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Ruptured aneurysm

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https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#1
Vladimír Beneš, Lubomír Jurák, Radim Brabec, Nina Nechanická, Miroslav Šercl, Ladislav Endrych, Pavel Buchvald, Petr Suchomel
BACKGROUND: Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. METHODS: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS)...
January 20, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28108425/increased-age-associated-with-reduced-likelihood-of-recurrence-after-coiling-of-ruptured-aneurysms
#2
Lorenzo Rinaldo, Giuseppe Lanzino
OBJECTIVE: The effect of patient age on the likelihood of recurrence of ruptured aneurysms after endovascular coil embolization is not well understood. Our aim was to compare the incidence of aneurysmal recurrence after coiling between young and old patients. METHODS: We performed a retrospective cohort study on patients presenting to our institution with a ruptured intracranial aneurysm treated with endovascular coiling. Aneurysm recurrence was defined as a Modified Raymond Roy Classification (MRRC) grade of 3A or 3B on follow-up angiography performed on first follow-up angiography...
January 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#3
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28106497/association-of-renin-angiotensin-system-genetic-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage
#4
Christoph J Griessenauer, R Shane Tubbs, Paul M Foreman, Michelle H Chua, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Ramaswamy Iyer, Rishikesh Haridas, Beverly C Walters, Salman Chaudry, Aisana Malieva, Samantha Wilkins, Mark R Harrigan, Winfield S Fisher, Mohammadali M Shoja
OBJECTIVE Renin-angiotensin system (RAS) genetic polymorphisms are thought to play a role in cerebral aneurysm formation and rupture. The Cerebral Aneurysm Renin-Angiotensin System (CARAS) study prospectively evaluated common RAS polymorphisms and their relation to aneurysmal subarachnoid hemorrhage (aSAH). METHODS The CARAS study prospectively enrolled aSAH patients and controls at 2 academic centers in the United States. A blood sample was obtained from all patients for genetic evaluation and measurement of plasma angiotensin-converting enzyme (ACE) concentration...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28104941/dacron-graft-aneurysm-with-dissection
#5
Asik Ali Mohamed Ali, Praveen Sharma, Rujuta N Rege, Saveetha Rajesh, Kulasekaran Nadhamuni
Dacron grafts have been used as a conduit for large caliber arteries for many years successfully. However, these grafts can undergo complications such as aneurysm formation, rupture, and failure. Evaluation of these complications are of paramount importance because of its tendency to rupture and cause death. Imaging plays an important role in identifying and monitoring of these complications, and also provides a road map to the vascular surgeons for early intervention and revascularization.
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28102102/impact-of-thoracic-endovascular-aortic-repair-on-pulsatile-circumferential-and-longitudinal-strain-in-patients-with-aneurysm
#6
Foeke J H Nauta, Guido H W van Bogerijen, Chiara Trentin, Michele Conti, Ferdinando Auricchio, Frans L Moll, Joost A van Herwaarden, Santi Trimarchi
PURPOSE: To quantify both pulsatile longitudinal and circumferential aortic strains before and after thoracic endovascular aortic repair (TEVAR), potentially clarifying TEVAR-related complications. METHODS: This retrospective study assessed the impact of TEVAR on pulsatile aortic strains through custom developed software and cardiac-gated computed tomography imaging of 8 thoracic aneurysm patients (mean age 71.0±8.2 years; 6 men) performed before TEVAR and during follow-up (median 0...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28101173/particularly-interesting-cys-his-rich-protein-is-highly-expressed-in-human-intracranial-aneurysms-and-resists-aneurysmal-rupture
#7
Yu-Tao Peng, Xiang-En Shi, Zhi-Qiang Li, Xin He, Yu-Ming Sun
Particularly interesting Cys-His-rich protein (PINCH) has several biological functions in cancer development, invasion and metastasis in malignant cells, and the expression of PINCH is upregulated in several cancer types, including breast cancer, gastric adenocarcinoma and rectal cancer. However, the contribution of PINCH to human cerebral aneurysms remains largely unknown. Therefore, the significance of PINCH expression in cerebral aneurysm growth and rupture was examined in the present study. The protein expression levels of alpha-smooth muscle actin, osteopontin (OPN), matrix metalloproteinase (MMP) 9 and PINCH were evaluated using immunohistochemistry and western blot analyses...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28100857/-clinical-features-and-findings-in-patients-with-unruptured-intracranial-aneurysms-aged-%C3%A2-80-years
#8
Tetsuhiro Kamo, Naoki Akioka, Daina Kashiwazaki, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
OBJECTIVE: It is difficult to decide whether to treat unruptured intracranial aneurysm(UIA)in elderly patients aged ≥80 years because they have potentially shorter life expectancy and risks related to treatment. Here, we report the results of the treatment of patients aged ≥80 years. METHODS: A retrospective review was performed in patients who underwent surgical or endovascular treatment between April 2012 and December 2015 at our institution. RESULTS: Between April 2012 and December 2015 we treated 130 UIA patients who presented with 145 aneurysms and 12 patients who presented with 14 aneurysms, who were aged ≥80 years...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28097189/is-the-sac-waiting-to-rupture-sinus-of-valsalva-aneurysm
#9
Ankur Phatarpekar, Milind Phadke, Charan Lanjewar, Prafulla Kerkar
Completely asymptomatic sinus of Valsalva aneurysms are rare entities, and there is no consensus regarding their management. We present the case of a patient who underwent atrial septal defect device closure at 5 years of age and was lost to follow-up, then presented 6 years later with unruptured sinus of Valsalva aneurysm and was closely followed. The aneurysm eventually ruptured and was successfully operated on with good outcomes.
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28096831/predeployed-aortic-extension-cuff-kilt-in-evar-with-hostile-neck-anatomy-using-endurant-ii-system-preliminary-results
#10
Krzysztof Szaniewski, Magdalena Biernacka, Ryszard L Walas, Marian Zembala
INTRODUCTION: Various modifications of standard endovascular aortic aneurysm repair (EVAR) have been developed to solve the problem of difficult neck anatomy. AIM: The authors propose the implantation of a predeployed extension cuff (kilt) using on-shelf Endurant II elements. In a vast majority of cases, the proposed method provides a solution for the hostile neck problem using standard Endurant II elements available in all centers performing subrenal EVAR procedures...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28096478/demographic-procedural-and-30-day-safety-results-from-the-web-intra-saccular-therapy-study-web-it
#11
David Fiorella, Andrew Molyneux, Alexander Coon, Istvan Szikora, Isil Saatci, Feyyaz Baltacioglu, Ali Sultan, Adam Arthur
INTRODUCTION: The Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). The WEB-IT Study is a pivotal Investigational Device Exemption (IDE) study to determine the safety and effectiveness of the WEB device for the treatment of WNBAs located in the anterior and posterior intracranial circulations. We present the patient demographics, procedural characteristics, and 30-day adverse event data for the US WEB-IT study...
January 17, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28095402/a-general-shear-dependent-model-for-thrombus-formation
#12
Alireza Yazdani, He Li, Jay D Humphrey, George Em Karniadakis
Modeling the transport, activation, and adhesion of platelets is crucial in predicting thrombus formation and growth following a thrombotic event in normal or pathological conditions. We propose a shear-dependent platelet adhesive model based on the Morse potential that is calibrated by existing in vivo and in vitro experimental data and can be used over a wide range of flow shear rates ([Formula: see text]). We introduce an Eulerian-Lagrangian model where hemodynamics is solved on a fixed Eulerian grid, while platelets are tracked using a Lagrangian framework...
January 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28094007/obtaining-the-biomechanical-behavior-of-ascending-aortic-aneurysm-via-the-use-of-novel-speckle-tracking-echocardiography
#13
Mohammed Alreshidan, Nastaran Shahmansouri, Jennifer Chung, Vynka Lash, Alexander Emmott, Richard L Leask, Kevin Lachapelle
INTRODUCTION: Ex vivo measurement of ascending aortic biomechanical properties may help understand the risk for rupture or dissection of dilated ascending aortas. A validated in vivo method that can predict aortic biomechanics does not exist. Speckle tracking transesophageal echocardiography (TEE) has been used to measure ventricular stiffness; we sought to determine whether speckle TEE could be adapted to estimate aortic stiffness in vivo and compare these findings with those obtained by ex vivo tissue measurements...
December 20, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28091826/paradigms-for-single-patient-multimodality-treatment-for-cerebral-aneurysms-single-center-eleven-year-experience
#14
Abdullah Alobaid, Erez Nossek, Katherine Wagner, Avi Setton, Amir R Dehdashti, David Langer, David Chalif
Endovascular and surgical techniques are conventional options for treating intracranial aneurysms, but criteria for selecting an optimal approach for individual patients remain variable across practitioners and institutions. While endovascular and surgical approaches are generally used alone, both modalities combined in single patients can produce efficacious outcomes. The aim of this study was to evaluate outcomes of combined, concomitant endovascular and surgical modalities in the treatment of multiple and/or complex aneurysms in single patients...
January 14, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28089197/long-term-follow-up-analysis-of-microsurgical-clip-ligation-and-endovascular-coil-embolization-for-dorsal-wall-blister-aneurysms-of-the-internal-carotid-artery
#15
Mason A Brown, Cristian F Guandique, Jonathan Parish, Aubrey C McMillan, Stephen Lehnert, Nassir Mansour, Michael Tu, Bradley N Bohnstedt, Troy D Payner, Thomas J Leipzig, Andrew J DeNardo, John A Scott, Aaron A Cohen-Gadol
: Blister aneurysms at non-branching sites of the dorsal internal carotid artery (dICA) are fragile, rare, and often difficult to treat. The purpose of this study is to address the demographics, treatment modalities, and long-term outcome of patients treated for dICA blister aneurysms. A retrospective review of medical records identified all consecutive patients who presented with a blister aneurysm from 2002 to 2011 at our institution. Eighteen patients (M=7, F=11; mean age: 48.4±15...
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28088803/small-versus-large-ruptured-intracranial-aneurysm-concerns-with-the-site-of-aneurysm
#16
Bum Joon Kim, Hyun Goo Kang, Byeong-Duk Kwun, Jae-Sung Ahn, Jisung Lee, Sung Ho Lee, Dong-Wha Kang, Jong S Kim, Sun U Kwon
BACKGROUND: Although size is one of the strongest predictors, small aneurysms often rupture. We compared the characteristics of small and large ruptured intracranial aneurysms (RIAs) according to their location to find the factors associated with small RIAs in each location. METHODS: Patients with subarachnoid hemorrhage due to saccular RIAs were consecutively enrolled. The sizes were dichotomized as small (<5 mm) or large, and the location was classified as paraclinoid-distal internal carotid artery, sidewalls of anterior or middle cerebral artery (MCA; sidewall), MCA-bifurcation, anterior or posterior communicating artery (Acom or Pcom, respectively), and posterior circulation RIAs...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28087488/cathepsin-k-targeted-sub-micron-particles-for-regenerative-repair-of-vascular-elastic-matrix
#17
Brenton Jennewine, Jonathan Fox, Anand Ramamurthi
: Abdominal Aortic Aneurysms (AAA) involve slow dilation and weakening of the aortic wall due to breakdown of structural matrix components, such as elastic fibers by chronically overexpressed matrix metalloproteinases (MMPs), primarily, MMPs-2 and -9. Auto-regenerative repair of disrupted elastic fibers by smooth muscle cells (SMCs) at the AAA site is intrinsically poor and together with chronic proteolysis prevents restoration of elastin homeostasis, necessary to enable AAA growth arrest or regression to a healthy state...
January 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28087432/stenting-after-coiling-using-a-single-microcatheter-for-treatment-of-ruptured-intracranial-fusiform-aneurysms-with-parent-arteries-less-than-1-5-mm-in-diameter
#18
Jian Liu, Yisen Zhang, Yang Wang, Shiqing Mu, Xinjian Yang
BACKGROUND: Ruptured intracranial fusiform aneurysms involving small-diameter parent arteries are difficult to treat. Parent artery occlusion is a relatively simple and reliable treatment. However, occasionally, the parent arteries have to be retained. The arrival of the low-profile stent (LVIS(TM) Jr.) has made reconstructive endovascular treatment for fusiform aneurysms involving small-diameter parent arteries possible. CASE DESCRIPTION: This report describes an innovative method for stent-assisted coiling (stenting after coiling technique using only one microcatheter), and describes our initial experience and feasibility of this technique...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28087184/clinical-characteristics-of-ruptured-distal-middle-cerebral-artery-aneurysms-review-of-the-literature
#19
REVIEW
Keiji Tsutsumi, Tetsuyoshi Horiuchi, Alhusain Nagm, Yasuyuki Toba, Kazuhiro Hongo
Middle cerebral artery (MCA) aneurysms usually arise at the primary MCA bifurcation or trifurcation. Distal MCA aneurysms are rarely considered as sources of aneurysmal subarachnoid hemorrhage (SAH). It has been reported that ruptured distal MCA aneurysms are associated with head trauma, neoplastic emboli, arterial dissection, or bacterial infection. We experienced five cases of ruptured distal MCA aneurysms and evaluated their clinical characteristics. Retrospective analysis of aneurysmal SAH at Kobayashi Neurosurgical Neurological Hospital was performed from January, 2004 to December, 2014...
January 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28079664/multidose-adenosine-used-to-facilitate-microsurgical-clipping-of-a-cerebral-aneurysm-complicated-by-intraoperative-rupture-a-case-report
#20
Ryan Vealey, Antoun Koht, Bernard Bendok
In some cases of cerebral aneurysm clipping, direct clip application to the aneurysm neck may be difficult or the aneurysm may rupture unexpectedly. In these cases, a clip may be temporarily applied to the parent artery to reduce aneurysmal wall tension, facilitate permanent clip placement, or control bleeding if the aneurysm ruptures. In certain circumstances, even applying a temporary clip may be challenging. We present a case in which the aneurysm ruptured and IV administration of adenosine was required to facilitate clipping...
January 11, 2017: A & A Case Reports
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