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Aneurysm score

Min-Qing Wang, Xu Zhao, Xiao-Fei Wang, Chao Han, De-Guang Xing, Cheng-Wei Wang
BACKGROUND: The purpose of this study was to assess the outcomes in aggressively treated patients with aneurysmal intracerebral hematoma (ICH) and signs of brain herniation, and to investigate possible predictive factors. METHODS: This retrospective study included 43 patients with aneurysmal ICH who presented with brain herniation at emergency department (ED) admission and received aggressive surgical treatment between 2008 and 2016. Emergency surgical clipping, removal of hematoma, and external decompression were combined as an aggressive surgical treatment...
March 12, 2018: World Neurosurgery
Yuji Shono, Hiroshi Sugimori, Ryu Matsuo, Yoshihisa Fukushima, Yoshinobu Wakisaka, Junya Kuroda, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono
Background The safety of antithrombotic therapy for patients with acute ischemic stroke harboring unruptured intracranial aneurysms remains unclear. Aims This study was performed to determine whether treatment with antiplatelets, anticoagulants, or intravenous thrombolytic agents is safe for patients with acute ischemic stroke and unruptured intracranial aneurysms. Methods Among 9149 patients with acute ischemic stroke enrolled in the Fukuoka Stroke Registry from June 2007 to December 2014, 8857 patients with data on cerebrovascular imaging and three-month outcomes were included in this study...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Waleed Brinjikji, Vitor M Pereira, Rujimas Khumtong, Alex Kostensky, Michael Tymianski, Timo Krings, Ivan Radovanovich
BACKGROUND AND PURPOSE: Understanding risk factors for intracranial aneurysm growth is important for patient management. We performed a retrospective study examining risk factors for growth of unruptured intracranial aneurysms followed at our institution examining both traditional risk factors and the PHASES score. MATERIALS AND METHODS: We retrospectively reviewed a consecutive series of unruptured intracranial aneurysms followed at our institution for a minimum of six months over a 15-year period...
March 9, 2018: World Neurosurgery
Stephan Reichenbach, Sabine Adler, Harald Bonel, Jennifer L Cullmann, Stefan Kuchen, Lukas Bütikofer, Michael Seitz, Peter M Villiger
Objective: To analyse magnetic resonance angiographic (MRA) vessel wall signals from a randomized controlled trial of tocilizumab (TCZ) to treat GCA. Methods: Participants were assigned in a 2:1 ratio to receive either TCZ + glucocorticoids (GCs) or placebo + GC infusions at 4-week intervals for 52 weeks. GCs were started at 1 mg/kg/day, then tapered to 0.1 mg/kg/day at week 12 and thereafter down to zero. Patients with initial positive MRA findings underwent control MRA at weeks 12 and 52...
February 23, 2018: Rheumatology
Torbjørn Øygard Skodvin, Øyvind Evju, Angelika Sorteberg, Jørgen Gjernes Isaksen
BACKGROUND: Maximal size and other morphological parameters of intracranial aneurysms (IAs) are used when deciding if an IA should be treated prophylactically. These parameters are derived from postrupture morphology. As time and rupture may alter the aneurysm geometry, possible morphological predictors of a rupture should be established in prerupture aneurysms. OBJECTIVE: To identify morphological parameters of unruptured IAs associated with later rupture. METHODS: Nationwide matched case-control study...
February 26, 2018: Neurosurgery
Adam A Dmytriw, Nimer Adeeb, Ashish Kumar, Christoph J Griessenauer, Kevin Phan, Christopher S Ogilvy, Paul M Foreman, Hussain Shallwani, Nicola Limbucci, Salvatore Mangiafico, Caterina Michelozzi, Timo Krings, Vitor Mendes Pereira, Charles C Matouk, Yuchen Zhang, Mark R Harrigan, Hakeem J Shakir, Adnan H Siddiqui, Elad I Levy, Leonardo Renieri, Christophe Cognard, Ajith J Thomas, Thomas R Marotta
BACKGROUND: Flow diversion for basilar apex aneurysms has rarely been reported. OBJECTIVE: To assess flow diversion for basilar apex aneurysms in a multicenter cohort. METHODS: Retrospective review of prospectively maintained databases at 8 academic institutions was performed from 2009 to 2016 to identify patients with basilar apex aneurysms treated with flow diversion. Clinical and radiographic data were analyzed. RESULTS: Sixteen consecutive patients (median age 54...
February 26, 2018: Neurosurgery
Fawaz Al-Mufti, Kalina Anna Misiolek, David Roh, Aws Alawi, Andrew Bauerschmidt, Soojin Park, Sachin Agarwal, Philip M Meyers, E Sander Connolly, Jan Claassen, J Michael Schmidt
BACKGROUND: Immune dysregulation has long been implicated in the development of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To determine the relationship of inflammatory cell biomarkers with DCI. METHODS: We evaluated 849 aSAH patients who were enrolled into a prospective observational cohort study and had a white blood cell (WBC) differential obtained within 72 h of bleed onset. RESULTS: WBC count > 12...
March 8, 2018: Neurosurgery
Martijn L Dijkstra, Tryfon Vainas, Clark J Zeebregts, Lotty Hooft, Maarten J van der Laan
INTRODUCTION: The incidence of spinal cord ischaemia (SCI) and subsequent paraplegia after thoracic endovascular aneurysm repair (TEVAR) and thoraco-abdominal endovascular aneurysm repair is estimated to be between 2.5% and 8%. The aim of this review is to provide an overview of SCI preventive strategies in TEVAR and thoraco-abdominal repair and recommend an optimal strategy. METHODS: Medline, Embase, and the Cochrane Library were searched for studies on TEVAR, thoraco-abdominal endovascular repair, and the use of SCI preventive measures...
March 7, 2018: European Journal of Vascular and Endovascular Surgery
Hélène Raoult, François Eugène, Anthony Le Bras, Géraldine Mineur, Béatrice Carsin-Nicol, Jean-Christophe Ferré, Jean-Yves Gauvrit
BACKGROUND AND PURPOSE: The WEB is an innovative flow disruption device for cerebral aneurysm embolization with rapidly expanding indications. Our purpose was to evaluate the diagnostic performance of CTA at 1-year follow-up of aneurysms treated with the WEB. MATERIALS AND METHODS: Between April 2014 and May 2016, the study prospectively included patients treated with the WEB at our institution, and followed up within 24hours by CTA and at 1 year by CTA, TOF MRA and DSA...
March 7, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Masaomi Koyanagi, Hitoshi Fukuda, Masaaki Saiki, Yoshihito Tsuji, Benjamin Lo, Toshinari Kawasaki, Yoshihiko Ioroi, Ryu Fukumitsu, Ryota Ishibashi, Masashi Oda, Osamu Narumi, Masaki Chin, Sen Yamagata, Susumu Miyamoto
OBJECTIVE Shunt-dependent hydrocephalus (SDHC) may arise after aneurysmal subarachnoid hemorrhage (aSAH) as CSF resorptive mechanisms are disrupted. Using propensity score analysis, the authors aimed to investigate which treatment modality, surgical clipping or endovascular treatment, is superior in reducing rates of SDHC after aSAH. METHODS The authors' multicenter SAH database, comprising 3 stroke centers affiliated with Kyoto University, Japan, was used to identify patients treated between January 2009 and July 2016...
March 9, 2018: Journal of Neurosurgery
Björn Pasternak, Malin Inghammar, Henrik Svanström
OBJECTIVE: To investigate whether oral fluoroquinolone use is associated with an increased risk of aortic aneurysm or dissection. DESIGN: Nationwide historical cohort study using linked register data on patient characteristics, filled prescriptions, and cases of aortic aneurysm or dissection. SETTING: Sweden, July 2006 to December 2013. PARTICIPANTS: 360 088 treatment episodes of fluoroquinolone use (78%ciprofloxacin) and propensity score matched comparator episodes of amoxicillin use (n=360 088)...
March 8, 2018: BMJ: British Medical Journal
Jingwei Zhao, Xuying Luo, Zheng Zhang, Kai Chen, Guangzhi Shi, Jianxin Zhou
OBJECTIVE: To explore the application value of short latency somatosensory evoked potentials (SLSEP) as a tool for preoperative assessment of surgical or interventional treatment in patients with severe aneurysmal subarachnoid hemorrhage (aSAH). METHODS: A prospective observational cohort study was conducted. The patients with severe aSAH with a WFNS grade of IV or V admitted to intensive care unit (ICU) of Beijing Tiantan Hospital of Capital Medical University from November 2016 to April 2017 were enrolled...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Anja Püschel, Rasmus Ebel, Patricia Fuchs, Janet Hofmann, Jochen K Schubert, Jan P Roesner, Stefan Bergt, Andreas Wree, Brigitte Vollmar, Ernst Klar, Carsten M Bünger, Sabine Kischkel
BACKROUND: Paraplegia due to spinal cord ischemia (SCI) is a serious complication after repair of thoraco-abdominal aortic aneurysms. For prevention and early treatment of spinal ischemia intraoperative monitoring of spinal cord integrity is essential. This study was intended to improve recognition of SCI through a combination of transcranial motor-evoked potentials (tc-MEPs), serum markers and innovative breath analysis. METHODS: In nine female German landrace pigs, tc-MEPs were captured, markers of neuronal damage were determined in blood and volatile organic compounds (VOCs) were analysed in exhaled air...
March 5, 2018: Annals of Vascular Surgery
Robert Fahed, Tim E Darsaut, Marc Kotowski, Igor Salazkin, Jean Raymond
Aim Flow diverters are increasingly used to treat aneurysms, but treatment is not always effective. The management of aneurysms that fail to occlude following flow diversion is problematic. We aimed to reproduce failures in an animal model and study re-treatment with additional flow diverters alone or with flow diverters and liquid embolic agent. Material and methods Twenty wide-necked aneurysms were created at the carotid-lingual bifurcation in 10 dogs, and were treated with flow diverters 4-6 weeks later...
January 1, 2018: Neuroradiology Journal
Jesse Manunga, Timothy Sullivan, Ross Garberich, Peter Alden, Jason Alexander, Nedaa Skeik, Jessica Titus, Elliott Stephenson, Andrew Cragg
OBJECTIVE: The objective of this study was to evaluate outcomes of patients with complex abdominal aortic aneurysms (cAAAs) treated with open repair (OR) or fenestrated/branched endovascular aneurysm repair (F/B-EVAR) from a single center. METHODS: A retrospective analysis of consecutive patients with cAAAs treated electively by OR or F/B-EVAR between January 2010 and February 2017 was conducted. Demographics of the patients, cardiovascular risk factors, procedure time, number of vessels incorporated, radiation dose, estimated blood loss, intensive care unit (ICU) length of stay (LOS), and hospital LOS were recorded...
March 3, 2018: Journal of Vascular Surgery
Barış Akça, Nevzat Erdil, Mehmet Cengiz Colak, Olcay Murat Disli, Bektas Battaloglu, Cemil Colak
BACKGROUND:  We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. METHODS:  This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study...
March 6, 2018: Thoracic and Cardiovascular Surgeon
Jung Hyun Park, Hoon Kim, Seong Rim Kim, Ik Seong Park, Min Seok Byeon, Young Woo Kim
BACKGROUND: To investigate the association between headache outcomes and coil embolization and to identify potential factors associated with different headache outcomes in patients with unruptured intracranial aneurysms (UIAs) after treatment with coil embolization. METHODS: A prospective study of patients with planned coil embolization for UIAs was conducted. The changes in headache patterns, headache-related disability, and depression were assessed before coil embolization and at 3 days and 2 and 6 weeks after coil embolization...
March 3, 2018: World Neurosurgery
Masaru Miura, Tohru Kobayashi, Tetsuji Kaneko, Mamoru Ayusawa, Ryuji Fukazawa, Naoya Fukushima, Shigeto Fuse, Kenji Hamaoka, Keiichi Hirono, Taichi Kato, Yoshihide Mitani, Seiichi Sato, Shinya Shimoyama, Junko Shiono, Kenji Suda, Hiroshi Suzuki, Jun Maeda, Kenji Waki, Hitoshi Kato, Tsutomu Saji, Hiroyuki Yamagishi, Aya Ozeki, Masako Tomotsune, Makiko Yoshida, Yohei Akazawa, Kentaro Aso, Shouzaburoh Doi, Yoshi Fukasawa, Kenji Furuno, Yasunobu Hayabuchi, Miyuki Hayashi, Takafumi Honda, Norihisa Horita, Kazuyuki Ikeda, Masahiro Ishii, Satoru Iwashima, Masahiro Kamada, Masahide Kaneko, Hiroshi Katyama, Yoichi Kawamura, Atushi Kitagawa, Akiko Komori, Kenji Kuraishi, Hiroshi Masuda, Shinichi Matsuda, Satoshi Matsuzaki, Sayaka Mii, Tomoyuki Miyamoto, Yuji Moritou, Noriko Motoki, Kiyoshi Nagumo, Tsuneyuki Nakamura, Eiki Nishihara, Yuichi Nomura, Shohei Ogata, Hiroyuki Ohashi, Kenichi Okumura, Daisuke Omori, Tetsuya Sano, Eisuke Suganuma, Tsutomu Takahashi, Shinichi Takatsuki, Atsuhito Takeda, Masaru Terai, Manatomo Toyono, Kenichi Watanabe, Makoto Watanabe, Masaki Yamamoto, Kenichiro Yamamura
Importance: Few studies with sufficient statistical power have shown the association of the z score of the coronary arterial internal diameter with coronary events (CE) in patients with Kawasaki disease (KD) with coronary artery aneurysms (CAA). Objective: To clarify the association of the z score with time-dependent CE occurrence in patients with KD with CAA. Design, Setting, and Participants: This multicenter, collaborative retrospective cohort study of 44 participating institutions included 1006 patients with KD younger than 19 years who received a coronary angiography between 1992 and 2011...
March 5, 2018: JAMA Pediatrics
Francesco Gianfagna, Giovanni Veronesi, Matteo Tozzi, Antonino Tarallo, Rossana Borchini, Marco M Ferrario, Lorenza Bertù, Andrea Montonati, Patrizio Castelli
OBJECTIVES: Prevalence data on abdominal aortic aneurysm (AAA) in women, subjects younger than 65 years and in subgroups carrying specific risk factors are scarce. AAA prevalence was evaluated in an Italian population including women and younger subjects, stratifying for the presence of cardiovascular disease (CVD) risk factors and CVD risk score. MATERIALS AND METHODS: A population based cross-sectional study was conducted between 2013 and 2016. Men aged 50-75 and women aged 60-75 years, resident in the city of Varese (northern Italy), were randomly selected from the civil registry...
March 2, 2018: European Journal of Vascular and Endovascular Surgery
Yuanming Luo, Zhiwei Fan, Stephen Baek, Jia Lu
Machine learning was applied to classify tension-strain curves harvested from inflation tests on ascending thoracic aneurysm samples. The curves were classified into rupture and non-rupture groups using pre-rupture response features. Two groups of features were used as the basis for classification. The first was the constitutive parameters fitted from the tension-strain data and the second was geometric parameters extracted from the tension-strain curve. Based on the importance scores provided by the machine learning, implications of some features were interrogated...
March 4, 2018: International Journal for Numerical Methods in Biomedical Engineering
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