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Cerebrovascular surgery

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https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#1
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
#2
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
https://www.readbyqxmd.com/read/28321002/five-year-outcomes-of-the-first-pivotal-clinical-trial-of-balloon-expandable-transcatheter-aortic-valve-replacement-in-japan-prevail-japan
#3
Yoshiki Sawa, Morimasa Takayama, Tsuyoshi Goto, Shuichiro Takanashi, Tatsuhiko Komiya, Tetsuya Tobaru, Koichi Maeda, Toru Kuratani, Yasushi Sakata
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been an alternative less invasive therapy for high-surgical risk/inoperable patients with aortic valve stenosis (AS) in Japan. We report 5-year outcomes of the first pivotal clinical trial of TAVR in Japan (PREVAIL JAPAN).Methods and Results:A total of 64 patients with AS who were considered unsuitable candidates for surgery were enrolled at 3 centers in Japan (mean age: 84.3±6.1 years, female: 65.6%, STS score: 9.0±4...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28291634/bilateral-lingual-artery-stenosis-a-rare-late-complication-of-chemoradiotherapy
#4
F Holtz, Y Monnier, U Borner, L Nisa
INTRODUCTION: Carotid artery stenosis following radiotherapy (RT) is a known risk factor for the development of cerebrovascular disease with a risk of subsequent stroke or transient ischaemic attack. In contrast, small vessel disease in the neck following RT has been more rarely described. CASE REPORT: The authors report the case of a 61-year-old man who developed partial lingual necrosis 4 years after surgery and postoperative chemoradiotherapy for squamous cell carcinoma of the floor of the mouth...
March 10, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28290169/a-systematic-review-and-meta-analysis-of-outcomes-following-mitral-valve-surgery-in-patients-with-significant-functional-mitral-regurgitation-and-left-ventricular-dysfunction
#5
Ali Andalib, Michael Chetrit, Masha Eberg, Kristian B Filion, Pascal Thériault-Lauzier, Ruediger Lange, Jean Buithieu, Giuseppe Martucci, Mark Eisenberg, Steven F Bolling, Nicolo Piazza
BACKGROUND: The surgical correction of functional mitral regurgitation (MR) remains challenging and controversial. The study aim was to systematically review the outcomes of surgical mitral valve repair (MVRpr) and mitral valve replacement (MVR) in patients with significant functional MR and left ventricular (LV) dysfunction. METHODS: A meta-analysis was performed of published data acquired from patients with moderate to severe functional MR and LV ejection fraction (LVEF) <40% who underwent surgical MVRpr or MVR...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28285387/development-and-external-validation-of-preoperative-risk-models-for-operative-morbidities-after-total-gastrectomy-using-a-japanese-web-based-nationwide-registry
#6
Hirotoshi Kikuchi, Hiroaki Miyata, Hiroyuki Konno, Kinji Kamiya, Ai Tomotaki, Mitsukazu Gotoh, Go Wakabayashi, Masaki Mori
BACKGROUND: Total gastrectomy is a relatively difficult and invasive procedure among gastrointestinal surgeries, and major morbidities following total gastrectomy can be serious and fatal. This study aimed to develop and validate preoperative risk models of morbidities associated with total gastrectomy using a Japanese web-based nationwide registry. METHODS: The national clinical database was used to retrieve the records of 39,253 patients who underwent total gastrectomy in 1,841 hospitals between January 1, 2011 and December 31, 2012...
March 11, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#7
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28277379/anesthesia-and-concussion
#8
Robert C Tasker
PURPOSE OF REVIEW: As clinicians preparing patients for general anesthesia, should we consider the possibility of concussion in our elective operative patients? If so, why is this necessary? Is it possible that exposure to an anesthetic is detrimental to recovery from concussion? If so, what should we do about the imperative/urgency for surgery? No answers are promised in this review. Rather, the focus is on the questions and approaches taken in the recent literature, as well as highlighting a need for more research...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28275477/curative-resection-for-lung-cancer-in-octogenarians-is-justified
#9
Michaela Tutic-Horn, Franco Gambazzi, Gaetano Rocco, Monique Mosimann, Didier Schneiter, Isabelle Opitz, Nono Martucci, Sven Hillinger, Walter Weder, Wolfgang Jungraithmayr
BACKGROUND: Due to an increased life expectancy in a healthy aging population and a progressive incidence of lung cancer, curative pulmonary resections can be performed even in octogenarians. The present study aims to investigate whether surgery is justified in patients reaching the age of 80 years and older who undergo resection for non-small cell lung cancer (NSCLC). METHODS: In this retrospective multi-centre analysis, the morbidity, mortality and long-term survival of 88 patients (24 females) aged ≥80 who underwent complete resection for lung cancer between 2000 and 2013 were analysed...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28275301/surgery-for-gastric-cancer-patients-of-age-85-and-older-multicenter-survey
#10
Hirotaka Konishi, Daisuke Ichikawa, Hiroshi Itoh, Kenichiro Fukuda, Naoki Kakihara, Manabu Takemura, Kaori Okugawa, Kiyoshi Uchiyama, Masashi Nakata, Hiroshi Nishi, Toshiyuki Kosuga, Shuhei Komatsu, Kazuma Okamoto, Eigo Otsuji
AIM: To investigate the surgical therapies for gastric cancer (GC) patients of age 85 or older in a multicenter survey. METHODS: Therapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28268106/right-brachial-access-is-safe-for-branched-endovascular-aneurysm-repair-in-complex-aortic-disease
#11
Beatrice Fiorucci, Tilo Kölbel, Fiona Rohlffs, Franziska Heidemann, Sebastian Eike Debus, Nikolaos Tsilimparis
BACKGROUND: The risk of perioperative cerebrovascular events in endovascular repair of thoracic and thoracoabdominal aneurysms is reported from 2% to 15%. The unavoidable use of an upper extremity access during branched endovascular aneurysm repair (b-EVAR) may play a role in embolic brain injuries. For this reason, some advocate the use of a left-sided upper access to avoid crossing the origin of supra-aortic vessels. However, the assumption that right brachial access has a higher risk for stroke during b-EVAR has not been confirmed in the literature...
March 4, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28265728/impact-of-comorbidity-and-prescription-drugs-on-haemorrhage-in-cholecystectomy
#12
J Strömberg, G Sandblom
BACKGROUND: The purpose of the present study was to analyse the impact of patient-related risk factors and medication drugs on haemorrhagic complications following cholecystectomy. METHODS: All cholecystectomies registered in the Swedish population-based Register for Gallstone Surgery and ERCP (GallRiks) were identified. Risk factors for bleeding were assessed by linking data in the GallRiks to the National Patient Register and the Prescribed Drug Register, respectively...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28262456/preoperative-use-of-clopidogrel-does-not-affect-outcomes-for-femoral-neck-fractures-treated-with-hemiarthroplasty
#13
Elie S Ghanem, Raveesh D Richard, Nathaniel C H Wingert, James R Gotoff, Jove H Graham, Thomas R Bowen
BACKGROUND: The antiplatelet effect of clopidogrel on blood loss and perioperative complications after surgical intervention remains ambiguous. The purpose of this study was to determine if patients on clopidogrel before hemiarthroplasty for femoral neck fracture are predisposed to greater surgical bleeding and perioperative complications compared with those not taking clopidogrel before surgery. METHODS: We conducted a review of our electronic medical record from 2006-2013 and identified 602 patients who underwent 623 hemiarthroplasty procedures for displaced femoral neck fracture, of which 54 cases (9%) were taking clopidogrel before hospital admission...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28256020/left-atrial-anatomy-and-patient-related-factors-associated-with-adverse-outcomes-with-the-watchman-device-a-real-world-experience
#14
Shishir Murarka, Mohamad Lazkani, Soundos Moualla, Divya Ratan Verma, Ashish Pershad
OBJECTIVE: This study sought to identify patient and left atrial morphology specific factors associated with early complications for left atrial appendage occlusion with the Watchman™ (Boston Scientific, Natick, MA) device. BACKGROUND: Oral anticoagulation (OAC) is recommended for patients with atrial fibrillation, however, long-term OAC compliance is poor. In randomized control trials, the Watchman™ device has demonstrated superiority over OAC with warfarin for all cause and cardiovascular mortality and hemorrhagic stroke...
March 2, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28247473/preoperative-intra-aortic-balloon-pump-use-in-high-risk-patients-prior-to-coronary-artery-bypass-graft-surgery-decreases-the-risk-for-morbidity-and-mortality-a-meta-analysis-of-9-212-patients
#15
REVIEW
Antje-Christin Deppe, Carolyn Weber, Oliver J Liakopoulos, Mohamed Zeriouh, Ingo Slottosch, Maximilian Scherner, Elmar W Kuhn, Yeong-Hoon Choi, Thorsten Wahlers
AIMS: Prophylactic intra-aortic balloon pump (IABP) support for high-risk patients before coronary artery bypass grafting (CABG) is controversial. This meta-analysis sought to determine the current role of preoperative IABP support. METHODS: We performed a meta-analysis of randomized (RCT) and observational trials (OT) that fulfilled the following criteria: (1) Group comparison of patients with prophylactic IABP implantation before CABG with a control group; (2) reporting at least one desired clinical endpoint, including all-cause mortality, myocardial infarction, cerebrovascular accident (CVA), and renal failure...
March 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28241749/development-and-validation-of-a-score-for-evaluating-comprehensive-stroke-care-capabilities-j-aspect-study
#16
Akiko Kada, Kunihiro Nishimura, Jyoji Nakagawara, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Kazunori Toyoda, Shinya Matsuda, Akifumi Suzuki, Hiroharu Kataoka, Fumiaki Nakamura, Satoru Kamitani, Koji Iihara
BACKGROUND: Although the Brain Attack Coalition recommended establishing centers of comprehensive care for stroke and cerebrovascular disease patients, a scoring system for such centers was lacking. We created and validated a comprehensive stroke center (CSC) score, adapted to Japanese circumstances. METHODS: Of the selected 1369 certified training institutions in Japan, 749 completed an acute stroke care capabilities survey. Hospital performance was determined using a 25-item score, evaluating 5 subcategories: personnel, diagnostic techniques, specific expertise, infrastructure, and education...
February 28, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28238929/comparison-between-open-and-endovascular-repair-for-the-treatment-of-juxtarenal-abdominal-aortic-aneurysms-a-single-center-experience-with-midterm-results
#18
Koji Maeda, Takao Ohki, Yuji Kanaoka, Takeshi Baba, Kenjirou Kaneko, Kota Shukuzawa
PURPOSE: To evaluate the optimal treatment for juxtarenal abdominal aortic aneurysm (JAAA) we compared outcomes of open surgical repair (OSR) with endovascular aortic repair (EVAR) utilizing a variety of fenestrated and snorkel EVARs. METHODS: We evaluated overall survival, aneurysm-related death, re-intervention and renal impairment in 152 JAAAs retrospectively, excluding cases of aortic dissection and rupture. Cox models were used to assess survival and assessed postoperative dialysis rates following surgery...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28236921/targeting-the-most-important-complications-in-vascular-surgery
#19
Kyla M Bennett, K Craig Kent, Jessica Schumacher, Caprice C Greenberg, John E Scarborough
OBJECTIVE: This study was conducted to identify the most clinically relevant and costly perioperative complications occurring in vascular surgery patients. METHODS: The analysis included patients in the 2012 to 2014 National Surgical Quality Improvement Program database undergoing one of four high-risk vascular procedures. The procedures-aortic reconstruction, lower extremity bypass, lower extremity amputation, and carotid endarterectomy (CEA)-were selected because they have been established as high risk in the literature, rendering them natural targets for quality improvement initiatives...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28228887/transarterial-embolization-of-a-hyperfunctioning-aldosteronoma-in-a-patient-with-bilateral-adrenal-nodules
#20
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
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