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Carotid artery surgery

Jung Hoon Kim, Joonho Chung, Seung Kon Huh, Keun Young Park, Dong Joon Kim, Byung Moon Kim, Jae Whan Lee
OBJECTIVES: Therapeutic strategies for residual or recurrent aneurysm (RRA) after microsurgical clipping have not been well established. The purpose of this study was to report our retreatment experiences with previously clipped aneurysms and to demonstrate retreatment strategies for these RRAs. PATIENTS AND METHODS: From 1996-2016, we treated 68 RRAs after previous clipping. Among them, 34 patients underwent microsurgical retreatment, and the other 34 underwent endovascular retreatment...
August 6, 2018: Clinical Neurology and Neurosurgery
Andrew W Francis, Ivy Zhu, Sidhiporn Borirakchanyavat, Daniel M Schwartz, David G Hwang
PURPOSE: To report a central retinal artery occlusion with cilioretinal artery sparing in a 48-year-old woman after laser-assisted in situ keratomileusis surgery. METHODS: Case history and clinical examination including best-corrected visual acuity, serum markers, slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus photography, fluorescein angiography, and optical coherence tomography. RESULTS: A 48-year-old woman underwent routine laser-assisted in situ keratomileusis surgery in both eyes...
August 10, 2018: Retinal Cases & Brief Reports
Mazlum Sahin, Semi Öztürk, Tugba I Mert, Gündüz Durmuş, Mehmet Mustafa Can
OBJECTIVE: To assess  outcomes of Syrian refugees undergoing coronary artery bypass surgery in a tertiary hospital in Turkey. METHODS:  We sought for in-hospital mortality and one year all-cause mortality as the main outcomes. We reviewed records of 67 Syrian and 427 Turkish patients undergoing isolated coronary bypass surgery between 2015 January and 2017 January retrospectively.  Results: History of coronary, peripheral and carotid artery diseases and obesity were more frequent in Syrian patients...
July 2018: Saudi Medical Journal
Enes Yigit, Engin Dursun, Elif Omeroglu, Ahmet Volkan Sunter, Deniz Tuna Edizer, Suat Terzi, Zerrin Ozergin Coskun, Munir Demirci
PURPOSE: To evaluate the course of lower cranial nerves (CNs) within the neck in relation to surrounding structures and anatomic landmarks via a cadaveric dissection study. METHODS: A total of 70 neck dissections (31 bilateral, 8 unilateral) were performed on 39 adult fresh cadavers [mean (SD) age: 38.5 (11.2) years, 29 male, 10 female] to identify the course of lower CNs [spinal accessory nerve (SAN), vagus nerve and hypoglossal nerve] within the neck in relation to surrounding structures [internal jugular vein (IJV), common carotid artery (CCA)] and distance to anatomical landmarks (cricoid cartilage, hyoid bone, digastric muscle)...
August 13, 2018: European Archives of Oto-rhino-laryngology
Sara Anne Ruggiero, Jason Huber, Coral L Murrant, Keith R Brunt, Jeremy Andrew Simpson
During physiological stress (e.g. exercise, hypoxia) blood flow is shunted to specific anatomical regions to protect critical organs, yet, splenic blood flow in these circumstances remains to be investigated. Despite being classically viewed as a non-critical organ, recent experimental and epidemiological evidence suggests the spleen plays a significant role in cardiovascular pathophysiology. We hypothesized that splenic blood flow is prioritized in the development of heart failure (i.e. chronic state of reduced cardiac output)...
August 13, 2018: Canadian Journal of Physiology and Pharmacology
Sorin Aldea, Stephan Gaillard
The eyebrow approach is a versatile technique that may apply to various vascular and tumoral pathologies of the anterior skull base. We present a case of multiple aneurysms clipping through the eyebrow approach and we discuss the nuances of this technique. A 44-yr-old patient presented with incidentally found aneurysms. Angiography showed 2 4.5-mm aneurysms on the left middle cerebral artery (MCA) and internal carotid artery (ICA) bifurcations. At surgery, the patient is positioned supine with the head elevated, slightly rotated, and extended in order to obtain good access and gravity retraction of the brain...
August 8, 2018: Operative Neurosurgery (Hagerstown, Md.)
Zhewei Zhao, Chengran Lu, Tianjia Li, Wenda Wang, Wei Ye, Rong Zeng, Leng Ni, Zhichao Lai, Xuebin Wang, Changwei Liu
Carotid endarterectomy (CEA) is the treatment of choice for carotid stenosis. Some patients develop ischemia and reperfusion (I/R) injury after CEA. This study was designed to investigate the neuroprotective effects of melatonin on I/R injury in both rats and humans. To this end, 36 male rats were evaluated, and a double-blind randomized controlled trial (RCT) including 60 patients was performed. A rat model of middle cerebral artery occlusion (MCAO) was used to mimic cerebral I/R. After 2 hr of occlusion and 24 hr of reperfusion, blood samples and brain tissues were harvested for further assessments...
August 11, 2018: Journal of Pineal Research
Ali Tayebi Meybodi, Evgenii G Belykh, Joseph Aklinski, Pareena Kaur, Mark C Preul, Michael T Lawton
BACKGROUND: The end-to-side anastomosis is one of the most common anastomosis configurations used in cerebrovascular surgery. Whereas several living practice models have been proposed for this technique, few involve purely arterial vessels. OBJECTIVE: The purpose of this study is to compare two arterial models using common carotid (CCA) and common iliac arteries (CIA) in rats. METHODS: CIAs and CCAs were exposed in 10 anesthetized rats with their lengths and diameters measured...
August 7, 2018: World Neurosurgery
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Robert J Weil
OBJECTIVE The goal of this study was to compare outcomes of carotid endarterectomy performed by neurological, general, and vascular surgeons. METHODS The authors identified 80,475 patients who underwent carotid endarterectomy between 2006 and 2015 in the National Surgical Quality Improvement Program, a prospectively collected, national clinical database with established reproducibility and validity. Nine hundred forty-three patients were operated on by a neurosurgeon; 75,649 by a vascular surgeon; and 3734 by a general surgeon...
August 10, 2018: Journal of Neurosurgery
Alin Borha, Vincent Patron, Herve Huet, Evelyne Emery, Charlotte Barbier
BACKGROUND: Aneurysms of the petrosal segment of the internal carotid artery are rare in children and are usually found secondary to trauma and infection or can have a congenital origin. Management includes endovascular therapy, surgery, and in rare cases observation. DISCUSSION: Here, we report our experience with a giant petrous internal carotid artery aneurysm in a 16-year-old boy successfully managed endovascularly by parent artery occlusion.
August 9, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Fabio Ramponi, Michael Seco, James B Edelman, Andrew G Sherrah, Paul G Bannon, R John L Brereton, Michael K Wilson, Michael P Vallely
Coronary surgery performed on an arrested heart, using one internal mammary artery and a saphenous vein carries two main potential drawbacks: the known failure rate of vein grafts and the relatively high rate of neurologic injury. To address these concerns, we describe a technique that achieves complete revascularization without manipulating the ascending aorta (anaortic, off-pump) and utilizing total arterial grafts. All patients undergo thorough preoperative investigation, including bilateral carotid, vertebral and subclavian artery Duplex ultrasounds...
July 2018: Annals of Cardiothoracic Surgery
Shinjiro Fukami, Jiro Akimoto, Hirokazu Fukuhara, Michihiro Kohno
BACKGROUND: Oculomotor nerve palsy is occasionally a key indicator of an internal carotid posterior communicating artery (ICPC) bifurcation aneurysm. The interval between the onset of palsy and the time of surgery is considered to be the most important factor affecting recovery from oculomotor nerve palsy. We encountered a rare case of oculomotor nerve palsy due to compression by the infundibular dilatation of the posterior communicating artery (PcomA) rather than by an ICPC aneurysm...
August 6, 2018: World Neurosurgery
Hanna J Zając, Krzysztof Lachowski, Agnieszka Lis, Tomasz Kręcicki, Jerzy Garcarek, Maciej Guziński, Tomasz Zatoński
BACKGROUND: The proximity of the internal carotid artery to the pharyngeal wall poses a risk of injury during nasopharyngeal surgery. OBJECTIVES: The aim of this study was to assess the distances between the extracranial internal carotid artery (ICA) and the pharyngeal wall. MATERIAL AND METHODS: Measurements were taken on certain levels of the pharynx using computed tomography angiography (angio-CT) scans of 97 patients. One-tailed Student's t-test for independent variables and a comparison of expected values for dependent pairs of observations were applied...
August 7, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Cristian A Naudy, Juan C Yanez-Siller, Paulo M Mesquita Filho, Matias Gomez G, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
BACKGROUND: The origin of the ophthalmic artery is within the surgical field of endoscopic endonasal approaches (EEAs) to the suprasellar and parasellar regions. However, its anatomy from the endoscopic point-of-view has not been adequately elucidated. OBJECTIVE: To highlight the anatomy of the ophthalmic artery origin from an endoscopic endonasal perspective. METHODS: The origin of the ophthalmic artery was studied bilaterally under endoscopic visualization, after performing transplanum/transtubercular EEAs in 17 cadaveric specimens (34 arteries)...
July 31, 2018: Operative Neurosurgery (Hagerstown, Md.)
Bo Yu, ZhenHua Liu, Chao Xue, JinCheng Liu, Jian Yang, ZhenXiao Jin, ShiQiang Yu, WeiXun Duan
OBJECTIVES: The aim of this study was to evaluate the safety and feasibility of total arch repair with open placement of a novel double-branched stent graft for acute Type A aortic dissection (TAAD). METHODS: We retrospectively analysed the effect of the double-branched stent graft for total aortic arch placement with acute TAAD from December 2013 to February 2015. The effectiveness of the open placement of the double-branched stent graft was estimated by complete thrombus obliteration of the false lumen surrounding it on computed tomography angiography...
August 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Jeffrey B Edwards, Mathew D Wooster, Adam Tanious, Martin R Back
OBJECTIVE: Renal artery anomalies occur at a rate of 1-2% and present a challenge to vascular surgeons performing aortic surgery. We describe adjuncts used to manage such anatomic variants. METHODS: A single surgeon registry of all abdominal aortic aneurysms repaired in an academic center was retrospectively reviewed. Patients with prior renal transplants, congenital pelvic kidneys, or horseshoe kidneys were included. Open repair was reserved for patients with no endovascular or hybrid repair options...
August 3, 2018: Annals of Vascular Surgery
Eleonora G Karthaus, Anco Vahl, Laurien S Kuhrij, Bernard H P Elsman, Robert H Geelkerken, Michel W J M Wouters, Jaap F Hamming, Gert J de Borst
BACKGROUND: The Dutch Audit for Carotid Interventions (DACI) registers all patients undergoing interventions for carotid artery stenosis in the Netherlands. This study describes the design of the DACI and results of patients with a symptomatic stenosis undergoing carotid endarterectomy (CEA). It aimed to evaluate variation between hospitals in process of care and (adjusted) outcomes, as well as predictors of major stroke/death after CEA. METHODS: All patients with a symptomatic stenosis, who underwent CEA and were registered in the DACI between 2014 and 2016 were included in this cohort...
August 1, 2018: European Journal of Vascular and Endovascular Surgery
Alexander Zimmermann, Christoph Knappich, Pavlos Tsantilas, Michael Kallmayer, Sofie Schmid, Thorben Breitkreuz, Martin Storck, Andreas Kuehnl, Hans-Henning Eckstein
OBJECTIVE: There is currently no clear consensus regarding the optimal perioperative antiplatelet therapy regimen for carotid surgery. Therefore, associations between different antiplatelet therapies and the risk of stroke or death and perioperative complications after carotid endarterectomy on a national level in Germany were analyzed. METHODS: Overall, 117,973 elective carotid endarterectomies for asymptomatic or symptomatic carotid artery stenosis between 2010 and 2014 were included...
July 28, 2018: Journal of Vascular Surgery
Sami Asfar, Ali Shuaib, Fatemah Al-Otaibi, Sora Asfar, Narayana Kilarkaje
BACKGROUND: Arterial myointimal hyperplasia (MIH) has a significant impact on long-term outcomes of vascular procedures such as bypass surgery and angioplasty. In this study, we describe a new and innovative technique to induce MIH by using a dental flossing cachet in Wistar rats. METHODS: The intimal damage in the common carotid artery was induced by inserting the tip of the dental flossing cachet through the external carotid artery into the common carotid artery and turned on for three rounds of 20 seconds each (n = 10)...
July 31, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Hao Shen, Cheng Wang, Le Xie, Shoujun Zhou, Lixu Gu, Hongzhi Xie
BACKGROUND: In cerebrovascular intervention (CVI), the use of robots has considerable advantages over conventional surgery. This study introduces a remote-controlled robotic system, including the first in vivo proof-of-concept trial. METHODS: The robotic system uses a master-slave control strategy. Omega 3 was selected as the master manipulator, and the slave side executed the procedure of inserting the guidewire and balloon catheter, and angiography. The first in vivo trial was conducted to test whether the guidewire could be successfully moved from a pig's femoral artery to its carotid artery using our robotic system...
July 30, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
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