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endovascular surgical neuroradiology

C Mayer, E Hattingen, H Schild, F Bootz, A Schröck
In interventional neuroradiology, endovascular embolization represents an important and helpful tool in the treatment of multiple head and neck diseases. These interventional procedures may be performed with curative intent, to reduce the surgical risk within a multimodal treatment concept, or to improve or at least maintain a good quality of life within a palliative therapy concept. In addition to a good understanding of disease pathology, knowledge of vascular anatomy, including collateral vessels and dangerous extracranial-intracranial anastomoses, is essential for successful treatment, as is implementation of an established technique using appropriate material...
June 2017: HNO
Johannes Hensler, Ulf Jensen-Kondering, Stephan Ulmer, Olav Jansen
INTRODUCTION: Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. METHODS: This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature...
October 2016: Neuroradiology
Rafael Badenes, María L García-Pérez, Federico Bilotta
PURPOSE OF REVIEW: This review reports recent evidence on intraoperative monitoring of cerebral oximetry and depth of anaesthesia during neuroanaesthesia procedures. RECENT FINDINGS: The clinical benefits of intraoperative monitoring with cerebral oximetry [near infrared spectroscopy (NIRS) and brain tissue oxygenation monitoring (brptiO2)] and depth of anaesthesia with bispectral index (BIS) have recently been studied in surgical (carotid endarterectomy, cerebral arteriovenous malformations resection and brain tumour resections) and neuroradiological vascular procedures...
October 2016: Current Opinion in Anaesthesiology
Giovanni Grasso, Giancarlo Perra
BACKGROUND: Management of small aneurysms often poses a therapeutic dilemma and surgical treatment or coiling can be considered as therapeutic choices. In the present study, we reviewed our series of ruptured small cerebral aneurysm treated surgically. METHODS: A total of 53 consecutive patients with ruptured small aneurysm were surgically treated between January 2008 and July 2014. Data were retrospectively collected. Procedure-related death and complications were systematically reviewed...
2015: Surgical Neurology International
Jian-min Zhang
Aneurysmal subarachnoid hemorrhage (aSAH) is a kind of hemorrhagic stroke with high mortality and morbidity. Although the preoperative diagnosis, surgical clipping, endovascular treatment, and intensive care have progressed in recent years, the overall prognosis of aSAH patients remains poor. In 2011, the Neurocritical Care Society organized an international, multidisciplinary consensus conference addressed the critical care management of SAH. In 2012, the American Stroke Association (AHA) updated the guidelines of diagnosis and treatment of aSAH published in 2009...
July 2015: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Pablo Sosa, Manuel Dujovny, Ibe Onyekachi, Noressia Sockwell, Fabián Cremaschi, Luis E Savastano
OBJECTIVE: The cerebellopontine angle is a common site for tumor growth and vascular pathologies requiring surgical manipulations that jeopardize cranial nerve integrity and cerebellar and brainstem perfusion. To date, a detailed study of vessels perforating the cisternal surface of the middle cerebellar peduncle-namely, the paraflocculus or parafloccular perforating space-has yet to be published. In this report, the perforating vessels of the anterior inferior cerebellar artery (AICA) in the parafloccular space, or on the cisternal surface of the middle cerebellar peduncle, are described to elucidate their relevance pertaining to microsurgery and the different pathologies that occur at the cerebellopontine angle...
February 2016: Journal of Neurosurgery
Mario Teo, Sean Martin, Arachchige Ponweera, Alistair Macey, Nigel Suttner, Jennifer Brown, Jerome St George
OBJECTIVES: It has been 10 years since the publication of International Subarachnoid Aneurysm Trial (ISAT) (1-3) and the first-line treatment for cerebral aneurysms in many UK neurosurgical centres is endovascular occlusion. Local audit has shown a significant reduction in surgical clipping cases since 2002, with a fall from over 150 cases per year pre ISAT, to approximately 25 cases per year currently. More so the cases referred for surgical occlusion represent more challenging lesions...
2015: British Journal of Neurosurgery
Alicia Martinez Piñeiro, Carles Cubells, Pablo Garcia, Carlos Castaño, Antonio Dávalos, Jaume Coll-Canti
BACKGROUND AND OBJECTIVE: Intraoperative monitoring (IOM) has been used in different surgical disciplines since the 1980s. Nonetheless, regular routine use of IOM in interventional neuroradiology units has only been reported in a few centers. The aim of this study is to report our experience, 1 year after deciding to implement standardized IOM during endovascular treatment of vascular abnormalities of the central nervous system. METHODS: Basic recordings included somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs)...
March 2015: Interventional Neurology
(no author information available yet)
No abstract text is available yet for this article.
January 2015: Clinical Privilege White Paper
Andreas Hartmann, J P Mohr
Major reasons to treat brain arteriovenous malformations (AVMs) are to reduce the risk of brain hemorrhage, control intractable seizure, and in some cases alleviate neurologic deficits. Once an AVM has hemorrhaged, the risk of further hemorrhage is increased and it should be treated. The treatment plan ideally is based on interdisciplinary discussion between neurosurgery, endovascular neuroradiology, and radiotherapy, moderated by neurology in an experienced center. Complete removal or obliteration of the malformation should be the goal, as partial treatment only exposes the patient to treatment risks with a residual hemorrhage risk...
May 2015: Current Treatment Options in Neurology
Giuseppe Esposito, Luca Regli
The treatment of complex intracranial aneurysms remains a therapeutic challenge. These lesions are frequently not amenable to selective clipping or coiling or other endovascular procedures and surgery still has a predominant role.We illustrate our "surgical decision making" for managing complex intracranial aneurysmal lesions. The best strategy is decided on the basis of pre-operative neuroradiological and intra-operative main determinants such as anatomical location, peri-aneurysmal angioanatomy (branch vessels, critical perforators), broad neck, intraluminal thrombosis, aneurysmal wall atherosclerotic plaques and calcifications, absence of collateral circulation, and previous treatment...
2014: Acta Neurochirurgica. Supplement
Marc Kotowski, Asita Sarrafzadeh, Bawarjan Schatlo, Colette Boex, Ana Paula Narata, Vitor Mendes Pereira, Philippe Bijlenga, Karl Schaller
BACKGROUND: Multimodality treatment suites for patients with cerebral arteriovenous malformations (AVM) have recently become available. This study was designed to evaluate feasibility, safety and impact on treatment of a new intraoperative flat-panel (FP) based integrated surgical and imaging suite for combined endovascular and surgical treatment of cerebral AVM. METHODS: Twenty-five patients with AVMs to treat with combined endovascular and surgical interventions were prospectively enrolled in this consecutive case series...
November 2013: Acta Neurochirurgica
Bogdan Czapiga, Marta Koźba-Gosztyła, Włodzimierz Jarmundowicz, Tomasz Szczepański
BACKGROUND: The treatment of cerebral aneurysms has undergone significant evolution since the 1990s when the endovascular methods were introduced. After the results of ISAT were published in 2002, a change in practice occurred which resulted in more ruptured aneurysms treated endovascularly rather than by surgical clipping. This change in practice was referred to as a paradigm shift. OBJECTIVES: The aim of this study was to review the treatment outcomes in patients with ruptured anterior cerebral aneurysms and to delineate the trends in surgical management in the age of the formation of centers for interventional neuroradiology...
July 2013: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Adnan I Qureshi
BACKGROUND AND PURPOSE: To determine the interobserver reliability of a newly proposed classification scheme for angiographic classification of spinal vascular malformations including arteriovenous fistulas (AVFs) and arteriovenous malformations (AVMs). METHOD: A study was performed done in which 1-2 representative angiographic images of 26 spinal AVFs and/or AVMs were independently classified by five fellows in the ACGME accredited Endovascular Surgical Neuroradiology (ESN) program and two external interventionalists in the absence of any other clinical or imaging data...
July 2013: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Wendi Rank
No abstract text is available yet for this article.
December 2012: Nursing
Gaurav Jindal, Joseph Gemmete, Dheeraj Gandhi
A review of the current clinical applications of a variety of percutaneous and endovascular interventional procedures of the extracranial head and neck is presented. After a description of general principles and embolic agents for interventional procedures, management of specific disorders is presented and procedural steps are described for epistaxis, embolization of vascular head and neck tumors, high-flow and low-flow cervical vascular malformations, head and neck trauma and bleeding, radiofrequency ablation and cryoablation of tumors, along with percutaneous biopsy within the head and neck...
December 2012: Otolaryngologic Clinics of North America
Jason Michael Perrin, Bernd Turowski, Hans-Jakob Steiger, Daniel Hänggi
OBJECTIVE: In this case report we describe a successful interdisciplinary approach (including flow redirection and endovascular occlusion) applied to a patient with a continuously growing extracranial giant aneurysm of the right internal carotid artery (ICA) due to known Ehlers-Danlos syndrome. CASE PRESENTATION: A 42-year-old man with a continuously growing extracranial giant aneurysm of the right ICA sought treatment after failed surgery of a similar lesion of the left ICA...
November 2013: Journal of Neurointerventional Surgery
B Mine, I Delpierre, S Hassid, O De Witte, B Lubicz
The management of hypervascular skull base tumours is complex and requires a multidisciplinary approach. Skull base surgery may be challenging because of the risk of serious intra-operative bleeding and of potential injuries to lower cranial nerves and/or large cervical vessels. Over the last four decades, advances in neuro-interventional procedures have produced a range of adjunctive endovascular techniques in addition to conventional surgery. Digital subtraction angiography (DSA) allows for a better understanding of tumour vascularisation and its relationship with Surrounding vessels...
2011: B-ENT
P M Meyers, K A Blackham, T A Abruzzo, C D Gandhi, R T Higashida, J A Hirsch, D Hsu, C J Moran, S Narayanan, C J Prestigiacomo, R Tarr, Muhammad Shazam Hussein
This is the first in a set of documents intended to standardize techniques, procedures, and practices in the field of endovascular surgical neuroradiology. Standards are meant to define core practices for peer review, comparison, and improvement. Standards and guidelines also form the basic dialogue, reporting, and recommendations for ongoing practices and future development.
January 1, 2012: Journal of Neurointerventional Surgery
Simone Peschillo, Roberto Delfini
BACKGROUND: The cerebrovascular discipline has undergone dramatic changes in recent years. This has been made possible by the work of pioneers in the fields of neurosurgery and neuroradiology. METHODS: In this article we review the evolution and fundamental stages that led to the birth of endovascular treatment and discuss why, also in Europe, this treatment must be included in neurosurgery, encouraging the training of endovascular neurosurgeons who can collaborate with their interventional neuroradiology colleagues in order to form unbiased surgeons who understand the disease from both the endovascular as well as the surgical prospective...
February 2012: World Neurosurgery
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