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https://www.readbyqxmd.com/read/28079915/intravenous-immunoglobulin-for-the-treatment-of-kawasaki-disease
#1
Stanford T Shulman
Standard first-line therapy for Kawasaki disease (KD) consists of intravenous immunoglobulin (IVIG) and aspirin. Current guidelines recommend 2 g/kg of IVIG and 80 to 100 mg/kg of aspirin administered within the first 10 days of illness. This regimen has marked efficacy in preventing the development of coronary artery aneurysms. Approximately 15% to 20% of treated patients require a second dose of IVIG to control the inflammatory process. The role of adjunctive corticosteroid therapy with IVIG and aspirin is evolving, with Japanese studies showing a clear benefit in those patients at highest risk for development of coronary disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28078379/chitosan-sodium-tetradecyl-sulfate-hydrogel-characterization-and-preclinical-evaluation-of-a-novel-sclerosing-embolizing-agent-for-the-treatment-of-endoleaks
#2
Fatemeh Zehtabi, Vincent Dumont-Mackay, Ahmed Fatimi, Antony Bertrand-Grenier, Hélène Héon, Gilles Soulez, Sophie Lerouge
PURPOSE: To compare the efficacy of an embolization agent with sclerosing properties (made of chitosan and sodium tetradecyl sulfate, CH-STS) with a similar embolization agent but without sclerosing properties (made of chitosan, CH) in treating endoleaks in a canine endovascular aneurysm repair model. METHODS: Two chitosan-based radiopaque hydrogels were prepared, one with STS and one without STS. Their rheological, injectability, and embolizing properties were assessed in vitro; afterwards, their efficacy in occluding endoleaks was compared in a canine bilateral aneurysm model reproducing type I endoleaks (n = 9 each)...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28077523/autologous-adipose-derived-mesenchymal-stem-cells-improve-healing-of-coiled-experimental-saccular-aneurysms-an-angiographic-and-histopathological-study
#3
Aymeric Rouchaud, Waleed Brinjikji, Daying Dai, Yong-Hong Ding, Tina Gunderson, Dana Schroeder, Laurent Spelle, David F Kallmes, Ramanathan Kadirvel
PURPOSE: Long-term occlusion of coiled aneurysms frequently fails, probably because of poor intrasaccular healing and inadequate endothelialization across the aneurysm neck. The purpose of this study was to determine if attachment of autologous mesenchymal stem cells (MSCs) to platinum coils would improve the healing response in an elastase-induced aneurysm model in rabbits. MATERIALS AND METHODS: With approval from the institutional animal care and use committee, aneurysms were created in rabbits and embolized with control platinum coils (Axium; Medtronic) (n=6) or coils seeded ex vivo with autologous adipose-tissue MSCs (n=7)...
January 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#4
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
January 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28066873/management-of-posterior-inferior-cerebellar-artery-aneurysms-what-factors-play-the-most-important-role-in-outcome
#5
Alena Sejkorová, Ondra Petr, Miriam Mulino, Jiří Cihlář, Aleš Hejčl, Claudius Thomé, Martin Sameš, Giuseppe Lanzino
BACKGROUND: Posterior inferior cerebellar artery (PICA) aneurysms are an uncommon, heterogeneous group of aneurysms with poorer clinical outcomes compared to other intracranial aneurysms. We performed a multicenter retrospective study to analyze the outcome in a large series of patients treated with modern microsurgical and endovascular techniques. METHODS: Records of 94 patients treated for PICA aneurysms between 2000 and 2015 at three large tertiary referral centers were retrospectively reviewed...
January 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28062803/posterior-circulation-perforator-aneurysms-a-proposed-management-algorithm
#6
Thomas J Buell, Dale Ding, Daniel M S Raper, Ching-Jen Chen, Harry R Hixson, R Webster Crowley, Avery J Evans, Mary E Jensen, Kenneth C Liu
INTRODUCTION: Subarachnoid hemorrhage (SAH) from posterior circulation perforator aneurysms (PCPAs) is rare and its natural history is unknown. Diagnosis may be difficult, acute management is poorly defined, and long-term recurrent SAH rates and clinical outcome data are lacking. METHODS: We searched our institution's records for cases of PCPA rupture and analyzed patient demographics, Hunt and Hess (HH) grades, diagnostic imaging, management, and clinical outcomes...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28059660/effects-of-decompressive-craniectomy-on-functional-outcomes-and-death-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#7
Naif M Alotaibi, Ghassan Awad Elkarim, Nardin Samuel, Oliver G S Ayling, Daipayan Guha, Aria Fallah, Abdulrahman Aldakkan, Blessing N R Jaja, Airton Leonardo de Oliveira Manoel, George M Ibrahim, R Loch Macdonald
OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059656/midterm-results-of-t-stent-assisted-coiling-of-wide-necked-and-complex-intracranial-bifurcation-aneurysms-using-low-profile-stents
#8
Kubilay Aydin, Serra Sencer, Mehmet Barburoglu, Mynzhylky Berdikhojayev, Yavuz Aras, Altay Sencer, Nail İzgi
OBJECTIVE Coiling of wide-necked and complex bifurcation aneurysms frequently requires implantation of double stents in various configurations. T-stent-assisted coiling involves the nonoverlapping implantation of 2 stents to protect the daughter vessels of bifurcation and is followed by coiling of the aneurysm. The authors studied the feasibility, efficacy, and safety of the T-stent-assisted coiling procedure as well as the midterm angiographic/clinical outcomes of patients with wide-necked bifurcation intracranial aneurysms treated using this technique...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#9
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, Satoru Takeuchi, Satoshi Tomura, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28043685/medium-or-higher-dose-acetylsalicylic-acid-for-acute-kawasaki-disease-and-patient-outcomes
#10
Gi Beom Kim, Jeong Jin Yu, Kyung Lim Yoon, Soo In Jeong, Young Hwan Song, Ji Whan Han, Young Mi Hong, Chan Uhng Joo
OBJECTIVE: To investigate the effect of medium- or higher-dose acetylsalicylic acid (ASA) for treating acute-phase Kawasaki disease to prevent coronary artery aneurysm (CAA). STUDY DESIGN: Among the children with acute Kawasaki disease investigated in the eighth nationwide survey in the Republic of Korea, 8456 children with adequate data were included in this study. The subjects were divided into 2 groups according to the use of medium- or higher-dose ASA (≥30 mg/kg/day), or-low dose ASA (3-5 mg/kg/day) during the acute febrile phase...
December 30, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28031096/impact-of-intraoperative-blood-pressure-control-and-temporary-parent-artery-blocking-on-prognosis-in-cerebral-aneurysms-surgery
#11
Min Xu, Zheng-Song Gu, Cun-Zu Wang, Xiao-Feng Lu, Ding-Chao Xiang, Zhi-Cheng Yuan, Qiao-Yu Li, Min Wu
Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporary parent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis is uncertain. In this study, we try to find out the association between methods above and prognostic indicators.Methods We held a retrospective analysis on patients' medical records of cerebral aneurysms surgical clipping and endovascular coiling , and recorded gender, age, diagnosis, Hunt-Hess grade, Glasgow coma scale score, treatment methods, a history of hypertension, preoperative systolic blood pressure, with or without controlled hypotension, systolic blood pressure difference before and after controlled hypotension, with or without temporary artery blocking, with or without hypertension after treated aneurysm, prognostic indicators including mortality after 1 month, intensive care unit (ICU) stay time of survivors, discharged Glasgow outcome scale (GOS) score...
June 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28028955/unruptured-intracranial-aneurysms-surgery-still-safe-as-a-treatment-option
#12
Marta Koźba-Gosztyła, Bogdan Czapiga, Włodzimierz Jarmundowicz, Łukasz Tomiałowicz
BACKGROUND: Despite a number of studies on the treatment of unruptured intracranial aneurysms (UIA), the optimal method still remains unclear. OBJECTIVES: The aim of the study was to demonstrate that UIA clipping is a safe procedure and can be a good alternative for patients not qualified for endovascular procedures and who have refused conservative management. MATERIAL AND METHODS: Results were gathered from a sample of 104 patients with UIA treated in our facility over a 9-year period starting January 2005...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28027841/kawasaki-disease-with-coronary-artery-aneurysms-psychosocial-impact-on-parents-and-children
#13
Nita Chahal, Ahlexxi Jelen, Janet Rush, Cedric Manlhiot, Katherine M Boydell, Renee Sananes, Brian W McCrindle
INTRODUCTION: For those living with Kawasaki disease and coronary artery aneurysms, little is known about the psychosocial burden faced by parents and their children. METHODS: Exploratory, descriptive, mixed-methods design examining survey and interview data about health-related uncertainty, intrusiveness, and self-efficacy. RESULTS: Parents' uncertainty was associated with missed diagnosis, higher income, and maternal education. Higher uncertainty scores among children were associated with absence of chest pain and lower number of echocardiograms...
December 24, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28017223/parent-vessel-occlusion-for-treatment-of-cerebral-aneurysms-is-there-still-an-indication-a-series-of-17-patients
#14
Nishant Ganesh Kumar, Travis R Ladner, Imad S Kahn, Scott L Zuckerman, Christopher B Baker, Marybess Skaletsky, Deborah Cushing, Matthew R Sanborn, J Mocco, Robert D Ecker
INTRODUCTION/PURPOSE: Flow diversion has allowed cerebrovascular neurosurgeons and neurointerventionalists to treat complex, large aneurysms, previously treated with trapping, bypass, and/or parent vessel sacrifice. However, a minority of aneurysms remain that cannot be treated endovascularly, and microsurgical treatment is too dangerous. However, balloon test occlusion (macro and micro), micro WADA testing, ICG, intra-angiography and intra-operative monitoring are all available to clinically test the hypothesis that vessel sacrifice is safe...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28017208/subjective-hearing-impairment-after-subarachnoid-haemorrhage-prevalence-and-risk-factors
#15
Erik M Vos, Paut Greebe, J M Anne Visser-Meily, Gabriel J E Rinkel, Mervyn D I Vergouwen
BACKGROUND: Sensorineural hearing impairment is a key symptom in patients with superficial siderosis of the central nervous system, a disease caused by chronic or intermittent haemorrhage into the subarachnoid space. We investigated the prevalence and risk factors of subjective hearing impairment after SAH. METHODS: We systematically interviewed all SAH patients admitted between June 2011 and December 2014, who were able to visit the SAH outpatient clinic six to eight weeks after hospital discharge...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28007769/surpass-flow-diverter-for-treatment-of-posterior-circulation-aneurysms
#16
C A Taschner, S Vedantham, J de Vries, A Biondi, J Boogaarts, N Sakai, P Lylyk, I Szikora, S Meckel, H Urbach, P Kan, R Siekmann, J Bernardy, M J Gounis, A K Wakhloo
BACKGROUND AND PURPOSE: Flow diverters for the treatment of posterior circulation aneurysms remain controversial. We aimed to identify factors contributing to outcome measures in patients treated with the Surpass flow diverter for aneurysms in this location. MATERIALS AND METHODS: We conducted an observational study of 53 patients who underwent flow-diverter treatment for posterior circulation aneurysms at 15 centers. Key outcome measures were mortality, complete aneurysm occlusion, and modified Rankin Scale score at follow-up...
December 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28007767/usefulness-of-non-contrast-enhanced-mr-angiography-using-a-silent-scan-for-follow-up-after-y-configuration-stent-assisted-coil-embolization-for-basilar-tip-aneurysms
#17
N Takano, M Suzuki, R Irie, M Yamamoto, N Hamasaki, K Kamagata, K K Kumamaru, M Hori, H Oishi, S Aoki
BACKGROUND AND PURPOSE: Y-configuration stent-assisted coil embolization is used for treating wide-neck aneurysms. Noninvasive alternatives to x-ray DSA for follow-up after Y-configuration stent-assisted coil embolization treatment are required. This study aimed to assess the usefulness of non-contrast-enhanced MRA by using a Silent Scan (silent MRA) for follow-up after Y-configuration stent-assisted coil embolization for basilar tip aneurysms. MATERIALS AND METHODS: Seven patients treated with Y-configuration stent-assisted coil embolization for basilar tip aneurysms underwent silent MRA, 3D TOF-MRA, and DSA...
December 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28004163/treatment-of-cerebral-vasospasm-following-aneurysmal-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#18
Grégoire Boulouis, Marc Antoine Labeyrie, Jean Raymond, Christine Rodriguez-Régent, Anne Claire Lukaszewicz, Damien Bresson, Wagih Ben Hassen, Denis Trystram, Jean Francois Meder, Catherine Oppenheim, Olivier Naggara
OBJECTIVES: To examine the clinical outcome of aneurysmal subarachnoid haemorrhage (aSAH) patients exposed to cerebral vasospasm (CVS)-targeted treatments in a meta-analysis and to evaluate the efficacy of intra-arterial (IA) approaches in patients with severe/refractory vasospasm. METHODS: Randomised controlled trials, prospective and retrospective observational studies reporting clinical outcomes of aSAH patients exposed to CVS targeted treatments, published between 2006-2016 were searched using PubMed, EMBASE and the Cochrane Library...
December 21, 2016: European Radiology
https://www.readbyqxmd.com/read/28003171/a-contralateral-transcondylar-fossa-approach-with-bilateral-v3-segment-exposure-for-repairing-complex-vertebral-artery-aneurysms-a-technical-case-report
#19
Nakao Ota, Rokuya Tanikawa, Masataka Miyama, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Fumihiro Sakakibara, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada
BACKGROUND: and Importance: Microsurgical treatment for vertebral artery aneurysms can be approached through the lateral aspect of the brainstem and cerebellum. Contralateral approach may be selected in case of complex aneurysms with tortuous running, and the intracranial vertebral artery distal to the aneurysm locates in contralateral cerebello-pontine angle. When performing the aneurysm repair, exposing the V3 segment before craniotomy is advantageous. We describe the detailed surgical procedures about contralateral transcondylar fossa approach with bilateral V3 segment exposure for the repair of a complex vertebral artery aneurysm...
December 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28003104/role-of-simulation-in-endovascular-aneurysm-repair-evar-training-a-preliminary-study
#20
A Saratzis, T Calderbank, D Sidloff, M J Bown, R S Davies
BACKGROUND: Endovascular aneurysm repair (EVAR) requires a high-level of technical-competency to avoid device-related complications. Virtual reality simulation-based training (SBT) may offer an alternative method of psychomotor skill acquisition; however, its role in EVAR training is undefined. This study aimed to: a) benchmark competency levels using EVAR SBT, and b) investigate the impact of supervised SBT on trainee performance. METHODS: EVAR procedure-related metrics were benchmarked by six experienced consultants using a Simbionix Angiomentor EVAR simulator...
December 18, 2016: European Journal of Vascular and Endovascular Surgery
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