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https://www.readbyqxmd.com/read/29932382/microsurgical-treatment-of-unruptured-middle-cerebral-artery-aneurysms-a-large-contemporary-experience
#1
Eric S Nussbaum, Michael T Madison, James K Goddard, Jeffrey P Lassig, Kevin M Kallmes, Leslie A Nussbaum
OBJECTIVE Advances in endovascular therapy for the treatment of middle cerebral artery (MCA) aneurysms have led to scrutiny of its benefits compared with microsurgical repair. To provide information regarding complication rates and outcomes, the authors reviewed the results of a large series of unruptured MCA aneurysms treated with open microsurgery. METHODS The authors included all patients who underwent surgical repair of an unruptured MCA aneurysm between 1997 and 2015. All surgical procedures, including clipping, wrapping, bypass, and parent artery occlusion, were performed by a single neurosurgeon...
June 22, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29926240/cerebral-oximetry-for-cardiac-surgery-a-preoperative-comparison-of-device-characteristics-and-pitfalls-in-interpretation
#2
Kensuke Kobayashi, Tadashi Kitamura, Satoshi Kohira, Shinzo Torii, Toshiaki Mishima, Hirotoki Ohkubo, Yuki Tanaka, Akihiro Sasahara, Takuma Fukunishi, Yuki Ohtomo, Rihito Horikoshi, Yuta Murai, Kagami Miyaji
Regional cerebral oximetry using near-infrared spectroscopy devices is commonly used for detecting cerebral ischemia during cardiopulmonary bypass, and aim to avoid poor cerebral perfusion which may result in perioperative neurological impairment. Today, several devices that can detect cerebral ischemia are commercially available. Although these devices operate on the same measurement principles, their algorithms for detecting and calculating cerebral ischemia are different and no criteria for directly comparing values measured by such different devices exist...
June 20, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29925095/coronary-artery-bypass-grafting-in-diabetic-patients-complete-arterial-versus-internal-thoracic-artery-and-sequential-vein-grafts-a-propensity-score-matched-analysis
#3
Takashi Kunihara, Olaf Wendler, Kerstin Heinrich, Ryota Nomura, Hans-Joachim Schäfers
BACKGROUND:  The optimal choice of conduit and configuration for coronary artery bypass grafting (CABG) in diabetic patients remains somewhat controversial, even though arterial grafts have been proposed as superior. We attempted to clarify the role of complete arterial revascularization using the left internal thoracic artery (LITA) and the radial artery (RA) alone in "T-Graft" configuration on long-term outcome. METHODS AND RESULTS:  From 1994 to 2001, 104 diabetic patients with triple vessel disease underwent CABG using LITA/RA "T-Grafts" (Group-A)...
June 20, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29920593/radial-artery-fascial-flow-through-free-flap-for-complex-cerebral-revascularization-technical-notes-and-long-term-neurologic-and-radiographic-outcomes
#4
Robert C Rennert, Kristine Ravina, Ben A Strickland, Joshua Bakhsheshian, Joseph Carey, Jonathan J Russin
BACKGROUND: Surgical innovation is critical for the management of challenging cerebrovascular pathology. Flow-through free flaps are versatile composite grafts that combine viable tissue with a revascularization source. Neurosurgical experience with these flaps is limited. OBJECTIVE: To provide an in-depth technical description of the radial artery fascial (and fasciocutaneous) flow-through free flap (RAFF and RAFCF, respectively) for complex cerebral revascularizations...
June 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29915888/moyamoya-disease-in-pregnancy-a-systematic-review
#5
REVIEW
Georgios A Maragkos, Luis C Ascanio, Kohei Chida, Myles D Boone, Christopher S Ogilvy, Ajith J Thomas, Ekkehard M Kasper
BACKGROUND: Moyamoya disease (MMD) management during pregnancy poses a challenge to health care providers, and recommendations are outdated, vague, and controversial. We conducted a systematic review to investigate and present the available evidence. METHOD: We searched five online databases and bibliographies of relevant published original studies to identify case reports, case series, cohort studies, and reviews reporting on patients diagnosed with MMD before, during, or shortly after pregnancy...
June 19, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29908036/acquired-von-willebrand-syndrome-in-congenital-heart-disease-surgery-results-from-an-observational-case-series
#6
Vanya Icheva, Martina Nowak-Machen, Ulrich Budde, Karl Jaschonek, Felix Neunhoeffer, Matthias Kumpf, Michael Hofbeck, Christian Schlensak, Gesa Wiegand
BACKGROUND: Cardiac surgery of the newborn and infant with complex congenital heart disease (CHD) is associated with a high rate of intraoperative bleeding complications. CHD-related anatomic features such as valve stenoses or patent arterial ducts can lead to enhanced shear stress in blood stream and thus cause acquired von Willebrand syndrome (aVWS). OBJECTIVE: To evaluate the intraoperative incidence and impact of aVWS after cardiopulmonary bypass (CPB) in neonates and infants with complex CHD...
June 16, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29907385/long-term-changes-in-cerebrovascular-reactivity-following-ec-ic-bypass-for-intracranial-steno-occlusive-disease
#7
Casey Rosen, Larissa McKetton, Jeremy Russell, Kevin Sam, Julien Poublanc, Adrian Crawley, Jay S Han, Olivia Sobczyk, James Duffin, Danny M Mandell, Michael Tymianski, Joseph A Fisher, David J Mikulis, Lashmi Venkatraghavan
The purpose of this retrospective observational study is to investigate the long-term changes in cerebrovascular reactivity (CVR) as a measure of cerebral hemodynamics in patients with intracranial steno-occlusive disease (IC-SOD) after they have undergone an Extracranial-intracranial (EC-IC) bypass. Twenty-six patients suffering from IC-SOD were selected from our CVR database. Nineteen patients underwent unilateral and 7 underwent bilateral revascularization. CVR measurements were done using BOLD-MRI and precisely controlled CO2 and expressed as ΔBOLD (%)/Δ PET CO2 (mmHg)...
June 12, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29901637/extracranial-intracranial-bypass-in-medial-sphenoid-ridge-meningioma-associated-with-severe-stenosis-of-the-intracranial-segments-of-the-internal-carotid-artery-a-case-report
#8
Yabo Huang, Zhong Wang, Qingdong Han
RATIONALE: Tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery (ICA) of intracranial segments has been rarely presented. Effective treatment as to the complex lesions may be complicated. Tumor resection and cerebrovascular protection should be both taken into consideration. PATIENT CONCERNS: We presented one case of medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29898143/predictors-of-outcomes-after-correction-of-acute-type-a-aortic-dissection-under-moderate-hypothermic-circulatory-arrest-and-antegrade-cerebral-perfusion
#9
George Samanidis, Charalampos Katselis, Constantinos Contrafouris, Georgios Georgiopoulos, Ioannis Kriaras, Theofani Antoniou, Konstantinos Perreas
INTRODUCTION: Hypothermic circulatory arrest is widely used for correction of acute type A aortic dissection pathology. We present our experience of 45 consecutive patients operated in our unit with bilateral antegrade cerebral perfusion and moderate hypothermic circulatory arrest. METHODS: Between January 2011 and April 2015, 45 consecutive patients were admitted for acute type A aortic dissection and operated emergently under moderate hypothermic circulatory arrest and bilateral antegrade cerebral perfusion...
March 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29897545/intraoperative-assessment-of-cortical-perfusion-after-intracranial-to-intracranial-and-extracranial-to-intracranial-bypass-for-complex-cerebral-aneurysms-using-flow-800
#10
Robert C Rennert, Ben A Strickland, Kristine Ravina, Joshua Bakhsheshian, Vance Fredrickson, Joseph Carey, Jonathan J Russin
BACKGROUND: Revascularization strategies for complex cerebral aneurysms are largely based on subjective interpretation of flow demands, or indirect measures of perfusion in at-risk territories. Indocyanine Green -based flow analyses ((ICG-BFA); Flow 800, Carl Zeiss, Oberkochen, Germany) provide a real-time, semiquantitative measure of intraoperative cortical perfusion during cerebral bypass surgery for complex aneurysms. OBJECTIVE: To determine the utility of intraoperative ICG-BFA for assessing cortical perfusion in at-risk territories during cerebral bypass for complex aneurysms requiring vessel sacrifice...
June 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29896989/correlation-among-decreased-regional-cerebral-oxygen-saturation-blood-levels-of-brain-injury-biomarkers-and-cognitive-disorder
#11
Birute Kumpaitiene, Milda Svagzdiene, Ingrida Drigotiene, Edmundas Sirvinskas, Ramune Sepetiene, Rolandas Zakelis, Rimantas Benetis
Objective This study was performed to investigate the correlation among decreased regional cerebral oxygen saturation (rSO2 ), blood levels of brain injury biomarkers, and postoperative cognitive disorder (POCD) after cardiac surgery with cardiopulmonary bypass (CPB). Methods This prospective observational study included 59 patients undergoing coronary artery bypass graft surgery with CPB. All patients underwent neuropsychological tests (Mini Mental State Evaluation, Rey Auditory Verbal Learning Test, digit span test, digit symbol substitution test, and Schulte table) the day before and 10 days after the surgery...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29890279/giant-serpentine-aneurysm-of-the-middle-cerebral-artery
#12
Jing Lan, Zheng-Yi Fu, Jian-Jian Zhang, Chao Ma, Chang-Jun Cao, Wen-Yuan Zhao, Pu-Cha Jiang, Jin-Cao Chen
BACKGROUND: Giant serpentine aneurysms (GSAs) were considered to be a subgroup of gaint intracranial aneurysm,distinct from saccular and fusiform varieties, which were defined as partially thrombosed giant aneurysm with tortuous internal vascular channel. The clinicopathological characteristics of giant serpentine middle cerebral artery aneurysm have been rarely reported in the literature and were discussed only radiologically. In this review we attempt to clarify patient clinical and neuroradiological features and to discuss the mechanism of formation and progression...
June 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29890151/repair-of-enlarging-left-ventricular-pseudoaneurysm-two-months-after-coronary-artery-bypass-grafting
#13
Daniel J Weber, Ahmad Y Sheikh, Brian S Cain, Jay I LaBourene, Vicken Melikian
Enlarging LV pseudoaneurysms are a rare complication (especially after surgical revascularization) and require tailored surgical decision-making and techniques for repair. We present a challenging case of a rapidly enlarging LV pseudoaneurysm four weeks after coronary bypass. The repair was approached via left thoracotomy utilizing circulatory arrest with selective antegrade cerebral perfusion.
June 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29886218/concomitant-hybrid-arch-vessel-reconstruction-and-intracranial-clot-retrieval-in-takayasu-s-arteritis-presenting-with-acute-cerebral-ischaemia-a-case-report
#14
Leonard Shan, David Goh, Timothy Wagner
INTRODUCTION: Type 1 Takayasu's arteritis (TA) predominantly affects the supra-aortic branches. Occlusive disease can cause catastrophic complications such as stroke and death. Open and endovascular techniques of revascularisation are described for extracranial disease. There is currently no default choice of surgical intervention. Furthermore, the management of distal intracranial complications has not been described. PRESENTATION OF CASE: A 25-year-old lady with known TA on immunosuppression presents with acute left middle cerebral artery (MCA) stroke...
June 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29875592/superficial-temporal-artery-middle-cerebral-artery-bypass-for-the-treatment-of-complex-middle-cerebral-artery-aneurysms
#15
Chien-Hui Lee, Sheng-Tzung Tsai, Tsung-Lang Chiu
Objectives: Direct microsurgical clipping for complex middle cerebral artery (MCA) aneurysms may require a long ischemic time. Sacrifice of the parent artery with trapping or endovascular coiling also may lead to ischemic stroke. We described our institutional experience with the treatment of complex MCA aneurysms using extracranial-intracranial (EC-IC) (superficial temporal artery [STA]-MCA) bypass. Materials and Methods: We retrospectively reviewed patients who had treatment of IC aneurysms with the assistance of STA-MCA bypass from July 2002 to December 2016...
April 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29863693/-perioperative-stroke-in-heart-valve-surgery-pathogenesis-clinical-findings-diagnosis-prevention-treatment
#16
N V Tsygan, R V Andreev, A S Peleshok, S V Kolomentsev, V A Yakovleva, A V Ryabtsev, M A Gumennaya, I V Litvinenko
AIM: To study risk factors, characteristics of clinical symptoms and diagnosis, and possibilities of prevention of perioperative stroke and other clinical types of cerebral dysfunction in main types of heart valve surgery. MATERIAL AND METHODS: The study included 83 patients, aged 63 (54; 70) years, undergoing heart valve surgery with cardiopulmonary bypass. RESULTS: Postoperative cerebral dysfunction was diagnosed in 37.3% of cases, including perioperative stroke in 3...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29850897/anatomical-assessment-of-the-temporopolar-artery-for-revascularization-of-deep-recipients
#17
Ali Tayebi Meybodi, Arnau Benet, Dylan Griswold, Flavia Dones, Mark C Preul, Michael T Lawton
BACKGROUND: Intracranial-intracranial and extracranial-intracranial bypass options for revascularization of deep cerebral recipients are limited and technically demanding. OBJECTIVE: To assess the anatomical feasibility of using the temporopolar artery (TPA) for revascularization of the anterior cerebral artery (ACA), posterior cerebral artery (PCA), and superior cerebellar arteries (SCA). METHODS: Orbitozygomatic craniotomy was performed bilaterally on 8 cadaveric heads...
May 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29850131/the-feasibility-and-safety-of-off-pump-coronary-bypass-surgery-in-emergency-revascularization
#18
Hyun-Chel Joo, Young-Nam Youn, Byung-Chul Chang, Kyung-Jong Yoo
Background: The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) in emergency revascularization remains controversial despite its widespread use. The aim of our study was to examine the applicability and safety of OPCAB in patients who were indicated for emergency surgery. Methods: This single-center study reviewed the indication, operative data, and early and long-term outcomes of 113 patients (mean age, 67.2±9.0 years; logistic EuroSCORE, 14...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29844213/positive-correlation-between-regional-cerebral-oxygen-saturation-and-mixed-venous-oxygen-saturation-during-off-pump-coronary-artery-bypass-surgery
#19
Zheng Guan, Jing-Jie Liu, Hui Yuan, Yan-Feng Gao
BACKGROUND: The balance of oxygen delivery and consumption is essential in patients who are critically ill. Mixed venous oxygen saturation (Sv̄O2 ) is a standard method to evaluate oxygen delivery and consumption during anesthesia. However, Sv̄O2 is monitored through a pulmonary artery catheter, which is invasive. Regional cerebral oxygenation (rScO2 ) reflects oxygen saturation in a small region of the frontal lobes and is monitored noninvasively through near-infrared spectroscopy...
May 29, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29807496/axillo-axillary-artery-bypass-with-coil-embolization-of-the-innominate-artery-for-a-traumatic-innominate-artery-aneurysm-a-case-report
#20
Ryota Sugisawa, Masaki Sano, Naoto Yamamoto, Kazunori Inuzuka, Hiroki Tanaka, Takaaki Saito, Kazuto Katahashi, Tatsuro Yata, Takafumi Kayama, Yuta Yamanaka, Hiroya Takeuchi, Naoki Unno
BACKGROUND: Innominate artery aneurysm (IAA) is a rare cervical artery aneurysm. Although atherosclerosis is its most common cause, IAAs due to cervical injury are often reported. Operative indications for IAAs include rupture or symptomatic aneurysm, saccular aneurysm, aneurysm with a diameter of 3 cm or greater, and aneurysmal change of the origin of the innominate artery. Although the ligature of the innominate artery or open surgical repair is well described, the usefulness of endovascular repair has also recently been reported...
January 1, 2018: Vascular and Endovascular Surgery
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