaysia, a prospective study by the Umum Sarawak Hospital, Neurosurgical Center, in the year 2000-2002 revealed an average of two cases of intracranial aneurysms per month with an operative mortality of 20% and management mortality of 25%. Failure to diagnose, delay in admission to a neurosurgical centre, and lack of facilities could have led to the poor surgical outcome in these patients...
February 2018: Malaysian Journal of Medical Sciences: MJMS
Gui-Bao Liu, Yuan-Yuan Mao, Chang-Ping Yang, Jin-Lin Cao
The best method to ligate the arteries during laparoscopic cholecystectomy or appendectomy remains controversy. The aim of this study is to introduce a new approach during laparoscopic combined cholecystectomy and appendectomy using a monopolar electrocautery to seal the cystic and appendix arteries. We retrospectively reviewed data from 57 patients who underwent laparoscopic combined cholecystectomy and appendectomy between December 2006 and June 2016. Each laparoscopic combined cholecystectomy and appendectomy was performed by coagulating and sealing the cystic and appendix arteries...
March 2018: Medicine (Baltimore)
Leann Kania, Flavius Guglielmo, Donald Mitchell
Few things in radiology are "pathognomonic" in their appearance or presentation. However, having an awareness of those findings which are specific to a certain entity is important when interpreting imaging studies. These classic findings can be identified with many imaging modalities, but no modality provides as many recognizable observations as an MRI. This results from the large variety of pulse sequences that provide high contrast resolution, prior to and following contrast administration. In this article, the most classically recognized abdominal findings are presented including the following: Liver: Cyst, hemangioma, focal nodular hyperplasia, hepatic adenoma, hemosiderosis, hepatocellular carcinoma...
March 28, 2018: Abdominal Radiology
Dorin Dumitru, Ayesha Khan, Giuseppe Catanuto, Nicola Rocco, Maurizio B Nava, John R Benson
Axillary surgery in breast cancer patients has shifted from more extensive to minimalist approaches with re-evaluation of the risks versus benefits of available treatment options which are increasingly tailored to individual patient characteristics.A radical axillary node dissection is rarely indicated nowadays due to several factors including screening with detection of small node negative cancers, introduction of targeted node sampling, less reliance on information from nodal staging for adjuvant therapy decision making and evidence that non-surgical treatments such as systemic therapies (chemotherapy, hormonal therapy, biological therapy) together with radiotherapy can safely treat low burden axillary disease...
March 28, 2018: Minerva Chirurgica
Yurong Jiao, Jinjie He, Jun Li, Dong Xu, Kefeng Ding
Vessel identification and dissection are the key processes of laparoscopic complete mesocolic excision (CME). Vascular injury will lead to complications such as prolonged operative time, intraoperative hemorrhage and ischemia of anastomotic stoma. Superior mesenteric artery (SMA), superior mesenteric vein(SMV), gastrointestinal trunk, left colic artery(LCA), sigmoid artery and marginal vessels in the mesentery have been found with possibility of heteromorphosis, which requires better operative techniques. Surgeons should recognize those vessel heteromorphosis carefully during operations and adjust strategies to avoid intraoperative hemorrhage...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Li-Min Xiao, Bin Tang, Shen-Hao Xie, Guan-Lin Huang, Zhi-Gang Wang, Er-Ming Zeng, Tao Hong
OBJECTIVE: Endoscopic endonasal clipping of intracranial aneurysms may utilize the microsurgical techniques as an alternative to the transcranial approach. The aim of this manuscript is to report a series of patients who underwent endoscopic endonasal approach(EEA) for microsurgical clipping of anterior circulation aneurysms. METHOD: A retrospective chart review was conducted. All the patients who underwent standard binostril EEA for aneurysm clipping were included...
March 21, 2018: World Neurosurgery
Ruiqi Chen, Rui Guo, Dingke Wen, Chao You, Lu Ma
OBJECTIVE: Giant wide-neck paraclinoid aneurysms remain a formidable challenge for neurosurgeons due to the brisk retrograde blood flow during surgical clipping. Theoretically, Entire orifice blockade (EOB) by placing a longitudinal intracarotid balloon catheter across the aneurysm neck could achieve a good vascular control in treating cerebral aneurysms, but related studies have been scarce. The aim of this study was to evaluate the safety and efficiency of the EOB-assisted microsurgical technique for treating giant wide-neck paraclinoid aneurysms...
March 20, 2018: World Neurosurgery
Tomohiro Abiko, Katsuya Saito, Makoto Murase, Hideyuki Tomita
Blister-like aneurysms(BLA)are morphologically thin-walled fragile structures that are associated with a high risk of intraoperative rupture. BLAs presumably originate from an arterial dissection and often stem from a non-branching site on the supraclinoid segment of the internal carotid artery. We report a rare case of a patient who was successfully treated for a ruptured BLA originating from the anterior communicating artery(Acom). A 60-year-old woman presented with severe headache and loss of consciousness...
March 2018: No Shinkei Geka. Neurological Surgery
Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
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