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Endovascular neurosurgery

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https://www.readbyqxmd.com/read/28472526/glycoprotein-iib-iiia-inhibitors-in-prevention-and-rescue-treatment-of-thromboembolic-complications-during-endovascular-embolization-of-intracranial-aneurysms
#1
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
#2
REVIEW
Michael A Bohl, Jay D Turner, Andrew S Little, Peter Nakaji, Francisco A Ponce
The second part of this study reanalyzes Ponce and Lozano's (2010) list of classics to create a new list of "foundational" papers in neurosurgery. Ponce and Lozano (2010) previously published a list of 106 neurosurgery classics, as defined by Garfield and his 400 citation criterion. 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...
April 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28413524/perioperative-complications-in-endovascular-neurosurgery-anesthesiologist-s-perspective
#3
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
#4
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...
April 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377249/trends-in-resident-operative-teaching-opportunities-for-treatment-of-intracranial-aneurysms
#5
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...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28257502/treatment-of-ruptured-intracranial-aneurysms-yesterday-and-now
#6
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
#7
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
#8
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...
February 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28165559/comparison-of-the-efficacy-of-surgical-clipping-and-embolization-for-oculomotor-nerve-palsy-due-to-a-posterior-communicating-artery-aneurysm
#9
G Gao, D-Q Gu, Y Zhang, J Yu, Y Chen, Y-J Chao, J-J Wei, X-M Fu, C-S Niu
OBJECTIVE: To aim at the efficacies of surgical clipping and endovascular embolization for oculomotor nerve palsy (ONP) as treatments for posterior communicating artery aneurysm (PcoAA), and the comparison and various influencing factors of the treatments. PATIENTS AND METHODS: An analysis of the clinical data of 52 enrolled PcoAA patients with ONP who had treatment in the Department of Neurosurgery in Anhui Provincial Hospital from January 2011 to June 2015 was conducted...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28163497/successful-endovascular-neurosurgical-practice-in-resource-poor-exclusive-rural-neuro-hospital-setup
#10
Kamble Jayaprakash Harsha
AIM: The aim of this study to evaluate the feasibility of establishing endovascular neurosurgery in remote resource-poor neuro-hospital setup and evaluate its outcome. MATERIALS AND METHODS: Retrospective analysis of diagnostic and therapeutic endovascular neurosurgical procedures performed during September 2013-June 2016. RESULTS: A total of 174 diagnostic cerebral and spinal digital subtraction angiograms and 70 major endovascular neurosurgeries were performed during the period...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28032181/transcardiac-migration-of-ventriculoperitoneal-shunt-requiring-open-cardiac-surgery-case-report-and-review-of-the-literature
#11
REVIEW
Ashley Ralston, Amanda Johnson, Gerhard Ziemer, David M Frim
INTRODUCTION: Cardiac migration of ventriculoperitoneal (VP) shunts has been reported, with most easily removed or shortened via a cervical incision. We present a review of the literature, highlighting our unique case with significant scarring requiring open, on-pump, cardiac surgery for removal of migrated distal tubing. CASE PRESENTATION: A 7-year-old boy underwent VP shunt insertion for hydrocephalus secondary to intracranial astrocytoma. He presented at age 17 with evidence of right heart strain, associated with the distal shunt catheter proximally migrated into his heart and pulmonary arteries...
April 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27813463/bypass-surgery-for-complex-middle-cerebral-artery-aneurysms-an-algorithmic-approach-to-revascularization
#12
Ali Tayebi Meybodi, Wendy Huang, Arnau Benet, Olivia Kola, Michael T Lawton
OBJECT Management of complex aneurysms of the middle cerebral artery (MCA) can be challenging. Lesions not amenable to endovascular techniques or direct clipping might require a bypass procedure with aneurysm obliteration. Various bypass techniques are available, but an algorithmic approach to classifying these lesions and determining the optimal bypass strategy has not been developed. The objective of this study was to propose a comprehensive and flexible algorithm based on MCA aneurysm location for selecting the best of multiple bypass options...
November 4, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27801398/-surgical-treatment-of-%C3%A2-mirror%C3%A2-aneurysms-of-the-internal-carotid-artery
#13
A O Sosnov, A V Dubovoi, V S Kiselev, D M Galaktionov, K S Ovsyannikov, A V Cherepanov, T K Istomina
BACKGROUND: A relatively high occurrence of "mirror" aneurysms of the anterior cerebral circulation in neurosurgical practice necessitates generalization of experience of using different surgical approaches. The choice of treatment is usually associated with the number of surgical stages. MATERIAL AND METHODS: Forty nine patients (19 males and 30 females) with mirror aneurysms of the anterior circulation underwent one- and two-step surgery at the Novosibirsk Federal Center of Neurosurgery in 2013-2015...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27781115/unexpected-rupture-of-a-giant-lobulated-thrombotic-middle-cerebral-artery-aneurysm-and-emergency-surgical-treatment-with-thrombectomy-a-case-report-and-review-of-the-literature
#14
Vaner Koksal, Selim Kayaci
INTRODUCTION: The treatment of giant intracranial aneurysms is one of the most challenging cerebrovascular problems of neurosurgery. We report the rupture of a giant, lobulated, and almost completely thrombosed middle cerebral artery (MCA) aneurysm that is the ninth such report in the literature. We also investigated additional solutions used in the treatment of this patient. CASE PRESENTATION: A 58-year-old man had been admitted with headache 8 years previously (in 2005), and a giant MCA aneurysm was detected...
August 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/27766029/clinical-importance-of-the-middle-meningeal-artery-a-review-of-the-literature
#15
REVIEW
Jinlu Yu, Yunbao Guo, Baofeng Xu, Kan Xu
The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27733961/simulator-based-angiography-and-endovascular-neurosurgery-curriculum-a-longitudinal-evaluation-of-performance-following-simulator-based-angiography-training
#16
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
https://www.readbyqxmd.com/read/27637647/epidemiologic-survey-of-dural-arteriovenous-fistulas-in-japan-clinical-frequency-and-present-status-of-treatment
#17
Naoya Kuwayama
BACKGROUND AND PURPOSE: There are few reports describing the prevalence of dural arteriovenous fistulas (dAVFs). We conducted a nation-wide retrograde survey on the clinical frequency and the status of treatment of dAVFs in Japan. METHODS: The first questionnaire was sent to 1,236 certified neurosurgery clinics in Japan to ask about the number of patients treated and the location of dAVF during the 5 years from 1998 to 2002. The second questionnaire was sent to 102 large-volume centers to ask the patients' ages, gender, location of the fistula, clinical presentation, treatment modalities, clinical and radiological results, and recurrence...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27637646/intracranial-and-spinal-dural-arterio-venous-fistula-davf-a-surgical-series-of-107-patients
#18
Alessandro Bertuccio, Chiara Robba, Giannantonio Spena, Pietro Primo Versari
INTRODUCTION: Dural arteriovenous fistulas (DAVFs) is a challenging condition in vascular neurosurgery. Development of new endovascular techniques has progressively modified treatment strategies; however, surgery is still considered a valid option of treatment of this pathology. MATERIALS AND METHODS: From a retrospective analysis of our database, we selected 107 patients who underwent surgical treatment for DAVFs. Patients were grouped into five categories according to the Borden and Cognard classifications...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27637644/advances-in-embolization-of-bavms
#19
L Renieri, N Limbucci, S Mangiafico
Brain AVMs are complex malformations, usually congenital, that need a deep understanding of anatomy and pathophysiology to be safely treated. Nowadays, embolization and radiosurgery are carried out more frequently due to their reduced invasiveness as compared to conventional neurosurgery. This paper aims to describe different and new endovascular approaches that allow the interventionalist to treat almost all the small AVMs and to reduce the nidus of the bigger ones in order to facilitate the surgical or radiosurgical intervention...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27593685/early-brain-injury-or-vasospasm-an-overview-of-common-mechanisms
#20
Basak Topkoru, Emrah Egemen, Ihsan Solaroglu, John Zhang
Subarachnoid hemorrhage (SAH) following rupture of an intracranial is associated with high mortality and morbidity. The late deterioration of the patient's neurological status or late cognitive dysfunctions even after secure clipping or decent endovascular treatment which is defined as delayed ischemic neurological deficits recently has been attributed to vasospasm. Due to the failure of specific anti-vasospastic agents in clinical trials researchers focused to explore new pathological mechanisms to be responsible for the delayed deterioration of the patients suffering from SAH...
September 5, 2016: Current Drug Targets
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