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Cerebrovascular surgery

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https://www.readbyqxmd.com/read/28438597/massive-middle-cerebral-artery-infarction-after-surgically-assisted-rapid-palatal-expansion-a-case-report
#1
Kenneth Kufta, Luis Perez Melean, M Sean Grady, Neeraj Panchal
Dentofacial deformities have a marked impact on a patient's quality of life. Fortunately, these deformities often can be corrected through orthodontic and surgical treatment. In adults, transverse maxillary discrepancies are often corrected by performing a surgically assisted rapid palatal expansion (SARPE) procedure. This procedure is accompanied by many of the same complications involved in performing a Le Fort I osteotomy. Although major complications from maxillary surgery are uncommon, severe hemorrhage and cerebrovascular accidents are real risks accompanied by serious sequelae...
March 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28438308/cardiovascular-outcomes-with-surgical-left-atrial-appendage-exclusion-in-patients-with-atrial-fibrillation-who-underwent-valvular-heart-surgery-from-the-national-inpatient-sample-database
#2
Ayman Elbadawi, Odunayo Olorunfemi, Gbolahan O Ogunbayo, Marwan Saad, Islam Y Elgendy, Zainab Arif, Haytham Badran, Deola Saheed, Hamdy M A Ahmed, Mohan Rao
Left atrial appendage (LAA) exclusion is a commonly performed procedure to reduce the embolic events in patients with atrial fibrillation (AF) who underwent cardiac surgeries. Our study aimed to evaluate the in-hospital outcomes of LAA exclusion in patients with AF who underwent valvular heart surgeries. We queried the Nationwide Inpatient Sample Database from 1998 to 2013 for patients with the International Classification of Diseases, Ninth Edition, Clinical Modification, diagnosis codes for AF and underwent any valvular heart surgery...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28437813/presenting-symptoms-of-pituitary-apoplexy
#3
Efstratios-Stylianos Pyrgelis, Ioannis Mavridis, Maria Meliou
The classical term "pituitary apoplexy" (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#4
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28415082/p210long-term-outcome-of-primary-mitral-valve-prolapse-results-from-a-population-of-250-patients-referred-to-a-tertiary-cardiovascular-center
#5
V Mecarocci, F Mori
Background: Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Purpose: To make a contemporary survey on the incidence of cardiovascular events in a selected population of patients affected by primary MVP referred to a tertiary cardiovascular center for the medical and surgical care of valvular heart disease...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#6
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#7
Paul M Foreman, Mark R Harrigan
BACKGROUND: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI). The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. SUMMARY: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma...
April 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#8
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28393660/plasma-low-molecular-weight-thiol-disulphide-homeostasis-as-an-early-indicator-of-global-and-focal-cerebral-ischaemia
#9
Alexander Vladimirovich Ivanov, Valery Vasil'evich Alexandrin, Alexander Alexandrovich Paltsyn, Ksenya Alexandrovna Nikiforova, Edward Danielevich Virus, Boris Petrovich Luzyanin, Marina Yurievna Maksimova, Mikhail Aleksanrovich Piradov, Aslan Amirkhanovich Kubatiev
OBJECTIVE: Recent studies have shown that cerebral ischaemia causes not only local, but also systemic oxidative stress. This leads to oxidation of thiol-containing compounds, including low-molecular-weight thiols (cysteine, glutathione, homocysteine and others). Therefore, the aim of this work was to verify the hypothesis that the thiol/disulphide homeostasis of low-molecular-weight thiols is disturbed in the early stages of cerebral ischaemia. METHODS: Two experimental rat models of ischaemia were used: a global model of vascular ischaemia (clamping the common carotid arteries + haemorrhage) and focal ischaemia (middle cerebral artery occlusion)...
April 8, 2017: Redox Report: Communications in Free Radical Research
https://www.readbyqxmd.com/read/28389295/a-meta-analysis-of-long-term-mortality-and-associated-risk-factors-following-lower-extremity-amputation
#10
REVIEW
Jordan R Stern, Christopher Kevin Wong, Marina Yerovinkina, Stephanie J Spindler, Ashley S See, Samira Panjaki, Sarah L Loven, Rick F D'Andrea, Roman Nowygrod
BACKGROUND: A majority of patients undergoing lower limb amputations have diabetes or peripheral artery disease. Despite improvements in care, there remains a substantial perioperative mortality associated with these procedures. Less well-defined is the mortality risk to these patients going forward, once outside the perioperative period. The aim of this systematic review is to summarize and pool the available data in order to determine the long term mortality associated with amputation in the diabetic and peripheral vascular patient, as well as to define specific factors associated with increased mortality risk...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28387790/impact-of-dual-antiplatelet-therapy-after-coronary-artery-bypass-surgery-on-1-year-outcomes-in-the-arterial-revascularization-trial%C3%A2
#11
Umberto Benedetto, Douglas G Altman, Stephen Gerry, Alastair Gray, Belinda Lees, Marcus Flather, David P Taggart
OBJECTIVES: There is still little evidence to boldport routine dual antiplatelet therapy (DAPT) with P 2 Y 12 antagonists following coronary artery bypass grafting (CABG). The Arterial Revascularization Trial (ART) was designed to compare 10-year survival after bilateral versus single internal thoracic artery grafting. We aimed to get insights into the effect of DAPT (with clopidogrel) following CABG on 1-year outcomes by performing a post hoc ART analysis. METHODS: Among patients enrolled in the ART ( n  = 3102), 609 (21%) and 2308 (79%) were discharged on DAPT or aspirin alone, respectively...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28383858/-blunt-cerebrovascular-injury
#12
P Bouchat, F Pitance, F Damas, L Trippaerts
A blunt cerebrovascular injury (BCVI) can cause severe cerebral ischemic sequelae. The diagnosis is tricky and often entails a latency period. Adequate treatment at this time will dramatically reduce mortality and morbidity. The Denver protocol guides the selection of the patients to be screened. Current treatment is based on heparin, anticoagulant antiplatelet drugs, interventional radiology and surgery. The treatment is based on a dynamic strategy.
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28376706/cardiovascular-risk-reduction-is-important-for-improving-patient-and-graft-survival-after-ligation-and-bypass-surgery-for-popliteal-artery-aneurysm
#13
N Dattani, M Ali, A Aber, R Yap Kannan, E C Choke, M J Bown, R D Sayers, R S Davies
OBJECTIVES: To report outcomes following ligation and bypass (LGB) surgery for popliteal artery aneurysm (PAA) and study factors influencing patient and graft survival. MATERIALS AND METHODS: A retrospective review of patients undergoing LGB surgery for PAA between September 1999 and August 2012 at a tertiary referral vascular unit was performed. Primary graft patency (PGP), primary-assisted graft patency (PAGP), and secondary graft patency (SGP) rates were calculated using survival analyses...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28373177/glycemic-control-status-after-percutaneous-coronary-intervention-and-long-term-clinical-outcomes-in-patients-with-type-2-diabetes-mellitus
#14
Jin Kyung Hwang, Seung Hwa Lee, Young Bin Song, Joonghyun Ahn, Keumhee Carriere, Mi Ja Jang, Taek Kyu Park, Seung-Hyuk Choi, Jeong Hoon Yang, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND: Data on the association between glycemic control after percutaneous coronary intervention and clinical outcomes are limited and controversial in diabetic patients. METHODS AND RESULTS: We studied 980 patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention using drug-eluting stents. Based on 2-year glycosylated hemoglobin A (HbA1c) levels, we divided patients into 2 groups of HbA1c<7.0 (n=489) and HbA1c≥7.0 (n=491). Propensity score-matched analysis was performed in 322 pairs...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28370456/predictors-for-detrusor-overactivity-following-extensive-vaginal-pelvic-reconstructive-surgery
#15
Tsia-Shu Lo, Shailaja Nagashu, Wu-Chiao Hsieh, Ma Clarissa Uy-Patrimonio, Lin Yi-Hao
AIM: This study aims to identify the predictors for detrusor overactivity (DO) in women following extensive vaginal pelvic reconstructive surgery (PRS) for advanced pelvic organ prolapse (POP). METHODS: We enrolled 1503 women who had prolapse POP-Q stage ≥ 3 and underwent vaginal PRS with or without MUS from January 2006 to December 2015. All subjects completed a 72-h voiding diary, IIQ-7, UDI-6, POPDI-6, and PISQ-12. Urodynamics (UDS) was performed pre- and post-operatively...
March 31, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28369643/epicardial-clip-occlusion-of-the-left-atrial-appendage-during-cardiac-surgery-provides-optimal-surgical-results-and-long-term-stability%C3%A2
#16
Vojtech Kurfirst, Aleš Mokrácek, Júlia Canádyová, Radim Frána, Petr Zeman
OBJECTIVES: Occlusion of the left atrial appendage (LAA) has become an integral and important part of the surgical treatment of atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with varying levels of short- and long-term success for closure. The purpose of this study was to evaluate long-term results of epicardial placement and endocardial occlusion in patients undergoing cardiac operative procedures. METHODS: A total of 101 patients (average age 65...
March 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28368531/academic-productivity-of-us-neurosurgery-residents-as-measured-by-h-index-program-ranking-with-correlation-to-faculty-productivity
#17
Christopher A Sarkiss, Kyle J Riley, Christopher M Hernandez, Eric K Oermann, Travis R Ladner, Joshua B Bederson, Raj K Shrivastava
Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database...
March 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28357585/uneven-cerebral-hemodynamic-change-as-a-cause-of-neurological-deterioration-in-the-acute-stage-after-direct-revascularization-for-moyamoya-disease-cerebral-hyperperfusion-and-remote-ischemia-caused-by-the-watershed-shift
#18
Xian-Kun Tu, Miki Fujimura, Sherif Rashad, Shunji Mugikura, Hiroyuki Sakata, Kuniyasu Niizuma, Teiji Tominaga
Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the standard surgical treatment for moyamoya disease (MMD). The main potential complications of this treatment are cerebral hyperperfusion (CHP) syndrome and ischemia, and their managements are contradictory to each other. We retrospectively investigated the incidence of the simultaneous manifestation of CHP and infarction after surgery for MMD. Of the 162 consecutive direct revascularization surgeries performed for MMD, we encountered two adult cases (1...
March 29, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#19
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
March 15, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28323878/microsurgery-for-intracranial-arteriovenous-malformation-long-term-outcomes-in-445-patients
#20
Qingqing Ren, Min He, Yunhui Zeng, Zhiyong Liu, Hao Liu, Jianguo Xu
BACKGROUND: The management of intracranial arteriovenous malformations(AVMs) poses challenges to the cerebrovascular specialists. OBJECTIVE: To review the long-term outcomes of intracranial AVMs treated with microsurgical resections. METHODS: We performed a retrospective review of 445 patients with intracranial AVMs treated in our hospital from January 1st, 2008 to December 31st, 2014. The extracted data included demographic characteristics, clinical presentations, Spetzler-Martin (SM) grades, Supplemented Spetzler-Martin (SM-Supp) Grades, treatment modalities, long-term outcomes, and obliteration rates...
2017: PloS One
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