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Endovascular neurosurgery

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https://www.readbyqxmd.com/read/29180081/the-patient-size-setting-a-novel-dose-reduction-strategy-in-cerebral-endovascular-neurosurgery-using-biplane-fluoroscopy
#1
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. While 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. OBJECTIVE: 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 2015-16 academic year were identified, and estimated procedural air kerma (AK) tabulated retrospectively...
November 24, 2017: 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
#2
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
#3
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
#4
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
#5
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
#6
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...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28780715/innovation-in-neurosurgery-less-than-ideal-a-systematic-review
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28565978/off-label-uses-of-the-pipeline-embolization-device-a-review-of-the-literature
#12
Purvee D Patel, Nohra Chalouhi, Elias Atallah, Stavropoula Tjoumakaris, David Hasan, Hekmat Zarzour, Robert Rosenwasser, Pascal Jabbour
The Pipeline embolization device (PED) is the most widely used flow diverter in endovascular neurosurgery. In 2011, the device received FDA approval for the treatment of large and giant aneurysms in the internal carotid artery extending from the petrous to the superior hypophyseal segments. However, as popularity of the device grew and neurosurgeons gained more experience, its use has extended to several other indications. Some of these off-label uses include previously treated aneurysms, acutely ruptured aneurysms, small aneurysms, distal circulation aneurysms, posterior circulation aneurysms, fusiform aneurysms, dissecting aneurysms, pseudoaneurysms, and even carotid-cavernous fistulas...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28472526/glycoprotein-iib-iiia-inhibitors-in-prevention-and-rescue-treatment-of-thromboembolic-complications-during-endovascular-embolization-of-intracranial-aneurysms
#13
David Dornbos, Joel S Katz, Patrick Youssef, Ciarán J Powers, Shahid M Nimjee
Thromboembolic complications remain a major risk of endovascular neurosurgery during the treatment of intracranial aneurysms, despite the use of therapeutic heparinization and oral antiplatelet therapy when indicated. Glycoprotein (GP) IIb/IIIa inhibitors target a nonredundant pathway of platelet aggregation following adhesion and activation. Initially established and implemented in the cardiovascular arena, this drug class has provided a new tool in the neurovascular armamentarium as well. Numerous case reports, case series, and retrospective reviews have evaluated the safety and efficacy of abciximab, eptifibatide, and tirofiban in the treatment of acute thromboembolic complications during the endovascular treatment of intracranial aneurysms...
May 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28438655/assessing-the-relevancy-of-citation-classics-in-neurosurgery-part-ii-foundational-papers-in-neurosurgery
#14
REVIEW
Michael A Bohl, Jay D Turner, Andrew S Little, Peter Nakaji, Francisco A Ponce
BACKGROUND: The second part of this study reanalyzes Ponce and Lozano's (2010) list of classics to create a new list of "foundational" articles in neurosurgery. Ponce and Lozano (2010) previously published a list of 106 neurosurgery classics, as defined by Garfield and his 400 citation criterion. METHODS: We used the Web of Science citation reports to create graphs for each study showing the total citations it received as a function of time. Each graph was subjectively analyzed independently and scored as "foundational" or "classic only," based on whether the trend of citations received per year was uptrending, neutral, or downtrending...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28413524/perioperative-complications-in-endovascular-neurosurgery-anesthesiologist-s-perspective
#15
Megha U Sharma, Pragati Ganjoo, Daljit Singh, Monica S Tandon, Jyotsna Agarwal, Durga P Sharma, Anita Jagetia
BACKGROUND: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. METHODS: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28383672/cerebral-revascularization-for-aneurysms-in-the-flow-diverter-era
#16
David C Straus, Harley Brito da Silva, Lynn McGrath, Michael R Levitt, Louis J Kim, Basavaraj V Ghodke, Jason K Barber, Laligam N Sekhar
BACKGROUND: Cerebral bypass has been an important tool in the treatment of complex intracranial aneurysms. The recent advent of flow-diverting stents (FDS) has expanded the capacity for endovascular arterial reconstruction. OBJECTIVE: We investigated how the advent of FDS has impacted the application and outcomes of cerebral bypass in the treatment of intracranial aneurysms. METHODS: We reviewed a consecutive series of cerebral bypasses during aneurysm surgery over the course of 10 years...
May 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377249/trends-in-resident-operative-teaching-opportunities-for-treatment-of-intracranial-aneurysms
#17
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...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28257502/treatment-of-ruptured-intracranial-aneurysms-yesterday-and-now
#18
Alexander Hammer, Anahi Steiner, Ghassan Kerry, Gholamreza Ranaie, Ingrid Baer, Christian M Hammer, Stefan Kunze, Hans-Herbert Steiner
OBJECTIVE: This prospective study is designed to detect changes in the treatment of ruptured intracranial aneurysms over a period of 17 years. METHODS: We compared 361 treated cases of aneurysm occlusion after subarachnoid hemorrhage from 1997 to 2003 with 281 cases from 2006 to 2014. Specialists of neuroradiology and vascular neurosurgery decided over the modality assignment. We established a prospective data acquisition in both groups to detect significant differences within a follow-up time of one year...
2017: PloS One
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#19
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28191601/the-maxillary-artery-and-its-variants-an-anatomical-study-with-neurosurgical-applications
#20
Jorge E Alvernia, Joaquin Hidalgo, Marc P Sindou, Chad Washington, Gustavo Luzardo, Eddie Perkins, Remi Nader, Patrick Mertens
BACKGROUND: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures. OBJECTIVES: To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner. METHODS: Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques...
April 2017: Acta Neurochirurgica
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