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Cerebrovascular surgery

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https://www.readbyqxmd.com/read/29669067/microvascular-anastomosis-proposition-of-a-learning-curve
#1
Pooneh Mokhtari, Ali Tayebi Meybodi, Arnau Benet, Michael T Lawton
BACKGROUND: Learning to perform a microvascular anastomosis is one of the most difficult tasks in cerebrovascular surgery. Previous studies offer little regarding the optimal protocols to maximize learning efficiency. This failure stems mainly from lack of knowledge about the learning curve of this task. OBJECTIVE: To delineate this learning curve and provide information about its various features including acquisition, improvement, consistency, stability, and recall...
April 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29664857/restrictive-versus-liberal-strategy-for-red-blood-cell-transfusion-a-systematic-review-and-meta-analysis-in-orthopaedic-patients
#2
Wan-Jie Gu, Xiao-Ping Gu, Xiang-Dong Wu, Hao Chen, Joey S W Kwong, Lu-Yang Zhou, Shuo Chen, Zheng-Liang Ma
BACKGROUND: Current guidelines recommend restrictive criteria for red blood-cell transfusion in most clinical settings. However, patients undergoing orthopaedic surgery may require distinct transfusion criteria since benefits and potential harm often vary considerably based on patient characteristics and surgical procedures. We aimed to assess the efficacy and safety of restrictive transfusion in patients undergoing orthopaedic surgery, especially in important subgroups. METHODS: Electronic databases were searched to identify randomized controlled trials investigating restrictive (mostly a hemoglobin level of 8...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29660676/cerebrovascular-myocardium-tissue-embolism-a-rare-complication-of-heart-surgery-autopsy-case-report
#3
Jan Hrudka, Jan Hlavička, Marie Claire Šmůlová, Petr Kujal
No abstract text is available yet for this article.
March 18, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/29656628/cerebral-thromboembolic-events-during-anterior-cervical-spine-surgery-retrospective-case-series-study-with-diffusion-weighted-magnetic-resonance-imaging-follow-up-in-the-immediate-postoperative-period
#4
Seok-Won Chung, Min-Soo Kang, Sang-Ho Lee, Shin-Young Lee, Yong-Hwan Shin, Chan-Hong Park
OBJECTIVE: We evaluated the efficacy of diffusion-weighted magnetic resonance imaging (DW-MRI) in detecting perioperative cerebral thromboembolic events after anterior cervical discectomy and fusion (ACDF). METHODS: This retrospective case series included 51 consecutive patients that underwent ACDF. To assess baseline presence of plaque or stenosis, all patients were assessed for risk factors of cerebrovascular events and underwent carotid ultrasound preoperatively and cerebral DW-MRI was performed in all patients postoperatively, with areas of high signal intensity interpreted as a cerebral thromboembolic event...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29649307/bilateral-carotid-artery-stenosis-causes-unexpected-early-changes-in-brain-extracellular-matrix-and-blood-brain-barrier-integrity-in-mice
#5
Jill M Roberts, Michael E Maniskas, Gregory J Bix
Bilateral carotid artery stenosis (BCAS) is one experimental model of vascular dementia thought to preferentially impact brain white matter. Indeed, few studies report hippocampal and cortical pathology prior to 30 days post-stenosis; though it is unclear whether those studies examined regions outside the white matter. Since changes in the blood-brain barrier (BBB) permeability precede more overt brain pathology in various diseases, we hypothesized that changes within the BBB and/or BBB-associated extracellular matrix (ECM) could occur earlier after BCAS in the hippocampus, cortex and striatum and be a precursor of longer term pathology...
2018: PloS One
https://www.readbyqxmd.com/read/29629837/impact-of-hypertension-on-early-outcomes-and-long-term-survival-of-patients-undergoing-aortic-repair-with-stanford-a-dissection
#6
Julia Merkle, Anton Sabashnikov, Antje-Christin Deppe, Mohamed Zeriouh, Kaveh Eghbalzadeh, Carolyn Weber, Parwis Rahmanian, Elmar Kuhn, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, Oliver Liakopoulos, Thorsten Wahlers
INTRODUCTION: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in hypertensive patients, requiring immediate surgical repair. The aim of this study was to evaluate early outcomes and long-term survival of hypertensive patients in comparison to normotensive patients suffering from Stanford A AAD. METHODS: In our center, 240 patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015. After statistical and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29628593/comparison-of-esmolol-and-dexmedetomidine-for-suppression-of-hemodynamic-response-to-laryngoscopy-and-endotracheal-intubation-in-adult-patients-undergoing-elective-general-surgery-a-prospective-randomized-controlled-double-blinded-study
#7
Sandeep Sharma, Om Prakash Suthar, M L Tak, Abhilasha Thanvi, Naveen Paliwal, Rakesh Karnawat
Context: Laryngoscopy and endotracheal intubation lead to strong sympathetic response which may precipitate arrhythmias, myocardial ischemia and cerebrovascular accidents in patients with preexisting cardiovascular disease. Aims: This study was aimed to compare the effect of dexmedetomidine and esmolol on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective surgery under general anesthesia. Settings and Design: This was a prospective, randomized controlled double-blinded study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628346/concomitant-surgical-closure-of-left-atrial-appendage-a-systematic-review-and-meta-analysis
#8
Masahiko Ando, Masaki Funamoto, Duke E Cameron, Thoralf M Sundt
OBJECTIVES: Although percutaneous closure of the left atrial appendage is supported as a potential alternative to lifelong anticoagulation in patients with atrial fibrillation, comprehensive evidence on surgical left atrial appendage closure in heart surgery is limited. METHODS: We conducted a meta-analysis of studies comparing patients who underwent open cardiac surgery with or without left atrial appendage closure. A literature search was performed on PubMed, Embase, and Cochrane Trials databases...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29618572/influence-of-diabetes-on-trends-in-perioperative-cardiovascular-events
#9
Jonathan D Newman, Tanya Wilcox, Nathaniel R Smilowitz, Jeffrey S Berger
OBJECTIVE: Patients undergoing noncardiac surgery frequently have diabetes mellitus (DM) and an elevated risk of cardiovascular disease. It is unknown whether temporal declines in the frequency of perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) apply to patients with DM. RESEARCH DESIGN AND METHODS: Patients ≥45 years of age who underwent noncardiac surgery from January 2004 to December 2013 were identified using the U.S. National Inpatient Sample...
April 4, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29616518/coronary-artery-bypass-surgery-in-patients-with-chronic-brain-hypoperfusion
#10
Hajime Imura, Yuji Maruyama, Kenichiro Takahashi, Dai Nishina, Takashi Nitta
BACKGROUND: Cerebrovascular disease (CVD) is a risk factor of stroke and cerebral hypoperfusion is one of the underlying mechanisms. We hypothesized that coronary artery bypass grafting (CABG) can be performed at an acceptable risk for such patients without concomitant surgery for CVD. METHODS: Carotid echo was carried out for 538 consecutive patients undergoing isolated CABG between 2005 and 2016. Magnetic resonance image/angiography (MRI/A) for neck and brain was performed for 288 patients (stenosis≥50% in echo were basically included)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29608734/results-of-surgery-for-low-grade-brain-arteriovenous-malformation-resection-by-early-career-neurosurgeons-an-observational-study
#11
Nirav J Patel, David Bervini, Behzad Eftekhar, Andrew Stewart Davidson, Daniel C Walsh, Nazih N Assaad, Michael Kerin Morgan
BACKGROUND: For sustainability of arteriovenous malformation (AVM) surgery, results from early career cerebrovascular neurosurgeons (ECCNs) must be acceptably safe. OBJECTIVE: To determine whether ECCNs performance of Spetzler-Ponce Class A AVM (SPC A) resection can be acceptably safe. METHODS: ECCNs completing a cerebrovascular fellowship (2004-2015) with the last author were included. Inclusion of the ECCN cases occurred if they: had a prospective database of all AVM cases since commencing independent practice; were the primary surgeon on SPC A; and had made the significant management decisions...
March 28, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29594413/risk-factors-for-postoperative-pneumonia-in-elderly-patients-with-colorectal-cancer-a-sub-analysis-of-a-large-multicenter-case-control-study-in-japan
#12
Masatoshi Kochi, Takao Hinoi, Hiroaki Niitsu, Hideki Ohdan, Fumio Konishi, Yusuke Kinugasa, Takaya Kobatake, Masaaki Ito, Masafumi Inomata, Toshimasa Yatsuoka, Takashi Ueki, Jo Tashiro, Shigeki Yamaguchi, Masahiko Watanabe
PURPOSE: Postoperative pneumonia affects the length of stay and mortality after surgery in elderly patients with colorectal cancer (CRC). We aimed to determine the risk factors of postoperative pneumonia in elderly patients with CRC, and to evaluate the impact of laparoscopic surgery on elderly patients with CRC. METHODS: We retrospectively investigated 1473 patients ≥ 80 years of age who underwent surgery for stage 0-III CRC between 2003 and 2007. Using a multivariate analysis, we determined the risk factors for pneumonia occurrence from each baseline characteristic...
March 29, 2018: Surgery Today
https://www.readbyqxmd.com/read/29588233/postpartum-increases-in-cerebral-edema-and-inflammation-in-response-to-placental-ischemia-during-pregnancy
#13
Ahsia M Clayton, Qingmei Shao, Nina D Paauw, Ashtin B Giambrone, Joey P Granger, Junie P Warrington
Reduced placental blood flow results in placental ischemia, an initiating event in the pathophysiology of preeclampsia, a hypertensive pregnancy disorder. While studies show increased mortality risk from Alzheimer's disease, stroke, and cerebrovascular complications in women with a history of preeclampsia, the underlying mechanisms are unknown. During pregnancy, placental ischemia, induced by reducing uterine perfusion pressure (RUPP), leads to cerebral edema and increased blood-brain barrier (BBB) permeability; however whether these complications persist after delivery is not known...
March 24, 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29584611/a-descriptive-retrospective-study-of-using-an-oblique-downward-design-gluteus-maximus-myocutaneous-flap-for-reconstruction-of-ischial-pressure-ulcers
#14
Chang-Yi Chou, Yu-Shan Sun, Yu-Jen Shih, Yuan-Sheng Tzeng, Shun-Cheng Chang, Niann-Tzyy Dai, Chin-Ta Lin
Despite advances in reconstruction techniques, ischial pressure ulcers continue to present a challenge for the plastic surgeon. The purpose of this retrospective study was to evaluate outcomes of using an oblique downward gluteus maximus myocutaneous (GMM) flap for coverage of grade IV ischial ulcers. Data regarding defect size, flap size, operation time, duration of wound healing, and surgical outcome were abstracted from the medical records of patients whose ischial pressure ulcers had been reconstructed using GMM island flaps between January 2010 and December 2015...
March 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29578039/in-vivo-assessment-of-the-human-cerebral-microcirculation-and-its-glycocalyx-a-technical-report
#15
R H L Haeren, K Rijkers, O E M G Schijns, J Dings, G Hoogland, M A M J van Zandvoort, H Vink, J J van Overbeeke
INTRODUCTION: The cerebral microcirculation and its glycocalyx, a matrix coating the luminal endothelium, are key regulators of capillary permeability and cerebral blood flow. Microvascular abnormalities are described in several neurological disorders. However, assessment of the cerebral microcirculation and glycocalyx has mainly been performed ex vivo. NEW METHOD: Here, the technical feasibility of in vivo assessment of the human cerebral microcirculation and its glycocalyx using sidestream dark field (SDF) imaging is discussed...
March 22, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29574221/endoscopic-endonasal-clipping-of-anterior-circulation-aneurysm-surgical-techniques-and-results
#16
Li-Min Xiao, Bin Tang, Shen-Hao Xie, Guan-Lin Huang, Zhi-Gang Wang, Er-Ming Zeng, Tao Hong
OBJECTIVE: Endoscopic endonasal clipping of intracranial aneurysms may utilize the microsurgical techniques as an alternative to the transcranial approach. The aim of this manuscript is to report a series of patients who underwent endoscopic endonasal approach(EEA) for microsurgical clipping of anterior circulation aneurysms. METHOD: A retrospective chart review was conducted. All the patients who underwent standard binostril EEA for aneurysm clipping were included...
March 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29573399/cerebrovascular-autoregulation-monitoring-and-patient-centred-outcomes-after-cardiac-surgery-a-systematic-review
#17
REVIEW
B Chan, E Butler, S A Frost, A Chuan, A Aneman
BACKGROUND: Impaired cerebrovascular autoregulation (CVAR) is observed in up to 20% of cardiac surgical patients. This systematic review aims to evaluate the association between impaired CVAR, measured by current monitoring techniques, and patient-centred outcomes in adults following cardiac surgery. METHODS: MEDLINE, EMBASE, PubMed, MEDLINE In-Process and Cochrane Library were systematically searched through 8 December 2017. Studies were included if they assessed associations between CVAR and patient-centred outcomes in the adult cardiac surgical population...
March 24, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29570209/long-term-outcomes-of-mitral-valve-annuloplasty-versus-subvalvular-sparing-replacement-for-severe-ischemic-mitral-regurgitation
#18
Baotong Li, Hengchao Wu, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
BACKGROUND: Although practice guidelines recommend surgery for patients with severe chronic ischemic mitral regurgitation (CIMR), they do not specify whether to repair or replace the mitral valve. The purpose of this study was to evaluate the long-term outcomes in patients with severe CIMR undergoing mitral valve annuloplasty (MVA) versus subvalvular sparing mitral valve replacement (MVR). METHODS: 392 consecutive patients who underwent MVA or subvalvular sparing MVR for treatment of severe CIMR were retrospectively reviewed...
March 23, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29566162/recombinant-activated-factor-vii-is-associated-with-postoperative-thromboembolic-adverse-events-in-bleeding-after-coronary-surgery
#19
Aly Makram Habib, Antonio Maria Calafiore, Marco Cargoni, Massimiliano Foschi, Michele Di Mauro
OBJECTIVES: To evaluate the impact of recombinant activated factor VII (rFVIIa) administration on thromboembolic adverse events (TAEs) in coronary artery bypass grafting (CABG) surgery patients showing postoperative bleeding. METHODS: From January 2004 to May 2015, 180 CABG surgery patients with postoperative bleeding were included in the study. All patients were managed conservatively and 81 (45%) also received rFVIIa. RESULTS: Ten patients developed new TAEs (5...
March 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29563384/coronary-artery-bypass-surgery-versus-percutaneous-coronary-intervention-for-left-main-coronary-artery-disease-with-chronic-kidney-disease
#20
Ting-Chao Lin, Tse-Min Lu, Feng-Chyn Huang, Pai-Feng Hsu, Chun-Che Shih, Shing-Jong Lin, Chiao-Po Hsu
Percutaneous coronary intervention (PCI) has emerged as an alternative treatment to coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease (ULMCAD). However, the optimal treatment for ULMCAD concomitant with chronic kidney disease (CKD) was rarely addressed. Herein, we compare the long-term outcomes of these patients treated with CABG or PCI.From January 2004 to December 2010, 185 patients with ULMCAD and CKD undergoing PCI (n = 84) or CABG (n = 101) were matched for the selection criteria...
March 20, 2018: International Heart Journal
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