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https://www.readbyqxmd.com/read/28431024/radiosurgery-for-unruptured-brain-arteriovenous-malformations-an-international-multicenter-retrospective-cohort-study
#1
Dale Ding, Robert M Starke, Hideyuki Kano, John Y K Lee, David Mathieu, John Pierce, Paul Huang, Symeon Missios, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
BACKGROUND: The role of intervention in the management of unruptured brain arteriovenous malformations (AVM) is controversial. OBJECTIVE: To analyze in a multicenter, retrospective cohort study, the outcomes following radiosurgery for unruptured AVMs and determine predictive factors. METHODS: We evaluated and pooled AVM radiosurgery data from 8 institutions participating in the International Gamma Knife Research Foundation. Patients with unruptured AVMs and ≥12 mo of follow-up were included in the study cohort...
April 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28428448/unruptured-cerebral-aneurysms-in-elderly-patients
#2
Tomohito Hishikawa, Isao Date
The prevalence of unruptured cerebral aneurysms (UCAs) in elderly patients is increasing in our aging population. UCA management in elderly patients has some difficulties, such as reduced life expectancy, increased comorbidities and treatment risks, and poor prognosis in case of rupture. In this review article, we summarize the most recent findings on the natural history, therapeutic options and treatment results for UCAs exclusively in elderly patients, and describe possible medical treatments for patients with UCAs...
April 19, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28427983/effect-of-headache-on-the-pathological-findings-of-unruptured-cerebral-saccular-aneurysms
#3
Masaaki Hokari, Naoki Nakayama, Yusuke Shimoda, Kiyohiro Houkin
BACKGROUND: Some patients with aneurysm exhibit warning headaches without minor bleeding, and this could be caused by stretching of the aneurysm wall. Recently, our pathological study observed subintimal fibrin deposition in a majority of the ruptured aneurysms. However, these findings were also observed in some unruptured aneurysms. In this report, two unruptured aneurysms exhibited subintimal fibrin, and interestingly, one of the patients experienced severe headache within 1 month before neuroimaging...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28419294/preliminary-study-of-tirofiban-infusion-in-coil-embolization-of-ruptured-intracranial-aneurysms
#4
Chang Hyo Yoon, Ho-Won Lee, Young Soo Kim, Sang Won Lee, Jeong A Yeom, Jieun Roh, Seung Kug Baik
BACKGROUND: There have been some reports on the use of intra-arterial tirofiban in ruptured intracranial aneurysms, but few studies have reported on the use of 24 h of intravenous tirofiban infusion in patients with subarachnoid hemorrhage. OBJECTIVE: To present our experience with intravenous tirofiban infusion, in the form of a monotherapy as well as in addition to intra-arterial tirofiban, as a prophylactic, and as a rescue management for thrombus in patients who have undergone embolization with coils for ruptured intracranial aneurysms...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28416410/progressive-occlusion-and-recanalization-after-endovascular-treatment-for-287-unruptured-small-aneurysms-5mm-a-single-center-6-year-experience
#5
Xin Feng, Luyao Wang, Erkang Guo, Baorui Zhang, Zenghui Qian, Peng Liu, Xiaolong Wen, Wenjuan Xu, Youxiang Li, Chuhan Jiang, Zhongxue Wu, Aihua Liu
OBJECT: We aimed to investigate the effect of coiling for small unruptured intracranial aneurysms(UIAs)﹤5mm) on progressive occlusion and recanalization, and the dubious factors related to progressive occlusion and recanalization among UIAs without complete occlusion. METHODS: A total of 264 patients with 287 small UIAs were coiled in our institute between June 2009 and December 2014. All UIAs enrolled were divided into small (3-5mm) and very small (<3mm) groups, and UIAs without initial complete occlusion were divided into progressive, stable and recanalization groups...
April 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28402453/medina%C3%A2-embolization-device-for-the-treatment-of-intracranial-aneurysms-safety-and-angiographic-effectiveness-at-6-months
#6
Nader-Antoine Sourour, Saskia Vande Perre, Federico Di Maria, Chrysanthi Papagiannaki, Joseph Gabrieli, Silvia Pistocchi, Bruno Bartolini, Vincent Degos, Alexandre Carpentier, Jacques Chiras, Frédéric Clarençon
BACKGROUND: The Medina Embolization Device (MED) is a new concept device that combines the design of a detachable coil and the one of an intrasaccular flow disruption device. OBJECTIVE: To evaluate the feasibility, safety, and 6- to 9-mo effectiveness of this new device for the treatment of intracranial wide-necked aneurysms. METHODS: Twelve patients (10 females, mean age = 56 yr) with 13 wide-necked intracranial aneurysms (3 ruptured; 10 unruptured) were treated by means of the MED from January 2015 to October 2015...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28401260/stent-assisted-coiling-of-wide-neck-bifurcation-aneurysms-with-a-branch-incorporated-in-the-aneurysm-base-long-term-follow-up-in-49-patients-with-53-aneurysms
#7
Boris Lubicz, Ricardo Morais, Pierre-Julien Bruyère, Noémie Ligot, Benjamin Mine
PURPOSE: Wide-neck bifurcation intracranial aneurysms (WNBA) with a branch incorporated in the aneurysm base remain difficult to treat by embolization. We aim to report our long-term follow-up of stent-assisted coiling (SAC) in this subgroup of patients. METHODS: This study was approved by our local ethical committee. A retrospective review of our prospectively maintained database identified all patients treated in our institution by SAC for a WNBA with a branch incorporated in the aneurysm base...
April 11, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28391019/perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-after-clipping-of-an-unruptured-aneurysm-case-report
#8
Kwang-Chun Cho, Jung-Jae Kim, Chang-Ki Hong, Jin-Yang Joo, Yong Bae Kim
BACKGROUND: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a benign form of subarachnoid hemorrhage with an excellent clinical outcome. The cause of PNSAH remains unknown. We report a case of PNSAH in a patient with a history of clipping of an unruptured aneurysm. PNSAH after clipping of an unruptured aneurysm is extremely rare. CASE DESCRIPTION: A 56-year-old man with a history of clipping surgery for an unruptured aneurysm 10 months previously, presented with severe headache...
April 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28387631/aneurysm-wall-enhancement-on-magnetic-resonance-imaging-as-a-risk-factor-for-progression-of-unruptured-vertebrobasilar-dissecting-aneurysms-after-reconstructive-endovascular-treatment
#9
Yisen Zhang, Binbin Sui, Jian Liu, Yang Wang, Zhongbin Tian, Junfan Chen, Zhongxue Wu, Xinjian Yang
OBJECTIVE The recurrence rate of vertebrobasilar dissecting aneurysms (VBDAs) after reconstructive endovascular treatment (EVT) is relatively high. The aneurysm wall enhancement on high-resolution MRI (HRMRI) reportedly predicts an unsteady state of an intracranial aneurysm. The authors used HRMRI to investigate the relationship between wall enhancement on HRMRI and progression of VBDAs after reconstructive EVT. METHODS From January 2012 to December 2015, patients with an unruptured VBDA who underwent reconstructive EVT were enrolled in this study...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387624/dolichoectatic-aneurysms-of-the-vertebrobasilar-system-clinical-and-radiographic-factors-that-predict-poor-outcomes
#10
David S Xu, Michael R Levitt, M Yashar S Kalani, Leonardo Rangel-Castilla, Celene B Mulholland, Isaac J Abecassis, Ryan P Morton, John D Nerva, Adnan H Siddiqui, Elad I Levy, Robert F Spetzler, Felipe C Albuquerque, Cameron G McDougall
OBJECTIVE Fusiform dolichoectatic vertebrobasilar aneurysms are rare, challenging lesions. The natural history of these lesions and medium- and long-term patient outcomes are poorly understood. The authors sought to evaluate patient prognosis after diagnosis of fusiform dolichoectatic vertebrobasilar aneurysms and to identify clinical and radiographic predictors of neurological deterioration. METHODS The authors reviewed multiple, prospectively maintained, single-provider databases at 3 large-volume cerebrovascular centers to obtain data on patients with unruptured, fusiform, basilar artery dolichoectatic aneurysms diagnosed between January 1, 2000, and January 1, 2015...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387620/reoperation-and-readmission-after-clipping-of-an-unruptured-intracranial-aneurysm-a-national-surgical-quality-improvement-program-analysis
#11
Hormuzdiyar H Dasenbrock, Timothy R Smith, Robert F Rudy, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured aneurysm electively were extracted from the prospective National Surgical Quality Improvement Program registry (2011-2014). Multivariable logistic regression and recursive partitioning analysis evaluated the independent predictors of nonroutine hospital discharge, unplanned 30-day reoperation, and readmission...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28385886/preliminary-experience-with-stent-assisted-coiling-of-aneurysms-arising-from-small-2-5-mm-cerebral-vessels-using-the-low-profile-visualized-intraluminal-support-device
#12
C-C Wang, W Li, Z-Z Feng, B Hong, Y Xu, J-M Liu, Q-H Huang
BACKGROUND AND PURPOSE: The Low-Profile Visualized Intraluminal Support (LVIS) stent is a new device recently introduced for the treatment of wide-neck intracranial aneurysms. This single-center study presents the authors' preliminary experience using the LVIS stent to treat saccular aneurysms with parent arteries smaller than 2.5 mm. MATERIALS AND METHODS: Aneurysms with a LVIS stent used in a small parent vessel (<2.5 mm in diameter) between October 2014 and April 2016 were included...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28377249/trends-in-resident-operative-teaching-opportunities-for-treatment-of-intracranial-aneurysms
#13
Matthew Piazza, Nikhil Nayak, Zarina Ali, Gregory Heuer, Matthew Sanborn, Sherman Stein, James Schuster, M Sean Grady, Neil R Malhotra
OBJECTIVE: The International Subarachnoid Aneurysm Trial heralded a paradigm shift in the treatment of intracranial aneurysms. During this same time frame neurosurgical training programs increased in size and scope. The present study examines the impact of trends in surgical clipping and the endovascular treatment of intracranial aneurysms, over one decade, and the neurosurgical resident complement on the resident teaching environment using the Nationwide Inpatient Sample (NIS). METHODS: The NIS was used to estimate the number of aneurysms treated with either surgical clipping and endovascular methods from 2002 through 2011 at teaching institutions...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28366751/risk-factors-to-predict-neurological-complications-after-endovascular-treatment-of-unruptured-paraclinoid-aneurysms
#14
Wenjun Ji, Lianfang Xu, Pengfei Wang, Liqian Sun, Xin Feng, Xianli Lv, Aihua Liu, Zhongxue Wu
OBJECTIVE: Unruptured paraclinoid aneurysms are often asymptomatic, and endovascular coiling is the main treatment. However, endovascular treatment of these lesions still leads to neurological complications. We aimed to identify predictors of neurological complications in these lesions. METHODS: We retrospectively analyzed patients with unruptured paraclinoid aneurysms who were treated with endovascular coiling between January 2014 and December 2015. A neurological complication was defined as any transient or permanent increase in the modified Rankin Scale score after aneurysm embolization...
March 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28363976/elapss-score-for-prediction-of-risk-of-growth-of-unruptured-intracranial-aneurysms
#15
Daan Backes, Gabriel J E Rinkel, Jacoba P Greving, Birgitta K Velthuis, Yuichi Murayama, Hiroyuki Takao, Toshihiro Ishibashi, Michiya Igase, Karel G terBrugge, Ronit Agid, Juha E Jääskeläinen, Antti E Lindgren, Timo Koivisto, Mikael von Und Zu Fraunberg, Shunji Matsubara, Junta Moroi, George K C Wong, Jill M Abrigo, Keiji Igase, Katsumi Matsumoto, Marieke J H Wermer, Marianne A A van Walderveen, Ale Algra, Mervyn D I Vergouwen
OBJECTIVE: To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth. METHODS: From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome...
March 31, 2017: Neurology
https://www.readbyqxmd.com/read/28363974/a-model-for-predicting-the-growth-of-unruptured-intracranial-aneurysms-beyond-fortune-telling
#16
Dale Ding, Nima Etminan
No abstract text is available yet for this article.
March 31, 2017: Neurology
https://www.readbyqxmd.com/read/28343249/intraobserver-and-interobserver-variability-in-ct-angiography-and-mr-angiography-measurements-of-the-size-of-cerebral-aneurysms
#17
Hye Jeong Kim, Dae Young Yoon, Eun Soo Kim, Hyung Jin Lee, Hong Jun Jeon, Jong Young Lee, Byung-Moon Cho
PURPOSE: Accurate and reliable measurement of aneurysm size is important for treatment planning. The purpose of this study was to determine intraobserver and interobserver variability of CTA and MRA for measurement of the size of cerebral aneurysms. METHODS: Thirty patients with 33 unruptured cerebral aneurysms (saccular, >3 mm in their maximal dimension, with no daughter sacs or lobulations) who underwent 256-row multislice CTA, 3-D TOF MRA at 3.0T, and 3D rotational angiography (3DRA) were retrospectively analyzed...
March 25, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#18
Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, Rolando Del Maestro
OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28331423/a-case-of-unruptured-right-gastroepiploic-artery-aneurysm-successfully-resected-by-laparoscopic-surgery
#19
Yuki Murakami, Hiroaki Saito, Shota Shimizu, Yusuke Kono, Hirohiko Kuroda, Tomoyuki Matsunaga, Yoji Fukumoto, Tomohiro Osaki, Yoshiyuki Fujiwara
A 50-year-old woman was admitted to our hospital to undergo surgery to remove a pituitary adenoma. Preoperative dynamic computed tomography revealed an incidental right gastroepiploic arterial aneurysm (GEAA). After removal of the pituitary adenoma, we performed a laparoscopic right gastroepiploic aneurysmectomy. The postoperative course was uneventful. Right GEAAs should be treated at diagnosis owing to the high possibility of rupture. Laparoscopic right gastroepiploic aneurysmectomy is feasible and should be considered for the treatment of right GEAAs...
March 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28329283/left-sinus-of-valsalva-aneurysm-as-a-cause-of-chronic-stable-angina
#20
Alexandre Ponti, Salah D Qanadli, Matthias Kirsch, Maxime Tapponnier
Sinus of Valsalva aneurysms are unusual, particularly when located on the left coronary sinus. They are mainly asymptomatic, however once ruptured, they are associated with high mortality. We present hereinafter an atypical case of a 71-year-old patient with an unruptured left sinus of Valsalva aneurysm causing myocardial ischaemia due to a compressed left main coronary artery. Surgical endoaneurysmorrhaphy was performed; however, a dehiscence of the suture line between the patch and the aortic wall required additional percutaneous implantation of a vascular occluder...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
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