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Cerebrovascular surgery

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https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#1
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29454185/preterm-infants-undergoing-laparotomy-for-necrotizing-enterocolitis-or-spontaneous-intestinal-perforation-display-evidence-of-impaired-cerebrovascular-autoregulation
#2
Sara J Kuik, Michelle E van der Laan, Margot T Brouwer-Bergsma, Jan B F Hulscher, Anthony R Absalom, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Preterm infants requiring surgery are at risk of impaired neurocognitive development caused, possibly, by cerebral ischemia associated with impaired cerebrovascular autoregulation (CAR). We evaluated CAR before, during, and after laparotomy. STUDY DESIGN: This was a hypothesis generating prospective observational cohort study. SUBJECTS: We included preterm infants requiring surgery for necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP)...
February 14, 2018: Early Human Development
https://www.readbyqxmd.com/read/29443766/meta-analysis-study-comparing-percutaneous-coronary-intervention-drug-eluting-stent-versus-coronary-artery-bypass-surgery-of-unprotected-left-main-coronary-artery-disease-clinical-outcomes-during-short-term-versus-long-term-1-year-follow-up
#3
Waleed E Ali, Satyanarayana R Vaidya, Sylvester U Ejeh, Kingsley U Okoroafor
BACKGROUND: Results on the safety and long-term efficacy of drug-eluting stent placement in unprotected left main coronary artery disease (ULMCAD) compared with those of coronary artery bypass surgery (CABG) remain inconsistent across randomized clinical trials and recent meta-analysis studies. We aimed to compare the clinical outcomes and safety over short- and long-term follow-ups by conducting a meta-analysis of large pooled data from randomized controlled trials and up-to-date observational studies...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29441169/perioperative-stroke-pathophysiology-and-management
#4
REVIEW
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29435269/current-understanding-of-chronic-total-occlusion-of-the-internal-carotid-artery
#5
Baofeng Xu, Chao Li, Yunbao Guo, Kan Xu, Yi Yang, Jinlu Yu
At present, there is limited understanding of chronic total occlusion (CTO) of the internal carotid artery (ICA). Therefore, the present report collected related cases from PubMed and reviewed the literature. Cerebral vessels may form collateral circulation immediately or gradually following CTO of the ICA. The natural history of CTO of the ICA includes a variety of outcomes, all of which are biased toward a non-benign progressive process and are characterized by insufficient cerebral perfusion, embolus detachment and cognitive dysfunction...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29430423/mid-term-results-of-minimally-invasive-direct-coronary-artery-bypass-grafting
#6
Dong Hyun Seo, Jun Sung Kim, Kay-Hyun Park, Cheong Lim, Su Ryeun Chung, Dong Jung Kim
Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data-including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention-were collected...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29416208/gigantic-thrombus-of-the-left-atrium-in-mitral-stenosis
#7
Enisa Hodzic, Nermir Granov
Introduction: Excess dilatation of the left atrium >65 mm is known in the literature as gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the left right shunt with cardiac insufficiency. Case report: In this paper is presented a case study of echocardiographically verified giant thrombus in left atrium in a 50 years old female patient aged 50 hospitalized because of tiredness, choking, heartburn and urinary tract symptoms...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29415505/in-vivo-evaluation-of-cerebral-hemodynamics-and-tissue-morphology-in-rats-during-changing-fraction-of-inspired-oxygen-based-on-spectrocolorimetric-imaging-technique
#8
Afrina Mustari, Takuya Kanie, Satoko Kawauchi, Shunichi Sato, Manabu Sato, Yasuaki Kokubo, Izumi Nishidate
During surgical treatment for cerebrovascular diseases, cortical hemodynamics are often controlled by bypass graft surgery, temporary occlusion of arteries, and surgical removal of veins. Since the brain is vulnerable to hypoxemia and ischemia, interruption of cerebral blood flow reduces the oxygen supply to tissues and induces irreversible damage to cells and tissues. Monitoring of cerebral hemodynamics and alteration of cellular structure during neurosurgery is thus crucial. Sequential recordings of red-green-blue (RGB) images of in vivo exposed rat brains were made during hyperoxia, normoxia, hypoxia, and anoxia...
February 6, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29405596/hybrid-coronary-revascularization-time-for-a-new-comparator
#9
EDITORIAL
Naoki Misumida, David J Moliterno
The present meta-analysis found no significant difference between hybrid coronary revascularization (HCR) and bypass surgery (CABG) regarding intermediate-term major adverse cardiac and cerebrovascular events. HCR is feasible, historically with higher revascularization rates but less perioperative morbidity With a comparable frequency of repeat revascularization between current-generation drug-eluting stents and CABG, future trials of HCR are considering multi-vessel PCI as the new comparator.
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29405536/sacrifice-and-extracranial-reconstruction-of-the-common-or-internal-carotid-artery-in-advanced-head-and-neck-carcinoma-review-and-meta-analysis
#10
Leif J J Bäck, Katri Aro, Laura Tapiovaara, Pirkka Vikatmaa, Remco de Bree, Verónica Fernández-Álvarez, Luiz P Kowalski, Iain J Nixon, Alessandra Rinaldo, Juan P Rodrigo, K Thomas Robbins, Carl E Silver, Carl H Snyderman, Carlos Suárez, Robert P Takes, Alfio Ferlito
BACKGROUND: Sacrifice and reconstruction of the carotid artery in cases of head and neck carcinoma with invasion of the common or internal carotid artery is debated. METHODS: We conducted a systematic search of electronic databases and provide a review and meta-analysis. RESULTS: Of the 72 articles identified, 24 met the inclusion criteria resulting in the inclusion of 357 patients. The overall perioperative 30-day mortality was 3.6% (13/357)...
February 5, 2018: Head & Neck
https://www.readbyqxmd.com/read/29402768/spotty-carotid-plaques-are-associated-with-inflammation-and-the-occurrence-of-cerebrovascular-symptoms
#11
Sanela Halak, Gerd Östling, Andreas Edsfeldt, Cecilia Kennbäck, Magnus Dencker, Isabel Gonçalves, Giuseppe Asciutto
BACKGROUND: Echolucent carotid plaques have been related to an increased risk of ischemic cerebrovascular events. The aim of the present study was to evaluate whether a new objective ultrasonographic parameter, the statistical geometric feature (SGF), reflecting spottiness of carotid plaques, can be associated with cerebrovascular symptoms and with a rupture-prone plaque phenotype. METHODS: The plaques of 144 patients who underwent carotid endarterectomy were included in this study...
January 15, 2018: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29399070/analysis-of-the-clinical-value-of-fractional-flow-reserve-for-prognosis-evaluation-of-patients-of-percutaneous-coronary-intervention
#12
Qingxia Zhao, Zheng Ji, Xia Li, Yali Di, Haojun An, Bin Wei, Liming Yang, Wensheng Chen
We investigated the clinical value of fractional flow reserve (FFR) for the prognostic evaluation of patients with percutaneous coronary intervention. We enrolled 120 patients who were admitted to the hospital to undergo percutaneous coronary intervention for acute coronary syndromes between May 2014 and June 2015. The 120 patients were divided into two groups, the observation group and the control group, according to the post-surgery level of FFR. Each cohort contained 60 patients. These patients were divided into the occurrence group (n=45) and the non-occurrence group (n=75), classified according to the occurrence of major adverse cardiovascular events (MACE)...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29397139/management-of-antiplatelet-therapy-in-patients-with-coronary-stents-undergoing-noncardiac-surgery-association-with-adverse-events
#13
A Rodriguez, N Guilera, A Mases, P Sierra, J C Oliva, C Colilles
BACKGROUND: Perioperative discontinuation of antiplatelet therapy (APT) in patients with coronary stents has been associated with major adverse cardiac events. Our aim was to analyse the perioperative management of APT in such patients and its relationship to the incidence of major adverse cardiac and cerebrovascular events (MACCE) and major bleeding events (MBE) in noncardiac surgery. METHODS: We completed a prospective multicentre observational study of patients with coronary stents undergoing noncardiac surgery in 11 hospitals in Spain...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29394733/-surgical-treatment-for-extremely-elderly-patients-over-90-years-of-age-with-stage-iv-colorectal-cancer-a-report-of-four-cases
#14
Tetsunori Yoshimura, Eisuke Yamamoto, Sakiko Yabe, Taiki Masuda, Hitoshi Sugimoto, Haruya Koshiishi
We report 4 cases ofStage IV colorectal cancer patients over 90 years ofage who received surgical treatment. All of 4 cases were right-sided advanced colon cancer(1 case had also recto-sigmoid advanced cancer)and were received emergency operation. Two cases received resection ofprimary tumors and anastomosis, the other 2 cases received only ileostomy or colostomy. Three cases were able to be discharged from hospital successfully, but unfortunately, we lost one case because of cerebrovascular complication after surgery...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29392458/cerebrovascular-events-in-takayasu-arteritis-a-multicenter-case-controlled-study
#15
Priscille Couture, Thibaud Chazal, Charlotte Rosso, Julien Haroche, Anne Léger, Baptiste Hervier, Sandrine Deltour, Zahir Amoura, Fleur Cohen Aubart
OBJECTIVES: Takayasu arteritis (TA) is a giant cell arteritis usually affecting young women and characterized by inflammatory and ischemic signs of large vessel involvement, including extracranial cerebral arteries. The impact of stroke on TA prognosis has not been well evaluated. METHODS: We performed a retrospective multicenter review of patients with definite TA who experienced at least one stroke and compared the findings to 17 matched patients with TA diagnosis without neurological involvement...
February 1, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29387434/beating-heart-minimally-invasive-mitral-valve-surgery-in-patients-with-previous-sternotomy-the-operative-technique-and-early-outcomes
#16
Robert B Xu, Mohammad Rahnavardi, Mart Nadal, Fabiano Viana, Robert G Stuklis, Michael Worthington, James Edwards
Objective: Reoperative mitral valve surgery is increasingly required and can be associated with significant morbidity and mortality. The beating heart minimally invasive mitral valve surgery has a proposed benefit in avoiding the risks of repeat sternotomy, with reducing the need for adhesiolysis and cardioplegia reperfusion injury. We describe our experience with such a technique in patients with previous sternotomy. Methods: A retrospective study was performed and all patients undergoing surgery of mitral valve through a right limited thoracotomy without application of an aortic cross-clamp (beating heart) as a redo cardiac surgery between January 2006 and January 2015 were included (n=25)...
2018: Open Heart
https://www.readbyqxmd.com/read/29383984/preoperatively-reduced-cerebrovascular-contractile-reactivity-to-hypocapnia-by-hyperventilation-is-associated-with-cerebral-hyperperfusion-syndrome-after-arterial-bypass-surgery-for-adult-patients-with-cerebral-misery-perfusion-due-to-ischemic-moyamoya-disease
#17
Shinpei Sato, Daigo Kojima, Yasuyoshi Shimada, Jun Yoshida, Kentaro Fujimato, Shunrou Fujiwara, Masakazu Kobayashi, Yoshitaka Kubo, Kenji Yoshida, Kazunori Terasaki, Shouta Tsutsui, Kenya Miyoshi, Kuniaki Ogasawara
The present study examined whether preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with development of cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease. Among 65 adult patients with ischemic moyamoya disease, 19 had misery perfusion in the precentral region on preoperative 15O positron emission tomography and underwent arterial bypass surgery for that region...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29383871/preoperative-platelet-transfusions-to-reverse-antiplatelet-therapy-for-urgent-non-cardiac-surgery-an-observational-cohort-study
#18
Marcel Baschin, Sixten Selleng, Astrid Hummel, Stephan Diedrich, Henry W Schroeder, Thomas Kohlmann, Antje Westphal, Andreas Greinacher, Thomas Thiele
BACKGROUND: Patients receiving antiplatelet therapy (APT) have an increased risk of perioperative bleeding and cardiac adverse events (CAE). Preoperative platelet transfusions may reduce the bleeding risk but may also increase the risk of CAE, particularly coronary thrombosis in patients after recent stent implantation. OBJECTIVES: To analyse the incidence of perioperative CAE and bleeding in patients undergoing non-cardiac surgery using a standardized management of transfusing two platelet concentrates pre-operatively and restart of APT within 24-72 hours after surgery...
January 31, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29380063/intraoperative-monitoring-of-cerebral-cortical-blood-flow-and-middle-cerebral-artery-pressure-as-a-substitute-for-preoperative-balloon-test-occlusion-in-patients-with-internal-carotid-artery-aneurysms
#19
Yoshitaka Kubo, Takahiro Koji, Ryushi Kondo, Kenji Yoshida, Kuniaki Ogasawara
BACKGROUND: Balloon test occlusion (BTO) is a useful examination to evaluate the indications and methods for revascularization when treating unclippable internal carotid artery (ICA) aneurysms by parent artery occlusion. The purpose of the present study was to investigate the relationship between intraoperative monitoring of cerebral cortical blood flow (CoBF) and middle cerebral artery (MCA) pressure during surgical parent artery occlusion and the findings of BTO. METHODS: Eleven patients with an ICA aneurysm in the cavernous portion underwent preoperative BTO with brain perfusion single-photon emission tomography...
January 29, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29378972/impact-of-the-use-of-intravascular-imaging-on-patients-who-underwent-orbital-atherectomy
#20
Michael S Lee, Evan Shlofmitz, Jeremy Kong, Gentian Lluri, Pratyaksh K Srivastava, Richard Shlofmitz
OBJECTIVES: We assessed the impact of intravascular ultrasound (IVUS)/optical coherence tomography (OCT) on outcomes of patients who underwent orbital atherectomy. BACKGROUND: Intravascular imaging provides enhanced lesion morphology assessment and optimization of percutaneous coronary intervention (PCI) outcomes. Severe coronary artery calcification increases the complexity of PCI and is associated with worse clinical outcomes. Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
February 2018: Journal of Invasive Cardiology
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