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https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#1
Igor Gunka, Dagmar Krajickova, Michal Lesko, Stanislav Jiska, Jan Raupach, Miroslav Lojik, Radovan Maly
BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28419229/non-invasive-assessment-of-cerebral-oxygen-metabolism-following-surgery-of-congenital-heart-disease
#2
Felix Neunhoeffer, Katharina Sandner, Milena Wiest, Christoph Haller, Hanna Renk, Matthias Kumpf, Christian Schlensak, Michael Hofbeck
OBJECTIVES: Cerebral protection is a major issue in the treatment of infants with complex congenital heart disease. We tested a new device combining tissue spectrometry and laser Doppler flowmetry for non-invasive determination of cerebral oxygen metabolism following cardiac surgery in infants. METHODS: We prospectively measured regional cerebral oxygen saturation cSO 2 and microperfusion (rcFlow) in 43 infants 12-24 h following corrective ( n  = 30) or palliative surgery ( n  = 13) of congenital heart defects...
April 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28416090/clipping-in-awake-surgery-as-end-stage-in-a-complex-internal-carotid-artery-aneurysm-after-failure-of-multimodal-endovascular-and-extracranial-intracranial-bypass-treatment
#3
Delia Cannizzaro, Simone Peschillo, Cristina Mancarella, Biagia La Pira, Emanuela Rastelli, Emiliano Passacantilli, Antonio Santoro
BACKGROUND: Intracranial carotid artery aneurysm can be treated via microsurgical or endovascular techniques. The optimal planning is the result of the careful patient selection through clinical, anatomic, and angiographic analysis. CLINICAL PRESENTATION: We present a case of ruptured internal carotid artery (ICA) aneurysm that became a complex aneurysm after failure of multi-endovascular and surgery treatment. We describe complete trapping in awake craniotomy after failure of coiling, stenting, and bypassing...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#4
Paul M Foreman, Mark R Harrigan
BACKGROUND: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI). The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. SUMMARY: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma...
April 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28392101/surgical-and-endovascular-treatments-of-extracranial-carotid-artery-aneurysms-report-of-six-cases
#5
Shusuke Yamamoto, Naoki Akioka, Daina Kashiwazaki, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
BACKGROUND: Although the natural course of extracranial carotid artery aneurysms (ECAAs) is still unknown, they may cause stroke or cranial nerve dysfunction unless they are treated. In this report, we reviewed the clinical results of 6 patients who underwent endovascular and surgical treatments for ECAAs. METHODS: A total of 6 patients underwent endovascular and surgical treatments for ECAAs for 9 years. The primary causes of ECAAs included Marfan syndrome (1 patient), infection (1 patient), trauma (2 patients), and unknown (2 patients)...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28324181/trigeminocardiac-reflex-during-endoscopic-juvenile-nasopharyngeal-angiofibroma-surgery-an-appraisal
#6
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
March 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28181086/bilateral-cavernous-carotid-aneurysms-treated-by-two-stage-extracranial-intracranial-bypass-followed-by-parent-artery-occlusion-case-report-and-literature-review
#7
Yaoling Liu, Xiang'en Shi, Fangjun Liu, Yuming Sun, Hai Qian, Ting Lei
Bilateral cavernous carotid aneurysms (CCAs) are often not amenable to neurosurgical clipping or endovascular coiling. Here, we report the case of a 50-year-old female who presented with a 1-year history of gradual severe headache. Preoperative angiograms revealed bilateral CCAs. Among these findings, the right giant CCA had been trapped after the external carotid artery-saphenous vein-middle cerebral artery (ECA-SV-MCA) bypass 8 years prior. Additionally, the left CCA was again trapped after the internal maxillary artery-radial artery-middle cerebral artery (IMA-RA-MCA) bypass, followed by parent artery occlusion (PAO), because of the enlargement of a 0...
February 8, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28162904/bilateral-internal-carotid-artery-aneurysms-at-the-subpetrosal-portion-with-unilateral-lower-cranial-nerve-palsies-review-and-consideration-of-surgical-strategy
#8
Kei Noguchi, Takachika Aoki, Rokudai Sakamoto, Kimihiko Orito, Yasuharu Takeuchi, Masaru Hirohata, Motohiro Morioka
BACKGROUND: Symptomatic bilateral extracranial internal carotid artery (ICA) aneurysms at the subpetrosal portion are extremely rare, and their treatment strategy remains unknown. CLINICAL PRESENTATION: A 42-year-old man presented to our hospital with a 2-month history of sudden onset of hoarseness, dysarthria, and dysphagia. Magnetic resonance imaging, magnetic resonance angiography, and computed tomography angiography revealed extracranial bilateral ICA aneurysms at the subpetrosal portion...
February 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28060096/safety-of-extracranial-intracranial-arterial-bypass-in-the-treatment-of-moyamoya-disease
#9
Lian Liu, Song Wei Su, Hong Yan Sun
OBJECTIVE: The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease. METHODS: Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28042220/internal-carotid-artery-fibromuscular-dysplasia-in-a-child-incidental-postmortem-finding-after-head-injury
#10
Arulselvi Subramanian, Garima Aggarwal, Deepak Agarwal, Sanjeev Lalwani
Fibromuscular dysplasia (FMD) is a rare, segmental, nonatheromatous, and noninflammatory arterial disease of unknown etiology. It predominantly involves renal artery (60-75%) followed by extracranial part of the internal carotid artery and vertebral arteries (25-30%). The disease typically affects middle-aged women and involves intermediate-sized arteries throughout the body. There are rare case reports of extracranial FMD compounding a trauma case. A patient was brought to trauma center emergency with a history of fall from height...
January 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28009766/urgent-bypass-surgery-following-failed-endovascular-treatment-in-acute-symptomatic-stroke-patient-with-mca-occlusion
#11
Chang Yeob Lee, Chang Hyun Kim, Chang-Young Lee, Sung-Il Sohn, Jeong-Ho Hong
INTRODUCTION: Although the benefits of extracranial-intracranial bypass surgery remain controversial, there is some surgical rationale for the augmentation of cerebral blood flow in cases of acute ischemic stroke with hemodynamic instability. CASE REPORT: We report a case of a 62-year-old woman who suddenly developed right hemiplegia and global aphasia. Initial magnetic resonance imaging and magnetic resonance angiography revealed a small acute ischemic lesion in left parietal lobe with occlusion at the left middle cerebral artery...
January 2017: Neurologist
https://www.readbyqxmd.com/read/27960189/surgical-therapy
#12
REVIEW
Chang Wan Oh, Gary K Steinberg
Many prior investigations have indicated the important role of medical treatment to prevent stroke in patients with intracranial atherosclerosis, with angioplasty and stenting occasionally being performed. In a subgroup of patients with severe hemodynamic impairment, extracranial-intracranial (EC-IC) bypass surgery may be considered. Additionally, in patients with massive infarctions due to middle cerebral artery (MCA) occlusion, the use of decompressive craniectomy may lower mortality rates and improve long-term quality of life...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27935890/-surgical-prevention-of-ischaemic-strokes-by-means-of-an-extraintracranial-microanastomosis-eicma-in-the-carotid-basin
#13
V V Krylov, V A Luk'yanchikov, A S Tokarev, O Yu Nakhabin, N A Polunina, I V Sen'ko, V A Dalibaldyan, E V Grigor'eva, N E Kudryashova, G K Guseinova, E V Udodov, T A Fedulova
BACKGROUND: Not less than 50% of all ischaemic strokes appear to occur resulting from pathology of extracranial arteries. Occlusions and stenoses are more commonly encountered in carotid arteries, with the incidence of occlusion of the internal carotid artery (ICA) ranging from 5 to 10% within the structure of all lesions of brachiocephalic arteries (BCA). AIM: The study was aimed at assessing the results of a surgical procedure of extra-intracranial microanastomosis (EICMA) performed in patients presenting with occlusive and stenotic lesions of BCA at the Neurosurgical Department...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27903112/bypass-surgery-to-treat-symptomatic-fusiform-dilation-of-the-internal-carotid-artery-following-craniopharyngioma-resection-report-of-2-cases
#14
Long Wang, Xiang'en Shi, Fangjun Liu, Hai Qian
Fusiform dilation of the internal carotid artery (FDICA) is an infrequent vascular complication following resection of suprasellar lesions in the pediatric population, and its course appears to be benign without apparent clinical symptoms. However, data correlating symptomatic FDICA with bypass surgery are scarce. The authors here report 2 symptomatic cases that were treated using internal maxillary artery bypass more than 5 years after total removal of a craniopharyngioma at an outside institution. Both cases of FDICA were resected to relieve the mass effect and to expose the craniopharyngioma...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27888087/coiling-of-a-ruptured-large-internal-carotid-artery-aneurysm-via-extracranial-intracranial-saphenous-vein-bypass-graft-just-after-proximal-ligation-of-the-internal-carotid-artery
#15
Hayato Tajima, Yoshio Araki, Takashi Izumi, Masahiro Nishihori, Sho Okamoto, Toshihiko Wakabayashi
BACKGROUND: Combined direct and endovascular surgery has been performed to treat large to giant internal carotid artery (ICA) aneurysms. This report describes successful treatment of a large ICA aneurysm by coiling of the aneurysm via an extracranial-intracranial saphenous vein (SV) graft just after bypass and ICA proximal ligation. CASE DESCRIPTION: A 66-year-old woman presented with a left ICA supraclinoid aneurysm with progressive visual field defect and impaired visual acuity in the left eye...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27861392/endovascular-stenting-for-extracranial-carotid-artery-aneurysms-experiences-and-mid-term-results
#16
Leng Ni, Zuo Pu, Rong Zeng, Rui Zhang, Yue-Hong Zheng, Wei Ye, Chang-Wei Liu
The aim of this study was to investigate the safety and effectiveness of endovascular stenting for extracranial carotid artery aneurysms (ECAAs) and evaluate the mid-term outcomes.Twelve consecutive symptomatic patients (mean age 43.8 ± 14.9 years; 8 men) with ECAAs who were treated with endovascular stenting between 1997 and 2015 were retrospectively analyzed. Clinical follow-up data including symptoms and neurological events were obtained from outpatient records. Imaging follow-up with duplex ultrasound and/or computed tomographic angiography (CTA) was performed to examine the aneurysm obliteration and patency of the stents at 3, 6, 12 months and yearly thereafter...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27857034/superficial-temporal-artery-to-middle-cerebral-artery-bypass-with-interposed-saphenous-vein-graft-in-patients-with-atherosclerotic-internal-carotid-artery-occlusive-disease-and-impaired-cerebral-hemodynamics
#17
Petr Galkin, Artem Gushcha, Andrey Chechetkin, Irina Krotenkova
BACKGROUND: The aim of this study was to evaluate the efficacy of interposed saphenous vein graft (SVG) usage during extracranial-intracranial (EC-IC) bypass surgery in patients with cerebral ischemia and appropriate donor artery absence. METHODS: Since October 2010 till January 2014, 62 EC-IC bypass surgeries were applied in 60 patients. In nineteen patients SVG was used to create low-flow bypasses between superficial temporal artery trunk and cortical segment of middle cerebral artery...
February 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27852286/the-carotid-and-middle-cerebral-artery-occlusion-surgery-study-cmoss-a-study-protocol-for-a-randomised-controlled-trial
#18
Yan Ma, Yuxiang Gu, Xiaoguang Tong, Jiyue Wang, Dong Kuai, Donghai Wang, Jun Ren, Lian Duan, Aili Maimaiti, Yiling Cai, Yujie Huang, Xiaojian Wang, Yi Cao, Chao You, Jiasheng Yu, Liqun Jiao, Feng Ling
BACKGROUND: Patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusion with haemodynamic insufficiency are at high risk for recurrent stroke when treated medically. METHODS: The Carotid or Middle cerebral artery Occlusion Surgery Study (CMOSS) trial is an ongoing, government-funded, prospective, multicentre, randomised controlled trial. The CMOSS will recruit 330 patients with symptomatic ICA or MCA occlusion (parallel design, 1:1 allocation ratio) and haemodynamic insufficiency...
November 16, 2016: Trials
https://www.readbyqxmd.com/read/27847769/clinical-utility-of-angiographic-ct-with-a-flat-detector-angiographic-system-during-endovascular-procedure
#19
Seon Woong Choi, Kwang Wook Jo, Young Woo Kim, Seong Rim Kim, Ik Seong Park, Hoon Kim
OBJECTIVE: We evaluated the feasibility of angiographic computed tomography (ACT) for visualizing stent material in patients who underwent intracranial or extracranial stent placement to treat atherosclerotic lesions or stent assisted coil embolization. MATERIALS AND METHODS: We performed intrarterial and intravenous ACT on biplane angiography system equipped with flat panel detectors (Axiom Arits dBA; Siemens Medical Solutions, Forchheim, Germany). Vistipaque 320 was injected for contrast medium, total 150 mL at flow rate of 5 mL/s through artery and 77 mL at flow rate of 3...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27832618/-indocyanine-green-videoangiography-guided-target-bypass-for-surgical-trapping-of-distal-middle-cerebral-artery-aneurysm-a-technical-case-report
#20
Takaya Yasuda, Hitoshi Fukuda, Masanori Kinosada, Masaki Chin, Sen Yamagata
Intraoperative indocyanine green(ICG)videoangiography is simple, less invasive, and enables real-time observation of hemodynamics during neurovascular surgery. In this article, we describe a case of ruptured distal middle cerebral artery aneurysm, which was unclippable and required parent artery occlusion with extracranial-intracranial bypass. Under temporary clipping of the proximal vessel, ICG videoangiography demonstrated the proper target vessel for bypass through delayed and retrograde filling of the dye...
November 2016: No Shinkei Geka. Neurological Surgery
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