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https://www.readbyqxmd.com/read/28637249/bypass-surgery-for-complex-intracranial-aneurysms-15-years-of-experience-at-a-single-institution-and-review-of-pertinent-literature
#1
Seung Pil Ban, Won-Sang Cho, Jeong Eun Kim, Chang Hyeun Kim, Jae Seung Bang, Young-Je Son, Hyun-Seung Kang, O-Ki Kwon, Chang Wan Oh, Moon Hee Han
BACKGROUND: Bypass surgery is a treatment option for complex intracranial aneurysms. OBJECTIVE: To determine the utility of bypass surgery for the treatment of complex intracranial aneurysms and to review the literature on this topic. METHODS: Sixty-two patients were included in this retrospective study. Unruptured aneurysms were dominant (80.6%), and the internal carotid artery was the most common location of the aneurysm (56.4%), followed by the middle cerebral artery (21...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28637201/size-is-the-most-important-predictor-of-aneurysm-rupture-among-multiple-cerebral-aneurysms-post-hoc-subgroup-analysis-of-unruptured-cerebral-aneurysm-study-japan
#2
Masaaki Shojima, Akio Morita, Hirofumi Nakatomi, Shinjiro Tominari
BACKGROUND: Multiple cerebral aneurysms are encountered in approximately 15% to 35% of patients harboring unruptured cerebral aneurysms. It would be of clinical value to determine which of them is most likely to rupture. OBJECTIVE: To characterize features of the ruptured aneurysm relative to other concomitant fellow aneurysms in patients with multiple cerebral aneurysms. METHODS: From a total of 5720 patients who were prospectively registered in the Unruptured Cerebral Aneurysm Study in Japan, a subgroup of patients with multiple cerebral aneurysms who developed subarachnoid hemorrhage was extracted for this post hoc analysis...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28634280/surgical-clipping-or-endovascular-coiling-for-unruptured-intracranial-aneurysms-a-pragmatic-randomised-trial
#3
Tim E Darsaut, J Max Findlay, Elsa Magro, Marc Kotowski, Daniel Roy, Alain Weill, Michel W Bojanowski, Chiraz Chaalala, Daniela Iancu, Howard Lesiuk, John Sinclair, Felix Scholtes, Didier Martin, Michael M Chow, Cian J O'Kelly, John H Wong, Ken Butcher, Allan J Fox, Adam S Arthur, Francois Guilbert, Lu Tian, Miguel Chagnon, Suzanne Nolet, Guylaine Gevry, Jean Raymond
BACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and are commonly treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. METHODS: We randomly allocated clipping or coiling to patients with one or more 3-25 mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial haemorrhage or residual aneurysm on 1-year imaging...
June 20, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28633255/surgical-management-of-giant-left-sinus-of-valsalva-aneurysm-causing-left-anterior-descending-coronary-artery-occlusion
#4
Zhaolei Jiang, Min Tang, Hao Liu, Ju Mei
Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly, which mostly occurs in the right or noncoronary sinus of Valsalva. Left sinus of Valsava is infrequent. Unruptured SVAs are usually asymptomatic, and the diagnosis of unruptured SVA is usually accidental. A giant unruptured SVA may compress the coronary artery and cause myocardial infarction. Here, we report a rare case of a 50-year-old patient with unruptured giant left SVA causing occlusion of the left anterior descending coronary artery, which was successfully managed with our apparently unique surgical procedure...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28623116/comparison-of-the-prevalence-of-ruptured-and-unruptured-cerebral-aneurysms-in-a-poor-urban-minority-population
#5
Todd S Miller, David Altschul, Nrupen Baxi, Joaquim Farinhas, David Pasquale, Judah Burns, David Gordon, Jacqueline Bello, Allan Brook, Eugene Flamm
BACKGROUND: Most ruptured cerebral aneurysms are small (<7 mm). Evidence suggests low rupture rates for such lesions (<1% per year). Population studies demonstrate a prevalence rate of 3.2%. This study simultaneously estimates the prevalence of aneurysms in a single geographic population while reporting the observed rate of aneurysmal subarachnoid hemorrhage (aSAH) in the same geographic region composed of a poor urban minority demographic. METHODS: This is an institutional review board-approved, Health Insurance Portability and Accountability Act of 1996-compliant retrospective study performed between 2005 and 2011 at a single center...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28619838/state-of-practice-endovascular-treatment-of-acute-aneurysmal-sah-in-germany
#6
H Janssen, A Berlis, J Lutz, N Thon, H Brückmann
BACKGROUND AND PURPOSE: Acute aneurysmal SAH is a severe disease that requires prompt treatment. Endovascular coiling and neurosurgical clipping are established treatment options. Our intention was to determine the state of current practice in acute aneurysmal SAH treatment in Germany, with emphasis on logistic and temporal aspects. MATERIALS AND METHODS: We interviewed 74 German university and nonuniversity hospitals with an anonymous questionnaire comprising 15 questions concerning the practice of treatment and diagnostics of acute aneurysmal SAH at their respective institutions...
June 15, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28619644/management-and-outcomes-of-symptomatic-abdominal-aortic-aneurysms-during-the-past-20%C3%A2-years
#7
Venita Chandra, Karen Trang, Whitt Virgin-Downey, Ken Tran, E John Harris, Ronald L Dalman, Jason T Lee, Matthew W Mell
OBJECTIVE: We compared the management of patients with symptomatic, unruptured abdominal aortic aneurysms (AAAs) treated at a tertiary care center between two decades. This 20-year period encapsulated a shift in surgical approach to aortic aneurysms from primarily open to primarily endovascular, and we sought to determine the effect of this shift in the evaluation, treatment, and clinical outcomes of patients with symptomatic AAA. METHODS: We reviewed 1429 consecutive patients with unruptured AAAs treated at a tertiary care hospital by six staff surgeons between 1995 and 2004 (era 1) and between 2005 and 2014 (era 2)...
June 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28619497/long-term-functional-outcome-of-symptomatic-unruptured-intracranial-aneurysms-in-an-interdisciplinary-treatment-concept
#8
M Kunz, F Dorn, T Greve, V Stoecklein, J C Tonn, H Brückmann, Ch Schichor
OBJECTIVE: In symptomatic unruptured intracranial aneurysms (UIA), data on long-term functional outcome are sparse in the literature, even in the light of modern interdisciplinary treatment decisions. We therefore analysed our in-house database for prognostic factors and long-term outcome of neurological symptoms after microsurgical/endovascular treatment. METHODS: Patients treated between 2000 and 2016 after interdisciplinary vascular board decision were included...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28619494/role-of-hemodynamics-forces-in-unruptured-intracranial-aneurysms-an-overview-of-a-complex-scenario
#9
REVIEW
Marcello Longo, Francesca Granata, Sergio Racchiusa, Enricomaria Mormina, Grasso Giovanni, Giuseppe Maria Longo, Giada Garufi, Francesco M Salpietro, Concetta Alafaci
BACKGROUND: The understanding of unruptured intracranial aneurysms (IAs) natural history has always played a critical role in pre-surgical or endovascular planning, in order to avoid possible fatal events. Size, shape, morphology and location are known risk factors for aneurysm's rupture, but morphologic parameters alone, may not be sufficient in order to perform a proper rupture risk stratification. METHODS: We performed a systematic PUBMED search and focused on hemodynamics forces which may influence aneurysmal initiation, growth and rupture...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28611648/complete-recovery-from-blindness-in-case-of-compressive-optic-neuropathy-due-to-unruptured-anterior-cerebral-artery-aneurysm
#10
Yurie Fukiyama, Hidehiro Oku, Yusuke Hashimoto, Yuko Nishikawa, Masahiro Tonari, Jun Sugasawa, Shigeru Miyachi, Tsunehiko Ikeda
It is not common for an isolated visual symptom to be the first indication of an aneurysm compressing the optic nerve. The compression can lead to blindness, and a recovery from the blindness is rare. We report a female with a left painless optic neuropathy caused by an unruptured anterior cerebral artery aneurysm. The patient had a temporal hemianopic visual field defect, which progressed to blindness in the left eye, while the right visual function was not affected. A coil embolization of the aneurysm completely restored her visual acuity to 20/20...
January 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28605505/impact-of-young-age-on-the-presentation-of-saccular-intracranial-aneurysms-population-based-analysis-of-4082-patients
#11
Sari Räisänen, Juhana Frösen, Mitja I Kurki, Terhi Huttunen, Jukka Huttunen, Timo Koivisto, Katariina Helin, Mikael von Und Zu Fraunberg, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: Formation and rupture of saccular intracranial aneurysms (sIAs) may have different pathobiologies in patients with younger age at first diagnosis of sIA disease. OBJECTIVE: To study the phenotype of sIA disease and formation of new (de novo) sIAs in patients below 40 yr. METHODS: A population-based cohort study was conducted in 613 young (<40 yr) sIA patients with first diagnosis between 1980 and 2014 and total angiographic follow-up of 3768 yr...
June 9, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28605486/aneurysm-morphology-and-prediction-of-rupture-an-international-study-of-unruptured-intracranial-aneurysms-analysis
#12
J Mocco, Robert D Brown, James C Torner, Ana W Capuano, Kyle M Fargen, Madhavan L Raghavan, David G Piepgras, Irene Meissner, John Huston Iii
BACKGROUND: There are conflicting data between natural history studies suggesting a very low risk of rupture for small, unruptured intracranial aneurysms and retrospective studies that have identified a much higher frequency of small, ruptured aneurysms than expected. OBJECTIVE: To use the prospective International Study of Unruptured Intracranial Aneurysms cohort to identify morphological characteristics predictive of unruptured intracranial aneurysm rupture. METHODS: A case-control design was used to analyze morphological characteristics associated with aneurysm rupture in the International Study of Unruptured Intracranial Aneurysms database...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28602498/risk-factors-for-angiographic-recurrence-after-treatment-of-unruptured-intracranial-aneurysms-outcomes-from-a-series-of-178-unruptured-aneurysms-treated-by-regular-coiling-or-surgery
#13
REVIEW
Anne-Laure Bernat, Frédéric Clarençon, Arthur André, Aurélien Nouet, Stéphane Clémenceau, Nader-Antoine Sourour, Federico Di Maria, Vincent Degos, Jean-Louis Golmard, Philippe Cornu, Anne-Laure Boch
BACKGROUND: Long-term stability after intracranial aneurysm exclusion by coiling is still a matter of debate; after surgical clipping little is known. OBJECTIVE: To study outcome after endovascular and surgical treatments for unruptured intracranial aneurysms in terms of short- and long-term angiographic exclusion and risk factors for recanalization. METHODS: From 2004 and 2009, patients treated for unruptured berry intracranial aneurysms by coiling or clipping were reviewed...
June 8, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28600013/management-of-small-incidental-intracranial-aneurysms
#14
REVIEW
Jan-Karl Burkhardt, Arnau Benet, Michael T Lawton
Advances in neuroimaging and its widespread use for screening have increased the diagnosis of unruptured intracranial aneurysms (UIAs), including small-sized UIAs. The clinical management of these small-sized UIAs requires a patient-specific judgment of the risk of aneurysm rupture, if not treated, versus the risk of complications from surgical or endovascular treatment. Experienced cerebrovascular teams recommend treating small UIAs in young patients or in patients with more than one aneurysm rupture risk factor who also have a reasonable life expectancy...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28599841/changing-paradigm-in-the-management-of-elderly-patients-with-intracranial-aneurysms-an-institutional-review
#15
Oleg Y Chernyshev, Shyamal C Bir, Tanmoy K Maiti, Devi Prasad Patra, Cesar Liendo, Hugo Cuellar, Alireza Minagar, Anil Nanda
Optimal treatment of intracranial aneurysms (IAs) in elderly patients has not yet been well established. We have investigated the clinical and radiological outcomes and predictors of unfavorable outcome of IAs in elderly patients. Radiological and clinical data of 85 elderly patients from 2010 through 2015 were retrospectively reviewed. Significant differences between the groups were determined by a chi-square test. Regression analysis was performed to identify the predictors of unfavorable outcome. Among the 85 patients with IAs, the number of patients with >7mm size aneurysm (p=0...
June 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28589068/endovascular-treatment-of-large-unruptured-fusiform-fenestrated-vertebrobasilar-junction-aneurysm
#16
Saeed A Alqahtani, Daniel R Felbaum, Alex Tai, Ai-Hsi Liu, Rocco A Armonda
Fenestrated vertebrobasilar junction aneurysms are rare vascular lesions. Microsurgical intervention is extremely difficult due to the complex anatomy in the vicinity of these aneurysms. Endovascular neurosurgery appears to be safe and should be considered as the first modality of treatment. This case study details the treatment of an unruptured fusiform fenestrated vertebrobasilar junction aneurysm with endovascular occlusion with stent-assisted coiling. The optimal angiographic exposure and selective microcatheterization of the aneurysm were challenging due to the patient's body habitus, and the aneurysm was large with one dominant fenestrated limb...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28586893/growth-and-rupture-risk-of-small-unruptured-intracranial-aneurysms-a-systematic-review
#17
Ajay Malhotra, Xiao Wu, Howard P Forman, Holly K Grossetta Nardini, Charles C Matouk, Dheeraj Gandhi, Christopher Moore, Pina Sanelli
Background: Small unruptured intracranial aneurysms (UIAs) are increasingly diagnosed. Management depends on growth and rupture risks, which may vary by aneurysm size. Purpose: To summarize evidence about the growth and rupture risk of UIAs 7 mm and smaller and to explore differences in growth and rupture risks of very small (≤3 mm) and small (≤5 mm) aneurysms. Data Sources: MEDLINE, EMBASE, Scopus, and the Cochrane Library from inception to 2017 (with no language restrictions)...
June 6, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28586440/circumferential-wall-enhancement-on-magnetic-resonance-imaging-is-useful-to-identify-rupture-site-in-patients-with-multiple-cerebral-aneurysms
#18
Shunsuke Omodaka, Hidenori Endo, Kuniyasu Niizuma, Miki Fujimura, Toshiki Endo, Kenichi Sato, Shin-Ichiro Sugiyama, Takashi Inoue, Teiji Tominaga
BACKGROUND: Identification of rupture sites in patients with multiple intracranial aneurysms is largely based on aneurysm size, location, and shape. Finding circumferential enhancement along the aneurysm wall (CEAW) on magnetic resonance (MR) vessel wall imaging was recently shown to be indicative of ruptured aneurysm. OBJECTIVE: To investigate the hypothesis that a higher degree of CEAW would identify the site of rupture in patients with multiple aneurysms. METHODS: We prospectively performed quantitative analysis of CEAW in consecutive patients with both aneurysmal subarachnoid hemorrhage and multiple aneurysms (26 patients with a total of 62 aneurysms), using MR vessel wall imaging...
June 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28584682/safe-time-duration-for-temporary-middle-cerebral-artery-occlusion-in-aneurysm-surgery-based-on-motor-evoked-potential-monitoring
#19
Jun Tanabe, Tatsuya Ishikawa, Junta Moroi
BACKGROUND: Temporary vessel occlusion of the parent artery is an essential technique for aneurysm surgery. Our aim was to clarify the safe time for temporary occlusion for aneurysm surgery, that is the "safe time duration" (STD), in which brain tissue exposed to ischemia will almost never fall into even the ischemic penumbra during temporary occlusion of the middle cerebral artery (MCA), and even transient postoperative motor impairment will be rare using intraoperative motor-evoked potentials (MEP)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28583450/intraprocedural-rupture-of-unruptured-cerebral-aneurysms-during-coil-embolization-a-single-center-experience
#20
Su Hee Cho, Mohammed Denewer, Won Hyong Park, Jae Sung Ahn, Byung Duk Kwun, DeokHee Lee, Jung Cheol Park
OBJECTIVE: The incidence of intraprocedural rupture (IPR) during endovascular coiling is reported to range from 2% to 5%. In this study, we reviewed the single center experiences of IPR during coil embolization for unruptured intracranial aneurysm. METHODS: At our institution, 849 patients were treated with endovascular therapy for unruptured intracranial aneurysm between January 2011 and April 2016. Ten (1.18%) of these patients had documented IPR. We reviewed the medical data to evaluate the characteristics of the aneurysms, angiographic findings related to rupture, management, and outcomes...
June 2, 2017: World Neurosurgery
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