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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/29199247/utility-of-indocyanine-green-video-angiography-for-sylvian-fissure-dissection-in-subarachnoid-hemorrhage-patients-sylvian-icg-technique
#1
Hiroyuki Toi, Nobuhisa Matsushita, Yukari Ogawa, Keita Kinoshita, Kohei Satoh, Hiroki Takai, Satoshi Hirai, Keijiro Hara, Shunji Matsubara, Masaaki Uno
Indocyanine green (ICG) emits fluorescence in the far-red domain under light excitation. ICG video angiography (ICG-VA) has been established as a useful method to evaluate blood flow in the operative field. We report the usefulness of ICG-VA for Sylvian fissure dissection in patients with subarachnoid hemorrhage (SAH). Subjects comprised 7 patients who underwent ICG-VA before opening the Sylvian fissure during neck clipping for ruptured cerebral aneurysm. We observed contrasted Sylvian veins before opening the Sylvian fissure using surgical microscopes...
December 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29198890/evaluation-of-patency-after-vascular-anastomosis-using-quantitative-evaluation-of-visualization-time-in-indocyanine-green-video-angiography
#2
Shunsuke Nakagawa, Yasuo Murai, Fumihiro Matano, Eitaro Ishisaka, Akio Morita
BACKGROUND: In vascular reconstructive surgery, intraoperative confirmation of the patency is performed by angiography, Doppler, or indocyanine videoangiography, but it is sometimes insufficient. OBJECTIVE: Using the FLOW 800 system (Carl Zeiss, Germany), we confirmed the patency in a quantitative relative evaluation of the timing of the luminance change of the regions of interest (ROIs) on the donor and recipient. METHODS: Thirty-seven patients (58 anastomoses) were divided into two groups: arteriosclerotic ischemic disease (CI group; n=23) or cerebral aneurysm (AN group; n=14)...
November 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29192858/head-up-display-may-facilitate-safe-keyhole-surgery-for-cerebral-aneurysm-clipping
#3
Terushige Toyooka, Naoki Otani, Kojiro Wada, Arata Tomiyama, Satoru Takeuchi, Kazuya Fujii, Kosuke Kumagai, Takashi Fujii, Kentaro Mori
OBJECTIVE The head-up display (HUD) is a modern technology that projects images or numeric information directly into the observer's sight line. Surgeons will no longer need to look away from the surgical view using the HUD system to confirm the preoperative or navigation image. The present study investigated the usefulness of the HUD system for performing cerebral aneurysm clipping surgeries. METHODS Thirty-five patients underwent clipping surgery, including 20 keyhole surgeries for unruptured cerebral aneurysm, using the HUD system...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29190810/aneurysmal-subarachnoid-haemorrhage-asah-five-consecutive-years-experience-of-fars-province-iran
#4
Abdolkarim Rahmanian, Mohammad Jamali, Kamran Bagheri Lankarani, Sulmaz Ghahramani
OBJECTIVE: Subarachnoid haemorrhage (SAH), caused by the rupture of intracranial aneurysms, is a devastating event with high rates of morbidity and mortality. Aneurysmal subarachnoid haemorrhage (aSAH) plays a critical role in the potential loss of life as its sufferers are usually of a young age. We aimed to investigate the incidence of aSAH along with the patients' characteristics over five consecutive years in Fars, a large province located in Southern Iran. METHODS: In this prospective study, anonymous data of all patients diagnosed with aSAH in Fars province were collected after patient admission and surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29190619/ruptured-de-novo-aneurysm-following-gamma-knife-surgery-for-arteriovenous-malformation-case-report
#5
Yun-Sik Dho, Dong Gyu Kim, Hyun-Tai Chung
Stereotactic radiosurgery is a well-known treatment tool for arteriovenous malformations (AVMs). The method has high validity and minimal invasiveness, but late-onset problems involving tumor formation and vasculopathy induced by radiation have been reported. We present a rare case of a radiation-induced ruptured de novo aneurysm following Gamma Knife surgery (GKS) for an AVM. A 17-year-old, right-handed male underwent GKS for AVM at the left parietal lobe. After 3 years, a follow-up angiogram showed a residual AVM at the angular gyrus...
December 1, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29186595/treatment-of-recurrent-intracranial-aneurysms-after-neck-clipping-novel-classification-scheme-and-management-strategies
#6
Shinya Kobayashi, Junta Moroi, Kentaro Hikichi, Shotaro Yoshioka, Hiroshi Saito, Jun Tanabe, Tatsuya Ishikawa
BACKGROUND: Recurrent aneurysms after initial clipping have been discussed as an important issue in the surgical management of aneurysm. OBJECTIVE: To report our experience with recurrent cerebral aneurysms after neck clipping and to discuss classification and recommended management. METHODS: Aneurysm treatments from a single institution over a 20-year period were retrospectively reviewed. Twenty-three recurrent aneurysms in 23 patients were managed during the study period...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29172200/-outcome-of-coil-embolization-for-subarachnoid-hemorrhage-accompanied-with-intracerebral-hematoma
#7
Fumiaki Maruyama, Koreaki Irie, Ichiro Yuki, Jun Takei, Keisuke Hatano, Toshihide Tanaka, Yuzuru Hasegawa, Yuichi Murayama
OBJECT: Aneurysmal subarachnoid hemorrhage(SAH)associated with intracerebral hematoma(ICH)typically has a poor outcome. SAH with ICH tends to have a worse prognosis than SAH alone. The aim of the present study was to evaluate whether coil embolization during endovascular surgery with ventricle drainage and without ICH evacuation is an appropriate treatment. METHODS: A retrospective review was conducted between March 2012 and May 2015. Thirteen patients with SAH with ICH who underwent coil embolization were retrospectively analyzed...
November 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29162651/transoceanic-management-and-treatment-of-aneurysmal-subarachnoid-hemorrhage-a-10-year-experience
#8
Mehdi Mejdoubi, Mathieu Schertz, Sylvia Zanolla, Hossein Mehdaoui, Michel Piotin
BACKGROUND AND PURPOSE: Because of the small number of yearly cases of ruptured cerebral aneurysms, endovascular treatment is not performed in Martinique. Therefore, patients from Martinique are sent 7000 km to Paris on commercial flights as soon as possible, where treatment is performed. Nontransportable patients are treated locally with either surgery or symptomatic care. The objective of our study was to assess patient outcomes and safety of this treatment strategy. METHODS: We retrospectively examined all cases of aneurysmal subarachnoid hemorrhage in Martinique diagnosed during 2004 to 2013...
November 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29162525/surgical-outcome-of-very-small-intracranial-aneurysms-utilizing-the-double-clip-technique
#9
Abdolkarim Rahmanian, Fariborz Ghaffarpasand, Ehsanali Alibai, Joham Choque-Velasquez, Behnam Rezai Jahromi, Juha Hernesniemi
OBJECTIVES: To report the outcome of patients with VSIA undergoing surgical clipping utilizing a double clip technique. METHODS: This cross-sectional study was conducted in Namazi hospital, the main referral neurovascular center in Southern Iran during a 6-year period from September 2010 to March 2016. All the patients with VSIAs (≤3mm) undergoing surgery by double clip technique were included. This technique reduces the clip slippage. The short- and long-term outcome determined by Glasgow Coma Scale (GOS), Modified Rankin Scale (MRS) and complications...
November 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29147918/aortic-arch-aneurysm-surgery-what-is-the-gold-standard-temperature-in-the-absence-of-randomized-data
#10
Amer Harky, Mohamad Bashir, Giovanni Mariscalco
In the absence randomized data for assessing the best and optimal temperature for managing open aortic arch surgery patients, cerebral protection method is still performed through hypothermic circulatory arrest with or without the use of adjuncts. A recent consensus has emerged setting to define the temperature levels. In an attempt, this was aimed to establish a solid ground for future trials in aortic arch surgery. This article reviews the current literature and the evidences behind using different temperature methods and their outcomes in patients undergoing open aortic arch surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#11
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29115588/limb-remote-ischemic-post%C3%A2-conditioning-reduces-injury-and-improves-long%C3%A2-term-behavioral-recovery-in-rats-following-subarachnoid-hemorrhage-possible-involvement-of-the-autophagic-process
#12
Xiang Hu, Tao Lv, Shao-Feng Yang, Xiao-Hua Zhang, Yi-Feng Miao
Hemorrhage‑related neurologic injury is a primary cause of disability and mortality following subarachnoid hemorrhage (SAH). The aim of the present study was to investigate the potential neuroprotective effect and the possible role of autophagy in limb remote ischemic post‑conditioning (RIPostC) using an endovascular puncture rat model of SAH. RIPostC was induced by three cycles of occlusion (10 min) and release (10 min) in the bilateral femoral artery using an aneurysm clip. Early RIPostC began immediately following SAH, delayed RIPostC began following a 30 min delay and the repeated RIPostC group underwent the protocol every day for 3 days...
October 24, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29114312/a-case-of-high-dose-adenosine-usage-for-anterior-communicating-artery-aneurysm-clip-ligation-what-is-the-dose-limit-for-a-resistant-response
#13
Shahid M Nimjee, David L McDonagh, Abhishek Agrawal, Gavin W Britz
Intraoperative adenosine is used to induce asystole to facilitate clip ligation of intracranial aneurysms. Typically, 5-10 mg doses are used per administration and approximately 30 mg is used for a given case. An obvious concern with using adenosine is that the patient can remain in asystole or that prolonged hypotension can result in cerebral or cardiovascular ischemia. The upper limit of adenosine administration remains unclear. We present a case of a patient with a large anterior communicating artery aneurysm requiring large doses of adenosine, far exceeding previously reported cases...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29114276/predictive-value-of-motor-evoked-potential-monitoring-during-surgery-of-unruptured-anterior-circulation-cerebral-aneurysms
#14
Yasuhiro Yamada, Yoko Kato, Mohsen Nouri, Tsukasa Ganaha, Motoki Oheda, Kohei Ishihara, Shigeta Moriya, Akiyo Sadato, Joji Inamasu, Yuichi Hirose
Objective and Background: Surgery of unruptured aneurysms is always a great challenge to neurovascular surgeons because no postoperative neurological deficits should be expected postoperatively as the patients are fully asymptomatic before the surgery. Here, we present our experience with selective motor evoked potential (MEP) monitoring of our patients in a 2-year time window. Patients and Methods: From 2012 to 2014, 27 patients with unruptured intracranial aneurysms were operated in our institute with the help of MEP monitoring...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29077162/stent-assisted-coiling-embolization-of-middle-cerebral-artery-trifurcation-wide-necked-aneurysms
#15
Y Chen, Y Zhang, Y-J Chao, G Gao, C-S Ni, X-M Fu, J-J Wei, D-Q Gu, J Yu
OBJECTIVE: The aim of this study was to examine the effects of stent-assisted coiling embolization of middle cerebral artery (MCA) trifurcation wide-necked aneurysms in clinical practice. PATIENTS AND METHODS: 57 patients with MCA trifurcation wide-necked aneurysms underwent stent-assisted coiling embolization using a solitaire AB stent. All 57 patients completed the surgery successfully. Embolization efficacy was graded according to the modified Raymond scale. RESULTS: There were 52 cases of complete embolization, 4 cases of residual aneurysm neck, and 1 case of residual aneurysm body...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29076786/adenosine-induced-cardiac-arrest-as-an-alternative-to-temporary-clipping-during-intracranial-aneurysm-surgery
#16
Patcharin Intarakhao, Peeraphong Thiarawat, Behnam Rezai Jahromi, Danil A Kozyrev, Mario K Teo, Joham Choque-Velasquez, Teemu Luostarinen, Juha Hernesniemi
OBJECTIVE The purpose of this study was to analyze the impact of adenosine-induced cardiac arrest (AiCA) on temporary clipping (TC) and the postoperative cerebral infarction rate among patients undergoing intracranial aneurysm surgery. METHODS In this retrospective matched-cohort study, 65 patients who received adenosine for decompression of aneurysms during microsurgical clipping were identified (Group A) and randomly matched with 65 selected patients who underwent clipping but did not receive adenosine during surgery (Group B)...
October 27, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29063277/3d-2d-registration-in-endovascular-image-guided-surgery-evaluation-of-state-of-the-art-methods-on-cerebral-angiograms
#17
Uroš Mitrović, Boštjan Likar, Franjo Pernuš, Žiga Špiclin
PURPOSE: Image guidance for minimally invasive surgery is based on spatial co-registration and fusion of 3D pre-interventional images and treatment plans with the 2D live intra-interventional images. The spatial co-registration or 3D-2D registration is the key enabling technology; however, the performance of state-of-the-art automated methods is rather unclear as they have not been assessed under the same test conditions. Herein we perform a quantitative and comparative evaluation of ten state-of-the-art methods for 3D-2D registration on a public dataset of clinical angiograms...
October 24, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29062560/use-of-a-minimally-invasive-cardiac-output-monitor-to-optimise-haemodynamics-in-a-patient-with-mitral-valve-disease-undergoing-cerebrovascular-surgery
#18
Ali M Al-Mashani, Niranjan D Waje, Neeraj Salhotra, Samaresh Das, Neelam Suri, Rashid A Al-Sheheimi, Nilay Chatterjee
Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29061453/prevention-of-the-rerupture-of-collateral-artery-aneurysms-on-the-ventricular-wall-by-early-surgical-revascularization-in-moyamoya-disease-report-of-two-cases-and-review-of-the-literature
#19
Fumiaki Kanamori, Syuntaro Takasu, Shinji Ota, Yukio Seki
BACKGROUND: Collateral artery aneurysms are a source of intracranial hemorrhage in moyamoya disease. Several reports have shown that surgical revascularization leads to the obliteration of collateral artery aneurysms. However, its effect on the prevention of rebleeding has not been established, and the optimal timing of the operation remains unclear. The purpose of the present study is to evaluate the effects of surgical revascularization and to investigate the optimal operation timing in patients with moyamoya disease who have ruptured collateral artery aneurysms on the ventricular wall...
October 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29053070/relationship-between-patient-safety-indicator-events-and-comprehensive-stroke-center-volume-status-in-the-treatment-of-unruptured-cerebral-aneurysms
#20
Chad W Washington, L Ian Taylor, Robert J Dambrino, Paul R Clark, Gregory J Zipfel
OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification. METHODS Using the 2002-2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected...
October 20, 2017: Journal of Neurosurgery
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