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https://www.readbyqxmd.com/read/28821992/analysis-of-outcome-at-discharge-after-aneurysmal-subarachnoid-hemorrhage-in-japan-according-to-the-japanese-stroke-databank
#1
Fusao Ikawa, Masaru Abiko, Daizo Ishii, Jyunpei Ohshita, Toshinori Matsushige, Takahito Okazaki, Shigeyuki Sakamoto, Eisuke Hida, Shotai Kobayashi, Kaoru Kurisu
The outcomes at discharge for ruptured cerebral aneurysms after subarachnoid hemorrhage (SAH) were investigated using data from the Japanese stroke databank. Among 101,165 patients with acute stroke registered between 2000 and 2013, 4693 patients had SAH caused by ruptured saccular aneurysm. Of these, 3593 patients (1140 men and 2453 women; mean age 61.3 ± 13.7 years) were treated by surgical clipping (SC) and/or endovascular coiling (EC). The outcomes of modified Rankin scale (mRS) at discharge were compared between the SC and EC groups...
August 19, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28821626/current-applications-and-future-perspectives-of-robotics-in-cerebrovascular-and-endovascular-neurosurgery
#2
REVIEW
Simon A Menaker, Sumedh S Shah, Brian M Snelling, Samir Sur, Robert M Starke, Eric C Peterson
Advances in robotic medicine have been adopted by various surgical subspecialties as the benefits of this technology become more readily apparent: precision in narrow operative windows, tremor controlled movements, and modestly improved outcomes, among others. Vascular neurosurgery, in particular, remains open to newer and more cutting edge treatment options for complex pathologies, and robotics may be on the horizon for such advances. We seek to provide a broad overview of these innovations in vascular neurosurgery for both practitioners well acquainted with robotics and those seeking to become more familiar...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28820303/rapid-ventricular-pacing-for-clip-reconstruction-of-complex-unruptured-intracranial-aneurysms-results-of-an-interdisciplinary-prospective-trial
#3
Juergen Konczalla, Johannes Platz, Stephan Fichtlscherer, Haitham Mutlak, Ulrich Strouhal, Volker Seifert
OBJECTIVE To date, treatment of complex unruptured intracranial aneurysms (UIAs) remains challenging. Therefore, advanced techniques are required to achieve an optimal result in treating these patients safely. In this study, the safety and efficacy of rapid ventricular pacing (RVP) to facilitate microsurgical clip reconstruction was investigated prospectively in a joined neurosurgery, anesthesiology, and cardiology study. METHODS Patients with complex UIAs were prospectively enrolled. Both the safety and efficacy of RVP were evaluated by recording cardiovascular events and outcomes of patients as well as the amount of aneurysm occlusion after the surgical clip reconstruction procedure...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28819885/adenosine-assisted-clipping-of-intracranial-aneurysms
#4
Torstein R Meling, Luis Romundstad, Geir Niemi, Jon Narum, Per Kristian Eide, Angelika G Sorteberg, Wilhelm A Sorteberg
Temporary parent vessel clip occlusion in aneurysm surgery is not always practical or feasible. Adenosine-induced transient cardiac arrest may serve as an alternative. We retrospectively reviewed our clinical database between September 2011 and July 2014. All patients who underwent microsurgical clipping of intracranial aneurysms under adenosine-induced asystole were included. A total of 18 craniotomies were performed, and 18 aneurysms were clipped under adenosine-induced asystole (7 basilar arteries, 8 internal carotid arteries, 1 middle cerebral artery, and 1 anterior communicating artery) in 16 patients (10 females, 6 males)...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28816882/a-narrative-review-of-adherence-to-subarachnoid-hemorrhage-guidelines
#5
Paolo Gritti, Oluwaseun Akeju, Ferdinando L Lorini, Luigi A Lanterna, Carlo Brembilla, Federico Bilotta
Over the past 2 decades, a large number of guidelines for aneurysmal subarachnoid hemorrhage (aSAH) management have been proposed. The primary aim of these "evidence-based" guidelines is to improve the care of aSAH patients by summarizing and making current knowledge readily available to clinicians. However, an investigation into aSAH guidelines, their changes along time and their successful translation into clinical practice is still lacking.We performed a literature search of historical events and subarachnoid hemorrhage guidelines using the Entrez PubMed NIH, Embase, and Cochrane databases for articles published up to November of 2016...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28815402/covered-esophageal-stenting-is-effective-for-symptomatic-gastric-lumen-narrowing-and-related-complications-following-laparoscopic-sleeve-gastrectomy
#6
Murad A Aburajab, Joshua B Max, Mel A Ona, Kapil Gupta, Miguel Burch, F Michael Feiz, Simon K Lo, Laith H Jamil
BACKGROUND AND STUDY AIMS: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity in treating morbid obesity. Prior studies showed a 3.5% risk of gastric sleeve stenosis (GSS). There is no consensus on how to treat these patients, and the role of endoscopic therapy has been addressed in only a few studies. We aim to assess the efficacy and safety of endoscopic stenting in the management of GSS following LSG. PATIENTS AND METHODS: Retrospective data were reviewed from July 2009 to November 2013...
August 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28811040/implant-specific-follow-up-imaging-of-treated-intracranial-aneurysms-tof-mra-vs-metal-artifact-reduced-intravenous-flat-panel-computed-tomography-angiography-fpcta
#7
N H Hänsel, G A Schubert, B Scholz, O Nikoubashman, A E Othman, M Wiesmann, R Pjontek, M A Brockmann
AIM: To compare the diagnostic quality of time-of-flight magnetic resonance angiography (TOF-MRA) and metal-artefact-reduction (MAR) flat-panel-detector computed tomography angiography (FPCTA) and to determine the imaging technique best suited for evaluation endovascular and surgically treated aneurysms. METHODS: The image quality of TOF-MRA and MAR-FPCTA of 44 intracranial implants (coiling: n=20; clipping: n=15; coiling + stenting: n=9) in a patient cohort of 25 was evaluated by two independent readers...
August 12, 2017: Clinical Radiology
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
#8
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/28798268/how-safe-and-effective-are-existing-treatments-for-wide-necked-bifurcation-aneurysms-literature-based-objective-performance-criteria-for-safety-and-effectiveness
#9
REVIEW
David Fiorella, Adam S Arthur, Richard Chiacchierini, Evelyne Emery, Andy Molyneux, Laurent Pierot
INTRODUCTION: Wide-necked bifurcation aneurysms (WNBAs) present unique technical challenges for both endovascular and surgical treatments which aim to achieve complete occlusion of the aneurysm without compromising the patency of the incorporated regional parent vessels. We present a meta-analysis of traditional therapies for WNBAs to provide critical benchmarks for safety and effectiveness. METHODS: Following a systematic search of the literature and the application of pre-specified appropriateness criteria, 43 (including 2794 aneurysms treated) and 65 (including 5366 patients treated) references with sufficient detail were identified to include in a meta-analysis of efficacy and safety, respectively...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28792158/robotic-cholecystectomy-using-the-newly-developed-korean-robotic-surgical-system-revo-i-a-preclinical-experiment-in-a-porcine-model
#10
Chang Moo Kang, Jae Uk Chong, Jin Hong Lim, Dong Won Park, Sung Jun Park, Suhyeon Gim, Hye Jin Ye, Se Hoon Kim, Woo Jung Lee
One Korean company recently successfully produced a robotic surgical system prototype called Revo-i (MSR-5000). We, therefore, conducted a preclinical study for robotic cholecystectomy using Revo-i, and this is a report of the first case of robotic cholecystectomy performed using the Revo-i system in a preclinical porcine model. Revo-i consists of a surgeon console (MSRC-5000), operation cart (MSRO-5000) and vision cart (MSRV-5000), and a 40 kg-healthy female porcine was prepared for robotic cholecystectomy with general anesthesia...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28791191/modified-extradural-temporopolar-approach-with-suction-decompression-for-clipping-of-large-paraclinoid-aneurysm-technical-note
#11
Naoki Otani, Terushige Toyooka, Kojiro Wada, Kentaro Mori
BACKGROUND: Surgical clipping of complicated large paraclinoid aneurysms are still challenging because strong adhesion of aneurysm itself may hinder the dissection of the perforators and the surrounding anatomical structures from the aneurysm dome. METHODS: We describe 13 consecutive patients and the clipping of complicated, large-sized paraclinoid aneurysms using a modified extradural temporopolar approach combined with retrograde suction decompression and discuss its advantages and pitfalls...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28781921/ruptured-mycotic-aneurysms-report-and-outcomes-of-two-surgically-managed-patients
#12
Aleena Khan, Muhammad Waqas, Waseem M Nizamani, Muhammad E Bari
BACKGROUND: Mycotic aneurysm is a rare potentially life-threatening complication of infective endocarditis (IE). Little data is available on the management and outcomes of ruptured mycotic aneurysms with large intracerebral hematoma. Few cases have been described on the management of mycotic aneurysm in the presence of life-threatening hematoma and mass effect. CASE DESCRIPTION: We are presenting two cases of ruptured mycotic aneurysm with intracerebral hematoma and impending brain herniation...
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/28768544/preoperative-endoscopic-titanium-clip-placement-facilitates-intraoperative-localization-of-early-stage-esophageal-cancer-or-severe-dysplasia
#14
Lei Tan, Juan Feng, Qin Zhao, Ping Chen, Guotao Yang
BACKGROUND: Accurate intraoperative localization of esophageal lesions is essential for successful surgical resection. We tested whether preoperative endoscopic placement of titanium clips could facilitate intraoperative localization of early-stage esophageal cancer or severe dysplasia. METHODS: A prospective randomized clinical trial was performed between May 2012 and July 2014. All enrolled patients received preoperative endoscopy and esophageal endoscopic ultrasound, as well as pathological study on the biopsy specimen, to confirm early stage esophageal cancer or severe dysplasia...
August 2, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28766234/localizing-the-clipped-node-in-patients-with-node-positive-breast-cancer-treated-with-neoadjuvant-chemotherapy-early-learning-experience-and-challenges
#15
Toan T Nguyen, Tina J Hieken, Katie N Glazebrook, Judy C Boughey
BACKGROUND: Placement of a clip in the positive node in patients presenting with node-positive breast cancer treated with neoadjuvant chemotherapy (NAC) allows resection of the clipped node at SLN surgery and improves the accuracy of surgical staging. We sought to evaluate our experience with SLN surgery with resection of the clipped node since incorporation into our practice. METHODS: With Institutional Review Board approval, we evaluated all breast cancer patients with a percutaneous biopsy-positive axillary lymph node, clipped at the time of diagnosis, who underwent NAC followed by surgery...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766199/a-patient-specific-3d-printed-form-accurately-transfers-supine-mri-derived-tumor-localization-information-to-guide-breast-conserving-surgery
#16
Richard J Barth, Venkataramanan Krishnaswamy, Keith D Paulsen, Timothy B Rooney, Wendy A Wells, Elizabeth Rizzo, Christina V Angeles, Jonathan D Marotti, Rebecca A Zuurbier, Candice C Black
BACKGROUND: Wire-localized excision of nonpalpable breast cancer is imprecise, resulting in positive margins 25-30% of the time. METHODS: Patients underwent preoperative supine magnetic resonance imaging (MRI). A radiologist outlined the tumor edges on consecutive images, creating a three-dimensional (3D) view of its location. Using 3D printing, a bra-like plastic form (the Breast Cancer Locator [BCL]) was fabricated, with features that allowed a surgeon to (1) mark the edges of the tumor on the breast surface; (2) inject blue dye into the breast 1 cm from the tumor edges; and (3) place a wire in the tumor at the time of surgery...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28765030/relationship-of-a1-segment-hypoplasia-to-the-radiological-and-clinical-outcomes-of-surgical-clipping-anterior-communicating-artery-aneurysm
#17
Fan Yang, Hao Li, Jun Wu, Maogui Li, Xin Chen, Pengjun Jiang, Zhengsong Li, Yong Cao, Shuo Wang
OBJECTIVE: This study aims to assess whether the A1 segment hypoplasia is a risk factor for unfavorable radiological and clinical outcomes of surgical clipping anterior communicating artery (ACoA) aneurysm. METHODS: We retrospectively reviewed 251 patients with ACoA aneurysm who underwent surgical clipping in Beijing Tiantan Hospital between September 2011 and September 2016. Their clinical and radiologic features, as well as clinical outcomes were reviewed. In addition, univariate and multivariate logistic regression analysis was performed to identify independent risk factors for the postoperative infarction and unfavorable clinical outcomes of surgical clipping ACoA aneurysm...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28765019/the-resolution-of-oculomotor-nerve-palsy-due-to-unruptured-posterior-communicating-artery-aneurysms-a-cohort-study-and-narrative-review
#18
Samuel Hall, Ahmed Ramadan-Sadek, Alexander Dando, Adam Grose, Borislav D Dimitrov, John Millar, Jason Hm Macdonald, Adam Ditchfield, Owen Sparrow, Diederik Bulters
OBJECTIVE: Recovery of oculomotor nerve palsy following microsurgical and endovascular treatment has been studied in numerous small series of predominantly ruptured aneurysms. Little consideration has been given to the distinction between ruptured and unruptured aneurysms. This study examines the influence of treatment modality on oculomotor palsy recovery due to unruptured posterior communicating artery aneurysms. METHODS: Patients who presented between 2003 and 2015 with an oculomotor palsy secondary to an unruptured posterior communicating artery aneurysm were identified from the hospital database...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28762229/-percutaneous-edge-to-edge-mitral-valve-repair-new-transcatheter-approach-and-nursing-experience-in-patients-with-severe-mitral-regurgitation-and-prohibitive-surgical-risk
#19
Hsiu-Fen Huang, Hui-Yun Yu, Ching-Wei Lee, Hui-Chuang Chang, Mei-Ling Lin, Shin-Huey Wung
Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28762204/sentinel-lymph-node-characterization-with-a-dual-targeted-molecular-ultrasound-contrast-agent
#20
Kibo Nam, Maria Stanczak, Flemming Forsberg, Ji-Bin Liu, John R Eisenbrey, Charalambos C Solomides, Andrej Lyshchik
PURPOSE: The purpose of this study was to assess the performance of molecular ultrasound with dual-targeted microbubbles to detect metastatic disease in the sentinel lymph nodes (SLNs) in swine model of naturally occurring melanoma. The SLN is the first lymph node in the lymphatic chain draining primary tumor, and early detection of metastatic SLN involvement is critical in the appropriate management of melanoma. PROCEDURE: Nine Sinclair swine (weight 3-7 kg; Sinclair BioResources, Columbia, MO, USA) with naturally occurring melanoma were examined...
July 31, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
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