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Cerebrovascular surgery

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https://www.readbyqxmd.com/read/28706116/training-standards-in-neuroendovascular-surgery-program-accreditation-and-practitioner-certification
#1
REVIEW
Arthur L Day, Adnan H Siddiqui, Philip M Meyers, Tudor G Jovin, Colin P Derdeyn, Brian L Hoh, Howard Riina, Italo Linfante, Osama Zaidat, Aquilla Turk, Jay U Howington, J Mocco, Andrew J Ringer, Erol Veznedaroglu, Alexander A Khalessi, Elad I Levy, Henry Woo, Robert Harbaugh, Steven Giannotta
BACKGROUND AND PURPOSE: Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential...
July 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28701487/differential-event-rates-and-independent-predictors-of-long-term-major-cardiovascular-events-and-death-in-5795-patients-with-unprotected-left-main-coronary-artery-disease-treated-with-stents-bypass-surgery-or-medication-insights-from-a-large-international-multicenter
#2
Se Hun Kang, Jung-Min Ahn, Cheol Hyun Lee, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. METHODS AND RESULTS: The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608)...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28698731/intermittent-hemiplegia-in-a-boy-with-primary-moyamoya-disease-a-case-report-from-iran
#3
Reza Bidaki, Ehsan Zarepur
Moyamoya is a rare chronic progressive occlusive cerebrovascular disease. Its manifestation varies from stroke, progressive learning impairment and transient ischemic attack to headache and seizure. There is no accepted medical treatment and surgery usually, is needed. We report here a case of 8 yr old boy referred to psychiatrist outpatient. An eight yr old boy with intermittent hemiplegia was brought to Imam Ali Clinic, Yazd, Iran in 2015 because his headache and medical problem began from 6 yr old. Stress and excitement exacerbated his condition...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#4
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28694612/cerebral-and-coronary-vasculature-in-disease-associations-and-dissociations-in-the-south-indian-population
#5
Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, G S Ravi
INTRODUCTION: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. PATIENTS AND METHODS: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28689345/extensive-brain-infarction-involving-deep-structures-during-an-acetazolamide-challenged-single-photon-emission-computed-tomography-scan-in-a-patient-with-moyamoya-disease
#6
Sangjoon Chong, June Dong Park, Jong Hee Chae, Jung-Eun Cheon, Seung-Ki Kim, Ji Hoon Phi, Ji Yeoun Lee, Jin Chul Paeng, Kyu-Chang Wang
BACKGROUND: Acetazolamide-challenged brain single-photon emission computed tomography (SPECT) is used for the evaluation of cerebral perfusion in cerebrovascular diseases including moyamoya disease (MMD). Not a few patients experience adverse side effects during the acetazolamide-challenged brain SPECT, but most of the symptoms are mild and transient. To our knowledge, this is the first case report of severe brain infarction leading to death during the examination of an acetazolamide-challenged brain SPECT in a patient with MMD...
July 8, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28686111/delayed-treatment-of-ruptured-brain-avms-is-it-ok-to-wait
#7
Jeffrey S Beecher, Kristopher Lyon, Vin Shen Ban, Awais Vance, Cameron M McDougall, Louis A Whitworth, Jonathan A White, Duke Samson, H Hunt Batjer, Babu G Welch
OBJECTIVE Despite a hemorrhagic presentation, many patients with arteriovenous malformations (AVMs) do not require emergency resection. The timing of definitive management is not standardized in the cerebrovascular community. This study was designed to evaluate the safety of delaying AVM treatment in clinically stable patients with a new hemorrhagic presentation. The authors examined the rate of rehemorrhage or neurological decline in a cohort of patients with ruptured brain AVMs during a period of time posthemorrhage...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28670776/myocardial-protective-effect-of-antegrade-cardioplegic-cardiac-arrest-versus-ventricular-fibrillation-during-cardiopulmonary-bypass-on-immediate-postoperative-and-mid-term-left-ventricular-function-in-right-ventricular-outflow-tract-surgery
#8
Sang Yoon Kim, Sungkyu Cho, Ji-Hyun Lee, Jin-Tae Kim, Woong-Han Kim
The objective of this study is to examine the myocardial protective effect of antegrade cardioplegic cardiac arrest (ACC) versus ventricular fibrillation (VF) on short-term and mid-term left ventricular (LV) function in right ventricular outflow tract (RVOT) surgery. RVOT operations conducted from January 2006 to December 2015 were reviewed. The numbers of cases using ACC and VF were 71 and 49, respectively. Postoperative mortality and morbidity were compared between the two groups. Before and after propensity score matching, left ventricular ejection fraction (LVEF) and left ventricular end-systolic/end-diastolic diameter (LVESD/LVEDD) in echocardiography were measured immediately after operation and at mid-term follow-up between postoperative 6 and 24 months...
July 2, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28664027/chronic-encapsulated-intracerebral-hematoma-endoscopic-removal-as-minimally-invasive-surgery-for-a-patient-with-alcoholic-cirrhosis
#9
Shunsuke Shibao, Takekazu Akiyama, Kazunari Yoshida, Takehito Akiyama
Chronic encapsulated intracerebral hematoma (CEIH) is a rare cerebrovascular disease. Here, we describe a case of a patient with alcoholic cirrhosis and an abnormal coagulation state that was treated with minimally invasive endoscopic hematoma removal. A 54-year-old man presented with a 2-week history of incoherent speech, incontinence, and repeated stumbling. Laboratory analysis showed thrombocytopenia and the prolongation of prothrombin time due to alcoholic cirrhosis. Computed tomography and magnetic resonance imaging showed a large mass in the left parieto-occipital lobe suggesting a hematoma...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28664022/intracerebral-hemorrhage-caused-by-cerebral-hyperperfusion-after-superficial-temporal-artery-to-middle-cerebral-artery-bypass-for-atherosclerotic-occlusive-cerebrovascular-disease
#10
Fumihiro Matano, Yasuo Murai, Takayuki Mizunari, Koji Adachi, Shiro Kobayashi, Akio Morita
Few papers have reported detailed accounts of intracerebral hemorrhage caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery bypass (STA-MCA) bypass for atherosclerotic occlusive cerebrovascular disease. We report a case of vasogenic edema and subsequent intracerebral hemorrhage caused by the cerebral hyperperfusion syndrome (CHS) after STA-MCA bypass for atherosclerotic occlusive cerebrovascular disease disease without intense postoperative blood pressure control. A 63-year-old man with repeating left hemiparesis underwent magnetic resonance angiography (MRA), which revealed right internal carotid artery (ICA) occlusion...
January 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28654542/percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia-a-comprehensive-meta-analysis
#11
Jiarong Wang, Chi Shu, Zhoupeng Wu, Jichun Zhao, Yukui Ma, Bin Huang, Ding Yuan, Yi Yang, He Bian, Yazhou He, Ziqiang Wang
OBJECTIVE: The aim of our study was to compare percutaneous vascular interventions (PVI) versus bypass surgeries (BSX) in patients with critical limb ischemia (CLI). BACKGROUND: Previous relevant reviews with limited numbers of included studies did not strictly confine the inclusion criteria to CLI, also involving patients with severe claudication, which may introduce bias in the decision-making of CLI revascularization. Current treatment strategies for CLI still remain controversial...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28652946/treatment-related-cardiovascular-outcomes-in-patients-with-symptomatic-subclavian-artery-stenosis
#12
Narendranath Epperla, Fan Ye, Amr Idris, Adeeb Sakkalaek, Hong Liang, Po-Huang Chyou, Richard A Dart, Joseph Mazza, Steven Yale
BACKGROUND: Subclavian artery stenosis (SAS) is narrowing of the subclavian artery most commonly caused by atherosclerosis. It serves as a marker for cerebrovascular and myocardial ischemic events. METHODS: A retrospective cohort study was conducted to determine the association of treatment via combination therapy (antiplatelet drug plus either by-pass surgery or percutaneous transluminal angioplasty (PTA) with or without stent implantation) versus antiplatelet drug therapy alone on cardiovascular events and all-cause mortality in Marshfield Clinic patients diagnosed with symptomatic SAS from January 1, 1995 to December 31, 2009...
May 19, 2017: Curēus
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#13
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647662/microsurgical-bypass-training-rat-model-part-1-technical-nuances-of-exposure-of-the-aorta-and-iliac-arteries
#14
Ali Tayebi Meybodi, Michael T Lawton, Pooneh Mokhtari, Sonia Yousef, Sirin Gandhi, Arnau Benet
BACKGROUND AND OBJECTIVE: Animal models using rodents are frequently used for the purpose of practicing microvascular anastomosis - an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in two consecutive articles...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642176/microsurgical-bypass-training-rat-model-part-2-anastomosis-configurations
#15
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Pooneh Mokhtari, Sirin Gandhi, Arnau Benet
BACKGROUND: Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal pre-clinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. OBJECTIVE: We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28641862/perioperative-beta-blockers-and-statins-for-noncardiac-surgery-patients-with-coronary-stents
#16
Joshua S Richman, Laura A Graham, Aerin DeRussy, Thomas M Maddox, Kamal M F Itani, Mary T Hawn
IMPORTANCE: Recent publications report that perioperative initiation of statin therapy is associated with improved outcomes particularly among patients with increased cardiac risk. However, findings on associations with beta blocker (BB) initiation are mixed. OBJECTIVE: This study examines associations between perioperative statin and BB use in a national sample of patients with cardiac stents. DESIGN: Retrospective cohort study. SETTING: VA Medical Centers nationwide...
May 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#17
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28634771/off-pump-versus-on-pump-coronary-surgery-in-patients-with-chronic-kidney-disease-a-meta-analysis
#18
Yushu Wang, Sui Zhu, Peijuan Gao, Juteng Zhou, Qing Zhang
BACKGROUND: Patients with chronic kidney disease (CKD) have worse adverse cardiovascular outcomes after coronary artery bypass grafting (CABG). However, the adverse cardiovascular outcomes between off-pump coronary artery bypass grafting (OPCAB) versus on-pump coronary artery bypass grafting (ONCAB) in these patients have been a subject of debate. METHODS: We undertook a comprehensive literature search of PubMed, Embase, and the Cochrane Library database to identify all relevant studies comparing techniques between OPCAB and ONCAB in CKD patients...
June 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28612915/how-to-predict-the-risk-of-postoperative-complications-after-coronary-artery-bypass-grafting-in-patients-under-50-and-over-80-years-old-a-retrospective-cross-sectional-study
#19
Jacek Piątek, Anna Kędziora, Grzegorz Kiełbasa, Marta Olszewska, Dorota Sobczyk, Bryan HyoChan Song, Janusz Konstanty-Kalandyk, Tomasz Darocha, Karol Wierzbicki, Irena Milaniak, Krzysztof Wróbel, Bogusław Kapelak
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of death in developed countries and there is an increasing number of both young and elderly patients requiring surgical treatment. Despite improvement of conventional risk stratification scores (EuroSCORE II, STS risk score), all of the calculations are estimated based on the typical population and the studies emphasize that the scales may need further investigation and modernization, as demographic changes of the population suffering from CAD are unavoidable...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28608014/incidence-and-risk-factors-for-postoperative-delirium-in-patients-after-hepatectomy
#20
Sung Ae Park, Yoshito Tomimaru, Asuka Shibata, Shinichi Miyagawa, Kozo Noguchi, Keizo Dono
BACKGROUNDS: Postoperative delirium is a common complication after surgery. However, the incidence and risk factors associated with delirium after liver resection have not been clarified. Thus, this study aimed to investigate the incidence and risk factors for delirium in patients that underwent liver resections. METHODS: This study included 196 consecutive patients that underwent a liver resection. Groups with and without delirium were compared to identify differential patient characteristics...
June 12, 2017: World Journal of Surgery
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