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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/29653272/evaluation-of-microsurgery-for-managing-giant-or-complex-cerebral-aneurysms-a-retrospective-study
#1
Nakao Ota, Hidetoshi Matsukawa, Kosumo Noda, Hirotaka Sato, Yuto Hatano, Atsumu Hashimoto, Takanori Miyazaki, Tomomasa Kondo, Yu Kinoshita, Norihiro Saito, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada, Rokuya Tanikawa
OBJECTS: Surgical or endovascular treatment for giant or complex aneurysms is challenging. To evaluate clinical outcomes and factors affecting the prognosis of giant or complex aneurysms, and to better establish the role of microsurgery in the management strategy. METHODS: One hundred fifty-nine patients with surgically treated complex aneurysms were included. Thirty-two (20.1%) patients had giant aneurysms (≥25 mm); 57 (35.8%) had large aneurysms (≥15 mm). Poor outcome was defined as modified Rankin scale scores 3-6...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29643435/higher-leukocyte-count-predicts-3-month-poor-outcome-of-ruptured-cerebral-aneurysms
#2
Pei-Sen Yao, Guo-Rong Chen, Xue-Ling Xie, Huang-Cheng Shang-Guan, Jin-Zhen Gao, Yuan-Xiang Lin, Shu-Fa Zheng, Zhang-Ya Lin, De-Zhi Kang
It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Here, we retrospectively analyzed the clinical data of 428 patients with ruptured CA between 2010 and 2015. Patients' demographic data, including gender, age, history of smoking, alcohol, hypertension, diabetes and hypercholesterolemia, Hunt-Hess and Fisher grade, occurrence of hydrocephalus, aneurysm location, time to surgery, delayed ischemic neurological deficit (DIND) and peak leukocyte of blood test from day 1 to 3 after aneurysmal rupture were recorded and analyzed...
April 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29629234/a-difficult-to-treat-acom-aneurysm-with-the-combined-vascular-anomaly-of-acom-fenestration-and-accessory-anterior-cerebral-artery
#3
Hideyuki Tomita, Katsuya Saito
Background: Vascular anomaly and aneurysmal formation of an anterior communicating artery (Acom) complex has often been reported. Because of such a complicated relationship between the vascular structure and aneurysms, Acom aneurysm is one of the most difficult aneurysms to treat among other common anterior circulation aneurysms. We experienced an extremely rare and difficult-to-treat case of ruptured Acom aneurysm with the combined vascular anomaly of the Acom fenestration and an accessory anterior cerebral artery (ACA)...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29611032/thoracoabdominal-aortic-replacement-in-patients-aged-50-and-younger
#4
REVIEW
Kenji Minatoya, Yosuke Inoue, Yoshimasa Seike, Atsushi Omura, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVE: Open repair of a thoracoabdominal aortic aneurysm (TAAA) has been regarded as one of the most invasive procedures in cardiovascular surgery. Conversely, endovascular technology currently enables the repair of the thoracoabdominal aorta, and this approach is less invasive. However, the long-term durability of this method of endovascular repair remains unknown. This investigation retrospectively analyzed the long-term durability of thoracoabdominal aorta repair in patients aged 50 and younger...
April 2, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29599633/the-factors-associated-with-outcomes-in-surgically-managed-ruptured-cerebral-aneurysm
#5
Lai Chuang Chee, Johari Adnan Siregar, Abdul Rahman Izani Ghani, Zamzuri Idris, Noor Azman A Rahman Mohd
Background: Ruptured cerebral aneurysm is a life-threatening condition that requires urgent medical attention. In Malaysia, a prospective study by the Umum Sarawak Hospital, Neurosurgical Center, in the year 2000-2002 revealed an average of two cases of intracranial aneurysms per month with an operative mortality of 20% and management mortality of 25%. Failure to diagnose, delay in admission to a neurosurgical centre, and lack of facilities could have led to the poor surgical outcome in these patients...
February 2018: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29582975/feasibility-of-endoscopic-endonasal-approach-for-clip-application-of-cerebral-aneurysms-a-systematic-review
#6
Jonathan A Forbes, Sophie D' Herbemont, Kurt R Lehner, Diego Pineda Martinez, Ignacio P Navarro-Chávez, Diego Mendez Rosito, Theodore H Schwartz
INTRODUCTION: While open, microsurgical clipping and endovascular coiling remain the gold standards for treatment of cerebral aneurysms, a growing number of aneurysms treated via endoscopic endonasal methods have been reported in the literature. The aim of this study was to conduct a systematic review of the literature to gain a more thorough appreciation of the potential benefits and drawbacks of the endoscopic endonasal strategy in this setting. EVIDENCE ACQUISITION: We performed a detailed systematic review of the medical literature on endoscopic endonasal skull base surgery for treatment of cerebral aneurysms utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29570011/clipping-as-re-treatment-strategy-after-treatment-of-a-cerebral-aneurysm-with-the-woven-endobridge-embolization-device-case-report
#7
Gregor Durner, Yigit Özpeynirci, Bernd Schmitz, Christian Rainer Wirtz, Ralph König, Andrej Pala
Recently, treatment of cerebral aneurysms with the Woven EndoBridge (WEB) device has become an established endovascular strategy. However, over time, neurosurgeons and neuroradiologists will be confronted with the challenge of how to treat aneurysm recanalization. The authors report the case of a 49-year-old woman who underwent re-treatment with clipping after the recanalization of a 4 × 3-mm anterior communicating artery aneurysm that had previously been treated using a 4 × 3 WEB device. In contrast to the authors' prior experiences with clipping of previously coiled aneurysms, the WEB device was found to have a responsive softness during clip placement, and the aneurysm was more maneuverable...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29567869/-computational-fluid-dynamic-analysis-of-intracranial-aneurysms-using-newly-developed-software-can-it-predict-the-thin-walled-region-of-intracranial-aneurysm-preoperatively
#8
Emiko Hori, Kimiko Umemura Oya, Satoshi Hori, Soshi Okamoto, Takashi Shibata, Michiya Kubo, Yukio Horie, Masaki Koh, Daina Kashiwazaki, Satoshi Kuroda
OBJECT: Recent studies have shown that computational fluid dynamics(CFD)analysis is useful to evaluate flow dynamics of intracranial aneurysms. However, CFD analysis still requires high costs and substantial time even now. This study aimed to evaluate whether newly developed software can shorten the time for analysis and serve useful information during clipping surgery for intracranial aneurysms. METHODS: CFD analysis was performed in 55 unruptured cerebral aneurysms in 51 patients...
March 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29548950/impact-of-intraoperative-3-dimensional-volume-rendering-rotational-angiography-on-clip-repositioning-rates-in-aneurysmal-surgery
#9
Yew-Weng Fong, Szu-Kai Hsu, Chih-Ta Huang, Cheng-Ta Hsieh, Ming-Hong Chen, Jing-Shan Huang, Chih-Ju Chang, I-Chang Su
OBJECTIVE: mThree-dimensional (3D) rotational angiography (RA), a gold-standard imaging tool for the post-clipping evaluation of cerebral aneurysms, can currently be performed intraoperatively in a hybrid operating room (OR). However, its role in intraoperative aneurysmal surgery is unclear. We aimed to study the value of intraoperative two-dimensional digital subtraction angiography (2D-DSA) and 3D-RA for the post-clipping evaluation of aneurysms, in terms of clip repositioning. METHODS: We included patients with cerebral aneurysms who were treated via microsurgical clipping in a hybrid OR...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29544752/management-of-an-internal-carotid-artery-injury-caused-by-a-displaced-titanium-plate-with-a-combination-of-interventional-vascular-radiology-and-surgery
#10
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29543217/-reasonability-and-efficacy-of-decompressive-craniectomy-in-patients-with-subarachnoid-hemorrhage-after-microsurgical-aneurysm-exclusion
#11
Yu V Pilipenko, An N Konovalov, Sh Sh Eliava, O B Belousova, D N Okishev, I A Sazonov, T F Tabasaranskiy
In recent years, the so-called primary or preventive decompressive craniectomy (DC) has been increasingly used in patients with aneurysmal subarachnoid hemorrhage (SAH). The main goal of the technique is prevention of refractory intracranial hypertension (ICH) and its consequences. PURPOSE: The study purpose was to define the CT criteria for reasonability and efficacy of DC as well as clarification of the indications for preventive DC in patients with SAH after microsurgical aneurysm exclusion...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29538196/surgical-interventions-of-isolated-active-mitral-valve-endocarditis-predisposing-factors-and-impact-of-neurological-insults-on-final-outcome
#12
Hsiu-An Lee, Chun-Yu Lin, Yung-Chang Chen, Shao-Wei Chen, Yu-Yun Nan, Kuo-Sheng Liu, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng-Jing Lin, Feng-Chun Tsai
The feasibility and durability of mitral valve (MV) repair in active infective endocarditis (IE) has been reported, but proper management of perioperative neurological complications and surgical timing remains uncertain and may crucially affect the outcome.In this single-center retrospective observational study, patients who underwent isolated MV surgery for active native IE in our institution between August 2005 and August 2015 were reviewed and analyzed. Patients who were operated on for healed IE or who required combined procedures were excluded from this study...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29536207/bypass-in-neurosurgery-indications-and-techniques
#13
REVIEW
L Wessels, N Hecht, P Vajkoczy
Since the introduction of cerebral bypass surgery by Professor Yasargil in 1967, a plethora of literature has been published on direct cerebral revascularization. Against this background, it is remarkable that at present, only three randomized controlled trials (RCTs) exist in the field, both dealing with extracranial to intracranial bypass surgery for flow augmentation in patients at risk to suffer ischemic or hemorrhagic stroke due to cerebrovascular disease. Next to flow augmentation, the other main indication for bypass surgery is to provide flow replacement following proximal vessel sacrifice for treatment of complex aneurysms or skull base tumors...
March 13, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29529913/smartphone-assisted-minimally-invasive-neurosurgery
#14
Mauricio Mandel, Carlo Emanuel Petito, Rafael Tutihashi, Wellingson Paiva, Suzana Abramovicz Mandel, Fernando Campos Gomes Pinto, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery...
March 13, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29529323/rapid-m1-hemoclips-arteriotomy-repair-after-emergency-coil-embolectomy
#15
Hassan Saad, Khaled M Krisht, Wei-Hsun Yang, Emad Aboud, Ali F Krisht
BACKGROUND: The vascular closure staple clips have been studied in animal models and shown to have comparable results with sutured repair when it comes to the healing process, degree of vessel narrowing, and risk of thrombosis. However, they are clearly superior when the speed of application is taken into account, and they were clinically used in many vascular repair processes. Nevertheless, their usefulness in intracranial vascular surgery has not been described. OBJECTIVE: To describe the usefulness of hemoclips in fast and efficient repair of medium-sized and large intracranial vessels...
February 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29526064/management-of-recurrent-cerebral-aneurysm-after-surgical-clipping-clinical-article
#16
Pius Kim, Suk Jung Jang
OBJECTIVE: Surgical clipping of the cerebral aenurysm is considered as a standard therapy with endovascular coil embolization. The surgical clipping is known to be superior to the endovascular coil embolization in terms of recurrent rate. However, a recurrent aneurysm which is initially treated by surgical clipping is difficult to handle. The purpose of this study was to research the management of the recurrent cerebral aneurysm after a surgical clipping and how to overcome them. METHODS: From January 1996 to December 2015, medical records and radiologic findings of 14 patients with recurrent aneurysm after surgical clipping were reviewed retrospectively...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29510287/endovascular-treatments-in-combination-with-extracranial-intracranial-bypass-for-complex-intracranial-aneurysms
#17
Kenichi Sato, Hidenori Endo, Miki Fujimura, Toshiki Endo, Yasushi Matsumoto, Hiroaki Shimizu, Teiji Tominaga
OBJECTIVE: Although most intracranial aneurysms can be treated with microsurgery or endovascular procedure alone, a subset of aneurysms may require a combined approach. The purpose of this study was to assess the efficacy of endovascular interventions combined with bypass surgery for the treatment of complex intracranial aneurysms. METHODS: We retrospectively reviewed medical records from a prospectively maintained patient database to identify patients who underwent endovascular treatment of an intracranial aneurysm at our institutes from 2007 to 2017...
March 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29502322/vascular-assessment-after-clipping-surgery-using-four-dimensional-ct-angiography
#18
Yusuke Kimura, Takeshi Mikami, Kei Miyata, Hime Suzuki, Toru Hirano, Katsuya Komatsu, Nobuhiro Mikuni
Recent advances in computed tomography angiography (CTA) enable repeated imaging follow up for post-clipping surgery. The purpose of this study was to clarify the critical volume and configuration of the aneurysmal clip in the postoperative evaluation using volume rendering (VR) imaging, and present four-dimensional (4D)-CTA for these larger metal artifacts. A total of 44 patients with cerebral aneurysm, treated using clipping surgery, were included in this study. The metal artifact volume was assessed using CTA and the association between the type of clips and its metal artifact volume was analyzed...
March 3, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29498577/botulinum-toxin-to-improve-vessel-graft-patency-in-cerebral-revascularization-surgery-report-of-3-cases
#19
Ben A Strickland, Robert C Rennert, Joshua Bakhsheshian, Sebina Bulic, Adrian J Correa, Arun Amar, Joseph Carey, Jonathan J Russin
Surgical revascularization continues to play an important role in the management of complex intracranial aneurysms and ischemic cerebrovascular disease. Graft spasm is a common complication of bypass procedures and can result in ischemia or graft thrombosis. The authors here report on the first clinical use of botulinum toxin to prevent graft spasm following extracranial-intracranial (EC-IC) bypass. This technique was used in 3 EC-IC bypass surgeries, 2 for symptomatic carotid artery occlusions and 1 for a ruptured basilar tip aneurysm...
March 2, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29489696/duplicated-middle-cerebral-artery-origin-with-an-aneurysm
#20
Hecheng Ren, Lin Ma, Ming Wei, Jialin Li, Mingsheng Yu, Long Yin
RATIONALE: Middle cerebral artery (MCA) anomalies are relatively rare and often related to aneurysms. Familiarity with these anomalies is important in resolving problems that arise in the complex angioarchitecture. Reports often describe that aneurysms that are related to accessory or duplicated MCA are often located at its origin. PATIENT CONCERNS: A 59-year-old man presented with a headache for 10 days, without nausea and vomiting. The physical examination was negative...
March 2018: Medicine (Baltimore)
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