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https://www.readbyqxmd.com/read/28060096/safety-of-extracranial-intracranial-arterial-bypass-in-the-treatment-of-moyamoya-disease
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
November 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27861392/endovascular-stenting-for-extracranial-carotid-artery-aneurysms-experiences-and-mid-term-results
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#13
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
December 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27813463/bypass-surgery-for-complex-middle-cerebral-artery-aneurysms-an-algorithmic-approach-to-revascularization
#14
Ali Tayebi Meybodi, Wendy Huang, Arnau Benet, Olivia Kola, Michael T Lawton
OBJECT Management of complex aneurysms of the middle cerebral artery (MCA) can be challenging. Lesions not amenable to endovascular techniques or direct clipping might require a bypass procedure with aneurysm obliteration. Various bypass techniques are available, but an algorithmic approach to classifying these lesions and determining the optimal bypass strategy has not been developed. The objective of this study was to propose a comprehensive and flexible algorithm based on MCA aneurysm location for selecting the best of multiple bypass options...
November 4, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27801400/-surgical-treatment-of-distal-extracranial-internal-carotid-artery-aneurysms-associated-with-pathological-artery-kinking
#15
V E Guzhin, A V Dubovoi, A V Cherepanov
Extracranial internal carotid artery (ICA) aneurysms located at the entrance of the skull are a rare pathology. Surgical treatment is indicated for this pathology because of the risk of arterio-arterial embolism and the development of cerebrovascular disease. The domestic and international literature reports single cases or small group cases of successful surgical treatment of patients with distal internal carotid artery aneurysms associated with pathological kinking of the artery. Open surgery for aneurysms of this localization is complicated because of a high injury risk associated with the approach...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27789786/non-invasive-near-infrared-fluorescence-imaging-of-the-neutrophil-response-in-a-mouse-model-of-transient-cerebral-ischaemia
#16
Markus Vaas, Gaby Enzmann, Therese Perinat, Ulrich Siler, Janine Reichenbach, Kai Licha, Anja Kipar, Markus Rudin, Britta Engelhardt, Jan Klohs
Near-infrared fluorescence (NIRF) imaging enables non-invasive monitoring of molecular and cellular processes in live animals. Here we demonstrate the suitability of NIRF imaging to investigate the neutrophil response in the brain after transient middle cerebral artery occlusion (tMCAO). We established procedures for ex vivo fluorescent labelling of neutrophils without affecting their activation status. Adoptive transfer of labelled neutrophils in C57BL/6 mice before surgery resulted in higher fluorescence intensities over the ischaemic hemisphere in tMCAO mice with NIRF imaging when compared with controls, corroborated by ex vivo detection of labelled neutrophils using fluorescence microscopy...
October 27, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27733025/reduction-of-midline-shift-following-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction
#17
Sang-Beom Jeon, Sun U Kwon, Jung Cheol Park, Deok Hee Lee, Sung-Cheol Yun, Yeon-Jung Kim, Jae-Sung Ahn, Byung-Duk Kwun, Dong-Wha Kang, H Alex Choi, Kiwon Lee, Jong S Kim
BACKGROUND AND PURPOSE: Hemicraniectomy is a decompressive surgery used to remove a large bone flap to allow edematous brain tissue to bulge extracranially. However, early indicators of the decompressive effects of hemicraniectomy are unclear. We investigated whether reduction of midline shift following hemicraniectomy is associated with improved consciousness and survival in patients with malignant middle cerebral artery infarctions. METHODS: We studied 70 patients with malignant middle cerebral artery infarctions (MMI) who underwent hemicraniectomies...
September 2016: Journal of Stroke
https://www.readbyqxmd.com/read/27671095/long-term-follow-up-for-a-giant-basilar-trunk-aneurysm-surgically-treated-by-proximal-occlusion-and-external-carotid-artery-to-posterior-cerebral-artery-bypass-using-a-saphenous-vein-graft
#18
Toshiharu Yanagisawa, Hiroyuki Kinouchi, Toshio Sasajima, Hiroaki Shimizu
The authors describe a case of a basilar trunk aneurysm with long-term follow-up after successful bypass and proximal occlusion. A 64-year-old woman had a giant aneurysm of the basilar trunk and underwent external carotid artery-to-posterior cerebral artery vein graft bypass surgery and proximal clipping of the basilar artery, which was followed by low-dose aspirin (100 mg/d) treatment. No ischemic symptoms and lesions developed and the thrombosed aneurysm was stable during 11 years of follow-up. An extracranial-intracranial high flow bypass combined with immediate proximal occlusion and aspirin administration may be an acceptable treatment option for patients with giant posterior circulation aneurysms...
November 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27639432/ultrasonographic-changes-after-indirect-revascularization-surgery-in-pediatric-patients-with-moyamoya-disease
#19
Shin-Joe Yeh, Sung-Chun Tang, Li-Kai Tsai, Ya-Fang Chen, Hon-Man Liu, Ying-An Chen, Yu-Lin Hsieh, Shih-Hung Yang, Yu-Hsuan Tien, Chi-Cheng Yang, Meng-Fai Kuo, Jiann-Shing Jeng
The marked cerebral hypoperfusion of moyamoya disease (MMD) can be treated with encephaloduroarteriosynangiosis (EDAS), an indirect revascularization surgery. Collateral establishment after the surgery is a gradual process; thus, easy access to serial assessment is of great importance. We prospectively recruited 15 pediatric moyamoya patients who underwent EDAS surgeries on a total of 19 hemispheres. Ultrasonography of extracranial and intracranial arteries was performed pre-operatively and post-operatively at 1, 3 and 6 mo...
December 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27611897/surgical-outcomes-of-majewski-osteodysplastic-primordial-dwarfism-type-ii-with-intracranial-vascular-anomalies
#20
Mario Teo, Jeremiah N Johnson, Teresa E Bell-Stephens, Michael P Marks, Huy M Do, Robert L Dodd, Michael B Bober, Gary K Steinberg
OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical revascularization or aneurysm-clipping cases have been reported because of the diminutive arteries and narrow surgical corridors in these patients. Here, the authors report on a large series of patients with MOPD II who underwent surgery for an intracranial vascular anomaly...
December 2016: Journal of Neurosurgery. Pediatrics
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