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https://www.readbyqxmd.com/read/29677060/cerebral-small-vessel-but-not-large-vessel-disease-is-associated-with-impaired-cerebral-autoregulation-during-cardiopulmonary-bypass-a-retrospective-cohort-study
#1
Yohei Nomura, Roland Faegle, Daijiro Hori, Abbas Al-Qamari, Alexander J Nemeth, Rebecca Gottesman, Gayane Yenokyan, Charles Brown, Charles W Hogue
BACKGROUND: Impaired cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB) is associated with stroke and other adverse outcomes. Large and small arterial stenosis is prevalent in patients undergoing cardiac surgery. We hypothesize that large and/or small vessel cerebral arterial disease is associated with impaired cerebral autoregulation during CPB. METHODS: A retrospective cohort analysis of data from 346 patients undergoing cardiac surgery with CPB enrolled in an ongoing prospectively randomized clinical trial of autoregulation monitoring were evaluated...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29676693/intraoperative-evaluation-of-local-cerebral-hemodynamic-change-by-indocyanine-green-videoangiography-prediction-of-incidence-and-duration-of-postoperative-transient-neurological-events-in-patients-with-moyamoya-disease
#2
Kenji Uda, Yoshio Araki, Shinsuke Muraoka, Shinji Ota, Kentaro Wada, Kinya Yokoyama, Masahiro Nishihori, Takashi Izumi, Sho Okamoto, Toshihiko Wakabayashi
OBJECTIVE Transient neurological events (TNEs) occur frequently in the acute phase after direct bypass surgery for moyamoya disease (MMD), but there is currently no way to predict them. FlowInsight is a specialized software for analyzing indocyanine green (ICG) videoangiography taken with a surgical microscope. The purpose of this study was to investigate whether intraoperative evaluation of local hemodynamic changes around anastomotic sites using FlowInsight could predict the incidence and duration of TNEs...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29673881/long-term-outcome-in-extracranial-intracranial-bypass-surgery-for-severe-steno-occlusive-disease-of-intracranial-internal-carotid-or-middle-cerebral-artery
#3
Kok Ann Colin Teo, Tseng Tsai Yeo, Vijay K Sharma
OBJECTIVES: We report the long-term outcome and rates of recurrent cerebral ischemic events in our cohort of carefully selected patients after STA-MCA bypass for severe steno-occlusive disease of intracranial ICA or MCA with exhausted cerebral vasodilatory reserve. PATIENTS AND METHODS: In this retrospective study, we reviewed the hospital records for all patients who underwent direct superficial temporal artery-middle cerebral artery bypass surgery at our institution from January 2010 to August 2017...
April 3, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29671862/predictors-of-periprocedural-complications-in-patients-undergoing-percutaneous-coronary-interventions-within-coronary-bypass-grafts
#4
Rafał A Januszek, Artur Dziewierz, Zbigniew Siudak, Tomasz Rakowski, Dariusz Dudek, Stanisław Bartuś
BACKGROUND: During the first decade following the coronary bypass grafting, at least 10 of the patients require percutaneous coronary interventions (PCI) due to graft failure. Saphenous vein grafts (SVG) are innately at a higher risk of periprocedural complications. The present study aimed to investigate predictors of periprocedural complications of PCI within coronary artery bypass grafts. METHODS: This study analyzed data gathered in the Polish National Registry (ORPKI) between January 2015 and December 2016...
April 19, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29660547/surgical-treatment-of-large-or-giant-fusiform-middle-cerebral-artery-aneurysms-a-case-series
#5
Feng Xu, Bin Xu, Lei Huang, Ji Xiong, Yuxiang Gu, Michael T Lawton
BACKGROUND: Management of large or giant fusiform middle cerebral artery (MCA) aneurysms represents a significant challenge. OBJECTIVE: To describe the author's experience in the treatment of large or giant fusiform MCA aneurysm by using various surgical techniques. METHODS: We retrospectively reviewed a database of aneurysm treated at our division between 2015 and 2017. RESULTS: Overall, 20 patients (11 males, 9 females) were identified with a mean age of 40...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29653272/evaluation-of-microsurgery-for-managing-giant-or-complex-cerebral-aneurysms-a-retrospective-study
#6
Nakao Ota, Hidetoshi Matsukawa, Kosumo Noda, Hirotaka Sato, Yuto Hatano, Atsumu Hashimoto, Takanori Miyazaki, Tomomasa Kondo, Yu Kinoshita, Norihiro Saito, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada, Rokuya Tanikawa
OBJECTS: Surgical or endovascular treatment for giant or complex aneurysms is challenging. To evaluate clinical outcomes and factors affecting the prognosis of giant or complex aneurysms, and to better establish the role of microsurgery in the management strategy. METHODS: One hundred fifty-nine patients with surgically treated complex aneurysms were included. Thirty-two (20.1%) patients had giant aneurysms (≥25 mm); 57 (35.8%) had large aneurysms (≥15 mm). Poor outcome was defined as modified Rankin scale scores 3-6...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29649651/internal-maxillary-artery-to-middle-cerebral-artery-cranial-bypass-the-new-work-horse-for-cerebral-flow-replacement
#7
Erez Nossek, David J Langer
No abstract text is available yet for this article.
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29628466/increase-carotid-flow-by-double-sheath-connection-technique-to-reduce-cerebral-ischemia-for-transcatheter-aortic-valve-implantation-through-transcarotid-approach
#8
Richard Tsai, I-Ming Chen, Po-Lin Chen, Hsin-Bang Leu, Ying-Hwa Chen, Hsiao-Huang Chang
PURPOSE: Transcarotid transcatheter aortic valve implantation (TAVI) is one alternative approach if unfavorable femoral access. However, this approach may cause cerebral vascular accidents (CVAs) by temporarily occluding common carotid artery (CCA). The purpose of this study is to develop a new method reducing cerebral ischemia during transcarotid TAVI. METHODS: We inserted an 8- and 18-Fr. sheath in CCA with tip toward brain and aortic arch, respectively, and connected their side arms to create a bypass flow...
April 6, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29627792/thrombectomy-for-late-occlusion-of-high-flow-extracranial-intracranial-saphenous-vein-bypass-graft-after-27-years-of-patency
#9
Michael A Silva, Rodolfo E Alcedo Guardia, Mohammad Ali Aziz-Sultan, Nirav J Patel
High flow extracranial-intracranial (EC-IC) bypass with a saphenous vein graft (SVG) has been used for more than 40 years in patients with giant aneurysms of the posterior circulation refractory to medical management, and has demonstrated high long term patency rates. We report the case of a patient treated with external carotid artery (ECA)-posterior cerebral artery SVG bypass in 1989 who presented 27 years later with paresthesias and confusion, and was found to have partial occlusion of her SVG bypass graft and a basilar occlusion...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29627790/embolization-of-a-cavernous-carotid-fistula-through-the-vein-of-labb%C3%A3-a-new-alternative-transvenous-access-route
#10
Angelos Aristeidis Konstas, Alice Song, Julia Song, Aristomenis Thanos, Ian B Ross
Endovascular treatment of carotid cavernous fistulas (CCFs) via a transvenous approach is standard, but in rare cases this approach is challenging due to absence or thrombosis of the commonly used venous routes. A 61-year-old woman presented with a symptomatic CCF with all but one of the venous access routes to the CCF thrombosed, leaving an engorged superficial middle cerebral vein (SMCV) as the only venous outflow from the cavernous sinus. Access to the CCF was made possible after careful navigation of the sigmoid sinus, the vein of Labbé and the SMCV, bypassing the need for surgical access to the SMCV or for a direct transorbital puncture...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29626683/assessment-of-hemodynamic-changes-and-hyperperfusion-risk-following-extracranial-to-intracranial-bypass-surgery-using-intraoperative-indocyanine-green-based-flow-analysis
#11
Robert C Rennert, Ben A Strickland, Kristina Ravina, Joshua Bakhsheshian, Jonathan J Russin
BACKGROUND: Intra-operative blood flow assessments during cerebral bypass would ideally assess vessel patency, downstream perfusion, and risk of post-operative hyperperfusion syndrome (HPS). Previous studies using Indocyanine Green-based flow analyses (ICG-BFA) have identified multiple parameters that can intra-operatively track bypass-related changes in cerebral perfusion and potentially predict post-operative HPS risk. Herein, we determine the most robust parameter and anatomic location for intra-operative ICG-BFA assessment of bypass-related perfusion changes and prediction of post-operative HPS risk...
April 4, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29624146/posterior-cerebral-artery-stenosis-and-posterior-circulation-revascularization-surgery-in-pediatric-patients-with-moyamoya-disease
#12
Tomomi Kimiwada, Toshiaki Hayashi, Reizo Shirane, Teiji Tominaga
OBJECTIVE Some pediatric patients with moyamoya disease (MMD) present with posterior cerebral artery (PCA) stenosis before and after anterior circulation revascularization surgery and require posterior circulation revascularization surgery. This study evaluated the factors associated with PCA stenosis and assessed the efficacy of posterior circulation revascularization surgery, including occipital artery (OA)-PCA bypass, in pediatric patients with MMD. METHODS The presence of PCA stenosis before and after anterior circulation revascularization surgery and its clinical characteristics were investigated in 62 pediatric patients (< 16 years of age) with MMD...
April 6, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29618068/occipital-artery-to-posterior-cerebral-artery-bypass-using-descending-branch-of-the-lateral-circumflex-femoral-artery-graft-for-treatment-of-fusiform-unruptured-posterior-cerebral-artery-aneurysm-3-dimensional-operative-video
#13
Kristine Ravina, Ian A Buchanan, Robert C Rennert, Ben A Strickland, Joseph N Carey, Jonathan J Russin
Posterior cerebral artery (PCA) aneurysms can be technically challenging lesions due to the intricacy of perforating branches and the relationship to cranial nerves and the brainstem. Fusiform aneurysms of the perimesencephalic segment of the PCA are a rare finding which does not favor direct clip occlusion or reconstruction. In such cases, proximal parent vessel occlusion is an option for aneurysm treatment. Extracranial-intracranial (EC-IC) bypass can be used to revascularize beyond the lesion when considering proximal occlusion...
April 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29617791/beating-heart-aortic-arch-surgery-in-neonates-and-infants
#14
Juan-Miguel Gil-Jaurena, María-Teresa González-López, Ana Pita, Ramón Pérez-Caballero, Mónica Herviás, Dorotea Blanco
OBJECTIVES: Aortic arch repair has been shifted from deep hypothermia plus circulatory arrest to cerebral perfusion at tepid temperatures. A step forward is a simultaneous brain-coronary perfusion, allowing beating-heart arch surgery. METHODS: A 'Y' cannula from the arterial line delivers oxygenated blood to brain and heart. The arch is repaired on a beating heart at 25°C. Intracardiac repair is performed after running cardioplegia through the root line. Fifty patients are classified into 3 groups: A, Norwood (8 neonates); B, aortic arch (14 children) and C, aortic arch plus intracardiac repair (28 patients)...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29616521/the-relationship-between-cerebral-oxygen-saturation-and-quantitative-metrics-of-neurological-function-after-coronary-bypass-surgery-a-feasibility-study
#15
Joanna S Semrau, Stephen H Scott, Andrew G Hamilton, Dimitri Petsikas, Darrin M Payne, Gianluigi Bisleri, Tarit Saha, J Gordon Boyd
BACKGROUND: It is well-known that patients undergoing coronary artery bypass grafting (CABG) surgery may experience neurological dysfunction following their operation. However, the nature of this dysfunction has not been properly quantified. Furthermore, the relationship between post-operative impairment and cerebral oxygen saturation during surgery has remained unclear. This study aims to define the feasibility of using robotic technology to quantify post- CABG neurocognitive function, and to correlate these objective metrics with intraoperative brain tissue oxygen...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29616518/coronary-artery-bypass-surgery-in-patients-with-chronic-brain-hypoperfusion
#16
Hajime Imura, Yuji Maruyama, Kenichiro Takahashi, Dai Nishina, Takashi Nitta
BACKGROUND: Cerebrovascular disease (CVD) is a risk factor of stroke and cerebral hypoperfusion is one of the underlying mechanisms. We hypothesized that coronary artery bypass grafting (CABG) can be performed at an acceptable risk for such patients without concomitant surgery for CVD. METHODS: Carotid echo was carried out for 538 consecutive patients undergoing isolated CABG between 2005 and 2016. Magnetic resonance image/angiography (MRI/A) for neck and brain was performed for 288 patients (stenosis≥50% in echo were basically included)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29610036/paradoxical-association-of-symptomatic-local-vasogenic-edema-with-global-cerebral-hypoperfusion-after-direct-revascularization-surgery-for-adult-moyamoya-disease
#17
Ryosuke Tashiro, Miki Fujimura, Shunji Mugikura, Kuniyasu Niizuma, Hidenori Endo, Toshiki Endo, Teiji Tominaga
BACKGROUND: Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the standard treatment for Moyamoya disease (MMD). Cerebral hyperperfusion syndrome is a potential complication of this procedure and can cause local vasogenic edema and/or delayed intracerebral hemorrhage. Cerebral hypoperfusion is a contradictory postoperative pathophysiological condition implicated in MMD, but its association with symptomatic local vasogenic edema has not been reported. CASE REPORT: A 31-year-old woman with MMD underwent left STA-MCA anastomosis 3 months after a minor completed stroke in bilateral hemispheres...
March 30, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29605960/moderate-hypothermic-circulatory-arrest-%C3%A2-28%C3%A2-c-with-selective-antegrade-cerebral-perfusion-for-total-arch-replacement-with-frozen-elephant-trunk-technique
#18
Ali El-Sayed Ahmad, Petar Risteski, Mahmut Ay, Nestoras Papadopoulos, Anton Moritz, Andreas Zierer
OBJECTIVES:  The optimal hypothermic level during circulatory arrest in aortic arch surgery remains controversial, particularly in frozen elephant trunk (FET) procedures. We describe herein our experience for total arch replacement with FET technique under moderate systemic hypothermic circulatory arrest (≥ 28°C) during selective antegrade cerebral perfusion. METHODS:  Between January 2009 and January 2016, 38 consecutive patients underwent elective total arch replacement for various aortic arch pathologies with FET technique using the E-vita Open hybrid prosthesis (Jotec GmbH, Hechingen, Germany)...
April 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29600916/risk-factors-for-and-outcomes-of-postoperative-complications-in-adult-patients-with-moyamoya-disease
#19
Meng Zhao, Xiaofeng Deng, Dong Zhang, Shuo Wang, Yan Zhang, Rong Wang, Jizong Zhao
OBJECTIVE The risk factors and clinical significance of postoperative complications in moyamoya disease are still unclear. The aim of this study was to investigate the predictors of postoperative complications in moyamoya disease and examine the impact of complications on outcomes. METHODS The authors reviewed consecutive cases involving adult moyamoya disease patients who underwent indirect, direct, or combined bypass surgery in their hospital between 2009 and 2015. Preoperative clinical characteristics and radiographic features were recorded...
March 30, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29600320/early-results-of-total-arch-replacement-under-partial-sternotomy
#20
Yosuke Inoue, Kenji Minatoya, Yoshimasa Seike, Atsushi Ohmura, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVE: Partial sternotomy with limited skin incision has been utilized for cardiac surgery. We, therefore, started to apply the partial sternotomy for total arch replacement since 2013 in selected cases. The aim of this study reported the results of our early experiences. METHODS: Between July 2013 and December 2015, we retrospectively reviewed 15 cases (median age 72, range 67-84, 15 male) who underwent total arch replacement thorough partial sternotomy. All procedures were performed under hypothermic circulatory arrest with selective cerebral perfusion...
March 29, 2018: General Thoracic and Cardiovascular Surgery
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