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Endovascular neurosurgery

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https://www.readbyqxmd.com/read/29807446/the-use-of-flow-diverters-to-treat-aneurysms-of-the-posterior-inferior-cerebellar-artery-report-of-three-cases
#1
Pervinder Bhogal, Jorge Chudyk, Carlos Bleise, Ivan Lylyk, Hans Henkes, Pedro Lylyk
Objective The objective of this study was to report our experience on the use of flow diverting stents placed within the posterior inferior cerebellar artery (PICA) as a treatment option for aneurysms of the PICA. Methods Three patients with aneurysms of the PICA, both ruptured and unruptured, underwent treatment of their aneurysms with placement of a single flow diverter in the PICA across the neck of the aneurysm. Adjunctive techniques such as coiling were not used. We present the angiographic and clinical follow-up data...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29796313/microvascular-anastomosis-training-in-neurosurgery-a-review
#2
REVIEW
Vadim A Byvaltsev, Serik K Akshulakov, Roman A Polkin, Sergey V Ochkal, Ivan A Stepanov, Yerbol T Makhambetov, Talgat T Kerimbayev, Michael Staren, Evgenii Belykh, Mark C Preul
Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques...
2018: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/29764206/management-of-incidental-aneurysms-comparison-of-single-centre-multi-disciplinary-team-decision-making-with-the-unruptured-incidental-aneurysm-treatment-score
#3
Alex Smedley, Nate Yusupov, Alaa Almousa, Thomas Solbach, Ahmed K Toma, Joan P Grieve
OBJECTIVE: To compare multidisciplinary team (MDT) decision making at our centre with the suggested management from the recently published Unruptured Intracranial Aneurysm Treatment Score (UIATS), with particular focus on disagreements between the two bodies of expert opinion. DESIGN: A retrospective audit of local practice. SUBJECTS: Adult patients with incidental cerebral saccular aneurysms referred to The National Hospital for Neurology and Neurosurgery Neurovascular MDT...
May 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29747898/trends-of-the-neurosurgical-economy-in-the-united-states
#4
William C Johnson, Ali Seifi
BACKGROUND: The objective of this study was to identify the neurosurgical MS-DRGs highest national bills and to analyze economic, demographic, and patient outcome trends. METHODS: This retrospective cohort study used the Nationwide Inpatient Sample (NIS) database to achieve the results. All MS-DRG codes for the years 2014 were ranked based on total aggregate charges. The highest ranked relevant to neurosurgery were identified and retrospectively reviewed to 2008...
May 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29742889/intraoperative-neurophysiological-monitoring-a-review-of-techniques-used-for-brain-tumor-surgery-in-children
#5
REVIEW
Keewon Kim, Charles Cho, Moon-Suk Bang, Hyung-Ik Shin, Ji-Hoon Phi, Seung-Ki Kim
Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues...
May 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29712519/systematic-review-of-health-economic-studies-in-cranial-neurosurgery
#6
Won Hyung A Ryu, Michael M H Yang, Sandeep Muram, W Bradley Jacobs, Steven Casha, Jay Riva-Cambrin
OBJECTIVE As the cost of health care continues to increase, there is a growing emphasis on evaluating the relative economic value of treatment options to guide resource allocation. The objective of this systematic review was to evaluate the current evidence regarding the cost-effectiveness of cranial neurosurgery procedures. METHODS The authors performed a systematic review of the literature using PubMed, EMBASE, and the Cochrane Library, focusing on themes of economic evaluation and cranial neurosurgery following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29519377/a-multidisciplinary-approach-on-the-perioperative-antithrombotic-management-of-patients-with-coronary-stents-undergoing-surgery-surgery-after-stenting-2
#7
REVIEW
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29482708/caroticocavernous-fistula-successful-reversal-by-endovascular-treatment
#8
Muhammad Mateen Amir, Naveen Abubakar Bugvi
A 22-year male presented in outpatient department with right sided proptosis and chemosis, after a roadside accident two months back. He was on treatment for orbital cellulitis and taking steroids with antibiotics, both orally and topically. He was also on topical antiglaucoma agents. Detailed examination revealed bruit on auscultation. On magnetic resonance imaging (MRI), dilated superior ophthalmic vein led to diagnosis of caroticocavernous fistula (CCF) and the patient was referred to Neurosurgery Department of Lahore General Hospital (LGH), Lahore, where digital subtraction angiography (DSA) and balloon catheterization by a radiologist in the same sitting, resulted in successful closure of fistula and amelioration of all the signs and symptoms within six weeks...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29351626/neuroendovascular-fellowship-training-self-assessment-of-a-program-accredited-by-the-committee-on-advanced-subspecialty-training
#9
Hakeem J Shakir, Hussain Shallwani, Leonardo Rangel-Castilla, Amade Bregy, Jason M Davies, Ashish Sonig, Christopher S Ogilvy, Kenneth V Snyder, L Nelson Hopkins, Adnan H Siddiqui, Elad I Levy
The University at Buffalo's neuroendovascular fellowship is one of the longest running fellowship programs in North America. The burgeoning neurointerventional workforce and the rapid growth in the neurointerventional space on the heels of groundbreaking clinical trials prompted us to assess the fellowship's academic impact and its graduates' perceptions and productivity. An anonymized web-based survey was sent to all former neuroendovascular fellows with specific questions pertaining to current practice, research and funding, and perceptions about the fellowship's impact on their skills, competitiveness, and compensation...
March 1, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29180081/the-patient-size-setting-a-novel-dose-reduction-strategy-in-cerebral-endovascular-neurosurgery-using-biplane-fluoroscopy
#10
Brian M Corliss, Jeffrey Bennett, Meghan M Brennan, Azar Rosemaryam, Cory Hartman, William R Stetler, Adam J Polifka, Brian L Hoh, Manuel M Arreola, W Christopher Fox
BACKGROUND: In some fluoroscopy machines, the dose-rate output of the fluoroscope is tied to a selectable patient size. Although patient size may play a significant role in visceral or cardiac procedures, head morphology is less variable, and high dose outputs may not be necessary even in very obese patients. We hypothesized that very small patient size setting can be used to reduce dose for cerebral angiography without compromising image quality. METHODS: Patients who underwent endovascular neurosurgical procedures during the 2015-2016 academic year were identified, and estimated procedural air kerma (AK) was tabulated retrospectively...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29068600/application-of-the-functional-capacity-scale-in-the-early-assessment-of-functional-efficiency-in-patients-after-aneurysm-embolization-preliminary-reports
#11
COMPARATIVE STUDY
Robert Ślusarz, Monika Biercewicz, Barbara Smarszcz, Maria Szewczyk, Joanna Rosińczuk, Maciej Śniegocki
BACKGROUND: While data on the long-term (e.g., 1 year and subsequent years) outcomes of intracranial aneurysms treatment is relatively well-documented mainly in the clinical aspect (comparability of treatment, mortality, and complications), little is known about the early results, in terms of the functional outcome. OBJECTIVES: The aim of the study was to analyze the use of Functional Capacity Scale (FCS) in the evaluation of patients in the early period after endovascular treatment of intracranial aneurysms...
September 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28987196/overview-of-neuroradiology
#12
REVIEW
Elna-Marie Larsson, Johan Wikström
Neuroradiology with computed tomography (CT) and magnetic resonance imaging (MRI) is essential for the initial evaluation of patients with a clinical suspicion of brain and spine disorders. Morphologic imaging is required to obtain a probable diagnosis to support the treatment decisions in pre- and perinatal disorders, vascular diseases, traumatic injuries, metabolic disorders, epilepsy, infection/inflammation, neurodegenerative disorders, degenerative spinal disease, and tumors of the central nervous system...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28931265/diagnostic-and-interventional-optical-angioscopy-in-ex-vivo-carotid-arteries
#13
Luis E Savastano, Neeraj Chaudhary, Carlos Murga-Zamalloa, Michael Wang, Thomas Wang, B Gregory Thompson
BACKGROUND: Angioscopy - or endovascular endoscopy - is a catheter-based technique employing a flexible fiberoptic angioscope to directly visualize arterial lumen. Poor resolution and excessive stiffness of pre-existent angioscopes limited their use clinically. Recent advances resulted in novel fused optical fiber bundle angioscopes with improved flexibility and imaging resolution. Use of these devices in endovascular neurosurgery is still largely unexplored. OBJECTIVE: To evaluate image quality and feasibility of optical angioscopes for diagnostic and interventional neuro-angioscopy in carotid arteries of human cadavers...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28867583/-hybrid-operating-room-for-what
#14
M Benoit, A Bouvier, P Bigot
Hybrid operating rooms (HOR) are rooms that mix interventional radiology and surgical equipments. They are usually used in heart, vascular, orthopedic and neurosurgery, and make it possible to consider new minimally invasive procedures in urology. Thanks to these, we developed a new partial nephrectomy technique without renal pedicle clamping and without ischemia. Renal cancer is now diagnosed at localized stage in most of the cases, and its treatment is mostly based on nephron sparing surgery. However, the hemorrhagic character of this intervention requires a renal pedicle clamping whose long-term consequences on renal function are discussed...
November 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28821626/current-applications-and-future-perspectives-of-robotics-in-cerebrovascular-and-endovascular-neurosurgery
#15
REVIEW
Simon A Menaker, Sumedh S Shah, Brian M Snelling, Samir Sur, Robert M Starke, Eric C Peterson
Advances in robotic medicine have been adopted by various surgical subspecialties as the benefits of this technology become more readily apparent: precision in narrow operative windows, tremor controlled movements, and modestly improved outcomes, among others. Vascular neurosurgery, in particular, remains open to newer and more cutting edge treatment options for complex pathologies, and robotics may be on the horizon for such advances. We seek to provide a broad overview of these innovations in vascular neurosurgery for both practitioners well acquainted with robotics and those seeking to become more familiar...
January 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28780715/innovation-in-neurosurgery-less-than-ideal-a-systematic-review
#16
REVIEW
I S Muskens, S J H Diederen, J T Senders, A H Zamanipoor Najafabadi, W R van Furth, A M May, T R Smith, A L Bredenoord, M L D Broekman
BACKGROUND: Surgical innovation is different from the introduction of novel pharmaceuticals. To help address this, in 2009 the IDEAL Collaboration (Idea, Development, Exploration, Assessment, Long-term follow-up) introduced the five-stage framework for surgical innovation. To evaluate the framework feasibility for novel neurosurgical procedure introduction, two innovative surgical procedures were examined: the endoscopic endonasal approach for skull base meningiomas (EEMS) and the WovenEndobridge (WEB device) for endovascular treatment of intracranial aneurysms...
October 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28593889/circonscript-subcutaneous-arteriovenous-malformation-of-the-head
#17
Vladimir Mirchevski, Elizabeta Zogovska, Aleksandar Chaparoski, Venko Filipce, Milenko Kostov, Mirko Mishel Mirchevski
The aim of this study is to show the various possibilities to treat this rare malformation, accentuating the results of the early surgical treatment before complications. MATERIAL: The authors present 8 cases of patients with subcutaneous arteriovenous malformations, 5 females and 3 males (age of 7, 13, 19, 23, 27, 52 and 58 years) treated in the period of 1999 until 2015 at the Clinic for Neurosurgery and the Clinic for Plastic, Aesthetic and Reconstructive Surgery in Skopje, Republic of Macedonia...
March 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28589068/endovascular-treatment-of-large-unruptured-fusiform-fenestrated-vertebrobasilar-junction-aneurysm
#18
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/28579600/incidence-management-and-short-term-outcome-of-stroke-in-a-general-population-of-1-4-million-japanese%C3%A3-shiga-stroke-registry
#19
Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Naomi Miyamatsu, Masaru Komori, Yoshihisa Sugimoto, Satoru Nagata, Katsuyuki Miura, Kazuhiko Nozaki
BACKGROUND: This study determined the current status of the incidence, management, and prognosis of stroke in Japan using a population-based stroke registry.Methods and Results:Shiga Stroke Registry is an ongoing population-based registry that covers approximately 1.4 million residents of Shiga Prefecture. Cases of acute stroke were identified using standard definitions through surveillance of both all acute-care hospitals with neurology/neurosurgery facilities and death certificates in 2011...
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28565988/postprocedural-midterm-and-long-term-results-of-cerebral-aneurysms-treated-with-flow-diverter-devices-7-year-experience-at-a-single-center
#20
Francesco Briganti, Giuseppe Leone, Luigi Cirillo, Oreste de Divitiis, Domenico Solari, Paolo Cappabianca
OBJECTIVE Flow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period. METHODS The authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed...
June 2017: Neurosurgical Focus
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