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Cerebrovascular surgery

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https://www.readbyqxmd.com/read/28228887/transarterial-embolization-of-a-hyperfunctioning-aldosteronoma-in-a-patient-with-bilateral-adrenal-nodules
#1
Jason T Salsamendi, Francisco J Gortes, Alejandro R Ayala, Juan D Palacios, Sanjit Tewari, Govindarajan Narayanan
Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. The patient presented with a cerebrovascular accident, and subsequently developed uncontrolled hypertension, hypokalemia, and a myocardial infarction...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28224216/vascular-surgery-the-main-risk-factor-for-mortality-in-146-takayasu-arteritis-patients
#2
Nilton Salles Rosa Neto, Samuel Katsuyuki Shinjo, Maurício Levy-Neto, Rosa Maria Rodrigues Pereira
Takayasu arteritis (TA) is an idiopathic chronic inflammatory disease that affects the aorta and its main branches. According to disease involvement, patients may require surgical treatment mainly due ischemic lesions in association with medical therapy. We evaluated the impact of vascular interventions in a cohort of TA patients. Medical records from 146 TA patients were reviewed. Clinical features, medical, and surgical treatment were revised and disease activity was determined by clinical, laboratorial, and imaging parameters...
February 21, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28222969/patient-tumour-and-treatment-factors-affect-complication-rates-in-soft-tissue-sarcoma-flap-reconstruction-in-a-synergistic-manner
#3
J Slump, P C Ferguson, J S Wunder, A M Griffin, H J Hoekstra, X Liu, S O P Hofer, A C O'Neill
INTRODUCTION: Flap reconstruction plays an essential role in the management of soft tissue sarcoma, facilitating wide resection while maximizing preservation of function. The addition of reconstruction increases the complexity of the surgery and identification of patients who are at high risk for post-operative complications is an important part of the preoperative assessment. This study examines predictors of complications in these patients. METHODS: 294 patients undergoing flap reconstruction following sarcoma resection were evaluated...
February 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28215461/the-use-of-ultrasound-for-postoperative-monitoring-of-cerebral-bypass-grafts-a-technical-report
#4
Ryan P Morton, Isaac Joshua Abecassis, Anne E Moore, Cory M Kelly, Michael R Levitt, Louis J Kim, Laligam N Sekhar
Duplex ultrasound and transcranial Doppler are valuable tools for post-operative monitoring of extracranial-intracranial cerebral bypass grafts. Here we describe our technique for the evaluation of both high-flow and low-flow cerebral bypass grafts over a nine year period. 186 bypass grafts were studied daily during the inpatient period between Jan 2005 and Dec 2014 after surgery for various cerebrovascular pathologies. There was a technical success rate of 97%. Duplex ultrasonographic flow measurements had excellent interobserver reliability with an intraclass correlation coefficient (ICC) of 0...
February 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28209313/the-arborization-bypass-sequential-intracranial-intracranial-bypasses-for-an-unruptured-fusiform-mca-aneurysm
#5
Jonathan J Russin
Revascularization techniques are being featured more prominently as endovascular treatments continue to select out complex cerebrovascular pathologies for open surgical management. The current healthcare environment requires decreased hospital stays and improved clinical outcomes despite the growing complexity of open surgical cases. Recent efforts to reduce operative room time and decrease risk for bypass surgery have focused on avoiding graft harvest and maintaining the entire bypass intracranial. The presented technique features an arborization bypass to serially anastomose the middle cerebral artery vessels allowing for proximal trapping of a complex aneurysm without graft harvest...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28207907/argon-does-not-affect-cerebral-circulation-or-metabolism-in-male-humans
#6
Frank Grüne, Stephan Kazmaier, Sanne Elisabeth Hoeks, Robert Jan Stolker, Marc Coburn, Andreas Weyland
OBJECTIVE: Accumulating data have recently underlined argon´s neuroprotective potential. However, to the best of our knowledge, no data are available on the cerebrovascular effects of argon (Ar) in humans. We hypothesized that argon inhalation does not affect mean blood flow velocity of the middle cerebral artery (Vmca), cerebral flow index (FI), zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe), resistance area product (RAP) and the arterio-jugular venous content differences of oxygen (AJVDO2), glucose (AJVDG), and lactate (AJVDL) in anesthetized patients...
2017: PloS One
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#7
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28191623/the-ivy-sign-on-fluid-attenuated-inversion-recovery-images-related-to-single-photon-emission-computed-tomography-cerebral-blood-flow-in-moyamoya-disease-a-case-report
#8
Fumihiro Matano, Yasuo Murai, Asami Kubota, Takayuki Mizunari, Shiro Kobayashi, Akio Morita
BACKGROUND: Moyamoya disease is an idiopathic progressive cerebrovascular steno-occlusive disorder characterized by the formation of numerous collaterals called moyamoya vessels. Accurate evaluation of vascular status and CBF is needed for prompt treatment to prevent ischemic and/or hemorrhagic events. The pathogenesis of the ivy sign on fluid attenuated inversion recovery (FLAIR) images of moyamoya disease patients is unclear. We report a moyamoya disease case wherein the ivy sign changed in relation to SPECT-measured CBF during progression and following treatment...
January 17, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#9
Kyle M Fargen, Hector E Soriano-Baron, Julia T Rushing, William Mack, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Maxim Mokin, Italo Linfante, Stacey Q Wolfe, John A Wilson, Joshua A Hirsch
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section...
February 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28180100/surgical-outcomes-of-forearm-loop-arteriovenous-fistula-formation-using-tapered-versus-non-tapered-polytetrafluoroethylene-grafts
#10
Sun Han, Pil Won Seo, Jae-Wook Ryu
BACKGROUND: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4-6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. METHODS: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25)...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28180098/analysis-of-risk-factors-for-conversion-from-off-pump-to-on-pump-coronary-artery-bypass-graft
#11
Junghyeon Lim, Won Yong Lee, Yong Joon Ra, Jae Han Jeong, Ho Hyun Ko
BACKGROUND: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. METHODS: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group)...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28153617/the-susceptibility-pathogenesis-of-the-moyamoya-disease
#12
Juntao Hu, Jie Luo, Qianxue Chen
Moyamoya disease (MMD) is a cerebrovascular disease characterized by progressive stenosis of the intracranial internal carotid arteries and their proximal branches. Epidemiologically, MMD is more prevalent in east Asia than any region worldwide, which have been estimated at 0.94 per 100 000 in Japanese and 0.43 per 100,000 in Chinese.However, the etiology of this rare disease remains unknown. Regarding biomarkers of moyamoya disease, moyamoya disease is characterized by an increased expression of angiogenic factors and pro-inflammatory molecules such as vascular endothelial growth factors and matrix metalloproteinase-9, which may partly explain its clinical manifestations of the pathologic angiogenesis, spontaneous hemorrhage, and higher incidence of cerebral hyperperfusion after revascularization surgery...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28137542/developing-the-first-highly-specialized-neurosurgical-center-of-excellence-in-trujillo-peru-work-in-progress-first-four-months-results
#13
Joham Choque-Velasquez, Roberto Colasanti, Virginia Baffigo-Torre, Luisa Estela Sacieta-Carbajo, Jacqueline Olivari-Heredia, Yolanda Falcon-Lizaraso, Juan Huber Mallma-Torres, Humberto Elera-Florez, Juha Hernesniemi
BACKGROUND: Economic, cultural, and geographical reasons usually limit the access to specialized health centers in developing countries, especially in rural areas. Peruvian health system indicators still highlight significant unmet clinical need for neurosurgical patients. Our project is to develop the first highly specialized neurosurgical center in the EsSalud hospital of Trujillo, with the goal to improve the treatment of neurosurgical diseases in that region, thus optimizing their outcomes while decreasing expensive and risky patients transfer to the neurosurgical departments in the capital district...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28123477/dexmedetomidine-alleviates-cerebral-ischemia-induced-short-term-memory-impairment-by-inhibiting-the-expression-of-apoptosis-related-molecules-in-the-hippocampus-of-gerbils
#14
In-Young Choi, Lakkyong Hwang, Jun-Jang Jin, Il-Gyu Ko, Sung-Eun Kim, Mal-Soon Shin, Key-Moon Shin, Chang-Ju Kim, Sung-Wook Park, Jin-Hee Han, Jae-Woo Yi
Cerebral ischemia results from cerebrovascular occlusion, which leads to neuronal cell death and eventually causes neurological impairments. Dexmedetomidine is a potent and highly selective α2-adrenoreceptor agonist with actions such as sedation, anxiolysis, analgesia and anesthetic-sparing effects. We investigated the effect of dexmedetomidine on apoptosis in the hippocampus after transient global ischemia in gerbils. Transient global ischemia was induced by ligation of both common carotid arteries. Dexmedetomidine was administrated intraperitoneally at three respective doses (0...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28121201/trigeminocardiac-reflex-in-cerebrovascular-surgery-a-review-and-an-attempt-of-a-predictive-analysis
#15
Nora Sandu, Tumul Chowdhury, Cyrill Meuwly, Bernhard Schaller
Trigemino-cardiac reflex (TCR) is a well-established neurogenic reflex that is primarily observed in many neurosurgical procedures, especially skull base surgery. Few management strategies have been highlighted in the literature; however, controversies still exist related to this topic. Areas covered: The authors present for the first time the results of a multivariable analysis to predict the TCR during cerebrovascular surgery. However, such first statistical results have not yet any impact on the treatment of the TCR, as correlation is not the cause...
January 25, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28119405/impact-of-gender-on-long-term-outcomes-after-surgical-repair-for-acute-stanford-a-aortic-dissection-a-propensity-score-matched-analysis%C3%A2
#16
Anton Sabashnikov, Stephanie Heinen, Antje Christin Deppe, Mohamed Zeriouh, Alexander Weymann, Ingo Slottosch, Kaveh Eghbalzadeh, Aron-Frederik Popov, Oliver Liakopoulos, Parwis B Rahmanian, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, André R Simon, Thorsten Wahlers, Jens Wippermann
OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching...
January 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28112459/deep-sedation-vs-general-anesthesia-in-232-patients-undergoing-percutaneous-mitral-valve-repair-using-the-mitraclip-%C3%A2-system
#17
Patrick Horn, Katharina Hellhammer, Michael Minier, Monika A Stenzel, Verena Veulemans, Tienush Rassaf, Peter Luedike, Julia Pohl, Jan Balzer, Tobias Zeus, Malte Kelm, Ralf Westenfeld
OBJECTIVES: To investigate in a series of 232 patients whether the MitraClip(®) procedure can be performed safely using deep sedation (DS) without general anesthesia (GA). BACKGROUND: Transcatheter mitral valve repair using the MitraClip(®) system is a safe and effective therapy for severe mitral regurgitation (MR) in patients who are at high operative risk or are unsuitable for surgery. For these patients, avoidance of GA might be beneficial. METHODS: Between 2011 and 2015, we performed 232 MitraClip(®) procedures for the treatment of severe MR...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28109683/incidence-and-risk-factors-of-delirium-in-patients-after-type-a-aortic-dissection-surgery
#18
Zhengqin Liu, Xinyan Pang, Xiquan Zhang, Guangqing Cao, Changcun Fang, Shuming Wu
OBJECTIVE: To study the incidence and related risk factors for postoperative delirium after type-A aortic dissection in patients who underwent Sun's procedure (total arch replacement using a tetrafurcate graft with stented elephant trunk implantation). DESIGN: A retrospective study. SETTING: A cardiac surgical intensive care unit. PARTICIPANTS: The study comprised 100 patients admitted to the intensive care unit for type-A aortic dissection...
November 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#19
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#20
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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