Journal of Cerebrovascular and Endovascular Neurosurgery最新文献

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Acute frame coil migration during filling coil retrieval in a cerebral aneurysm embolization case: A possible result of a venturi effect? 脑动脉瘤栓塞病例填充线圈取出时急性框架线圈移位:文丘里效应的可能结果?
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2022-03-01 Epub Date: 2021-11-02 DOI: 10.7461/jcen.2021.E2021.03.005
Omer Doron, Eran Meirowitz, Eitan Abergel
{"title":"Acute frame coil migration during filling coil retrieval in a cerebral aneurysm embolization case: A possible result of a venturi effect?","authors":"Omer Doron,&nbsp;Eran Meirowitz,&nbsp;Eitan Abergel","doi":"10.7461/jcen.2021.E2021.03.005","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.03.005","url":null,"abstract":"<p><p>Coil migration is a known complication of endovascular coiling of cerebral aneurysms. We report an acute coil migration occurring during coiling of an unruptured anterior choroidal aneurysm, while a separate coil was retrieved into the microcatheter concomitantly without direct contact between the coils. The \"pulling\" of a previously deployed stable coil is presented as an adverse effect that should be noted. This case exemplifies that not only direct entanglement or erroneous malposition can generate acute migration, but possibly, also alteration of physical forces during coil retrieval. A potential mechanism, similar to a venturi effect, caused by a quick suction within the microcatheter at its distal end, is suggested, and the clinical relevance of the case is discussed.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"24 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/76/jcen-2021-e2021-03-005.PMC8984644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39582194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Y-stent-assisted coiling with Neuroform Atlas stents for wide-necked intracranial bifurcation aneurysms: A preliminary report. y型支架辅助卷绕与神经形态Atlas支架治疗颅内宽颈分岔动脉瘤:初步报告。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2022-03-01 Epub Date: 2021-09-28 DOI: 10.7461/jcen.2021.E2021.06.010
Dongkyu Kim, Joonho Chung
{"title":"Y-stent-assisted coiling with Neuroform Atlas stents for wide-necked intracranial bifurcation aneurysms: A preliminary report.","authors":"Dongkyu Kim,&nbsp;Joonho Chung","doi":"10.7461/jcen.2021.E2021.06.010","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.06.010","url":null,"abstract":"<p><strong>Objective: </strong>To report our experience on Neuroform Atlas Y-stenting for coiling of unruptured wide-neck bifurcation aneurysms.</p><p><strong>Methods: </strong>From March 2018 to January 2021, we treated 473 aneurysms in 436 patients with coil embolization, of which 15 cases with wide-necked bifurcation aneurysms were treated by Y-stent-assisted coiling with two Neuroform Atlas stents. We retrospectively reviewed the characteristics of patients and aneurysms, procedure-related complications, radiographic results, and clinical outcomes.</p><p><strong>Results: </strong>All 15 cases using Neuroform Atlas Y-stenting were successful. Patients included 6 men and 9 women with a mean age ± standard deviation of 56.4±6.6 years. The mean dome and neck sizes were 6.4±3.1 mm and 4.7±1.8 mm, respectively. Immediate post-procedural angiograms showed complete occlusion in 46.7%, neck remnant in 13.3%, and incomplete occlusion in 40% of cases. No treatment-related morbidity or mortality occurred in any patients. All patients had good clinical outcomes (Glasgow Outcome Score 5) at both discharge and during a mean 12.3-month (range 1-28 months) follow-up. All aneurysms showed improved or stable occlusion on follow-up imaging. Further, the latest follow-up angiography showed complete occlusion in 73.3%, neck remnant in 6.7%, and incomplete occlusion in 20%. Conclusions: Y-stent-assisted coiling with Neuroform Atlas stents might be a feasible and safe option for wide-necked bifurcation aneurysms.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"24 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/fb/jcen-2021-e2021-06-010.PMC8984637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39465526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage. 动脉瘤性蛛网膜下腔出血患者线圈栓塞后再出血的相关因素。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2022-03-01 Epub Date: 2021-10-26 DOI: 10.7461/jcen.2021.E2021.05.006
Donghee Kim, Jinsu Pyen, Kum Whang, Sungmin Cho, Yeongyu Jang, Jongyeon Kim, Younmoo Koo, Jongwook Choi
{"title":"Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage.","authors":"Donghee Kim,&nbsp;Jinsu Pyen,&nbsp;Kum Whang,&nbsp;Sungmin Cho,&nbsp;Yeongyu Jang,&nbsp;Jongyeon Kim,&nbsp;Younmoo Koo,&nbsp;Jongwook Choi","doi":"10.7461/jcen.2021.E2021.05.006","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.05.006","url":null,"abstract":"<p><strong>Objective: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality rate, and hemorrhage amounts and perioperative rebleeding importantly determines prognosis. However, despite adequate treatment, prognosis is poor in many ruptured aneurysm cases. In this study, we identified and evaluated factors related to perioperative rebleeding in patients with aSAH.</p><p><strong>Methods: </strong>The medical and surgical records of 166 patients that underwent endovascular embolization for a ruptured cerebral aneurysm at a single institution from 2014 to 2016 were retrospectively analyzed to identify risk factors of rebleeding. All patients were examined for risk factors and evaluated for increased hemorrhage by brain computed tomography at 3 days after surgery.</p><p><strong>Results: </strong>This series included 54 men (32.5%) and 112 women (67.5%) of mean age 58.3±14.3 years. After procedures, 26 patients (15.7%) experienced rebleeding, and 1 of these (0.6%) experienced an intraoperative aneurysmal rupture. External ventricular drainage (EVD) (odds ratio [OR] 5.389, [95% confidence interval (CI) 1.171- 24.801]) and modified Fisher grade (OR 2.037, [95% CI 1.077-3.853]) were found to be independent risk factors of rebleeding, and perioperative rebleeding was strongly associated with patient outcomes (p<0.001). Conclusions: We concluded the rebleeding risk after aSAH is greater in patients with large hemorrhage amounts and a high pre-operative modified Fisher grade, and thus, we caution neurosurgeons should take care in such cases.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"24 1","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/bb/jcen-2021-e2021-05-006.PMC8984641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39559106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Transcranial Doppler study in acute spontaneous intracerebral hemorrhage: The role of pulsatility index. 经颅多普勒研究急性自发性脑出血:脉搏指数的作用。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-09-28 DOI: 10.7461/jcen.2021.E2021.05.001
Jiyong Park, Sung-Kyun Hwang
{"title":"Transcranial Doppler study in acute spontaneous intracerebral hemorrhage: The role of pulsatility index.","authors":"Jiyong Park,&nbsp;Sung-Kyun Hwang","doi":"10.7461/jcen.2021.E2021.05.001","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.05.001","url":null,"abstract":"<p><strong>Objective: </strong>Pulsatility index (PI) is a parameter calculated by transcranial Doppler sonography (TCD), which is commonly used for patients with subarachnoid hemorrhage or ischemic stroke. However, we performed a retrospective analysis of patients with acute spontaneous intracerebral hemorrhage (ICH) to assess the function of TCD, particularly the PI.</p><p><strong>Methods: </strong>This study involved a total of 46 patients with acute ICH who received treatment at a single center between May 2013 and December 2014. Medical records of baseline characteristics, except for the modified Rankin scale, were obtained at initial evaluation in the emergency room, and TCD was used to calculate middle cerebral artery flow velocity (MFV) and PI at admission (baseline), 24 h, and 7 days. The PI and MFV values on the affected middle cerebral artery were compared with those on the contralateral side. Linear regression analysis was used for statistical analyses (SPSS 21.0, IBM Corp., Armonk, NY, USA).</p><p><strong>Results: </strong>Statistical analysis indicated that sex, age, Glasgow coma scale, intraventricular hemorrhage, and hematoma size were not correlated with PI (p>0.05); however, only PI was positively correlated with functional outcome at 6 months after treatment (R=0.846, p=0.002).</p><p><strong>Conclusions: </strong>These results provide evidence that the parameter of PI is an independent determinant prognostic factor in acute spontaneous ICH. Further research is needed to investigate the influence of cerebral blood flow dynamics on a larger, more controlled, and more randomized basis.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"334-342"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/57/jcen-2021-e2021-05-001.PMC8743820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39465527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extending the stroke treatment window beyond DAWN in patients with very slow progressor type collaterals: How far can we go? 将进展缓慢型络的卒中治疗窗口期延长至黎明以外:我们能走多远?
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-12-17 DOI: 10.7461/jcen.2021.E2021.01.003
Igor Pagiola, Olivier Chassin, Sophie Gallas, Mariana Sarov Riviere, Nicolas Legris, Cristian Mihalea, Jildaz Caroff, Leon Ikka, Vanessa Chalumeau, Guilherme Brasileiro de Aguiar, Augustin Ozanne, Jacques Moret, Christian Denier, Laurent Spelle
{"title":"Extending the stroke treatment window beyond DAWN in patients with very slow progressor type collaterals: How far can we go?","authors":"Igor Pagiola,&nbsp;Olivier Chassin,&nbsp;Sophie Gallas,&nbsp;Mariana Sarov Riviere,&nbsp;Nicolas Legris,&nbsp;Cristian Mihalea,&nbsp;Jildaz Caroff,&nbsp;Leon Ikka,&nbsp;Vanessa Chalumeau,&nbsp;Guilherme Brasileiro de Aguiar,&nbsp;Augustin Ozanne,&nbsp;Jacques Moret,&nbsp;Christian Denier,&nbsp;Laurent Spelle","doi":"10.7461/jcen.2021.E2021.01.003","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.01.003","url":null,"abstract":"<p><p>Five trials published in 2015 showed the benefit of endovascular thrombectomy (ET) in patients with stroke and large vessel occlusion, extending the treatment window has become an obsession of all physicians. In 2018, the DAWN and DEFUSE-3 trials showed that, with careful selection of patients, the procedure could be carried out up to 24 hours after symptom onset with good outcomes. In addition, there have been cases where the DAWN criteria were met, and treatment occurred >24 hours after symptom onset. We present the case of a 68-year-old female whose groin puncture occurred 52 hours after the time last known well (TLKW), after neurological worsening of the initial situation, with a large mismatch ratio observed on magnetic resonance imaging, achieving TICI (the Thrombolysis in Cerebral Infarction scale) grade 3 recanalization. Five days after the procedure, the patient was discharged with NIHSS (National Institutes of Health Stroke Scale) score of 3. Some types of collateral circulation (slow progressors and \"turtle\" progressors, our term for very slow progressors) can extend the treatment window beyond 24 hours of the TLKW but can lead to a hyperperfusion-like syndrome immediately after the ET. Further studies are needed to evaluate the reproducibility of this hypothetical syndrome.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"354-358"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/e9/jcen-2021-e2021-01-003.PMC8743825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39731503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
A bibliometric analysis on the most-cited publications on carotid endarterectomy throughout history. 对历史上被引用最多的颈动脉内膜切除术文献计量学分析。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-12-02 DOI: 10.7461/jcen.2021.E2021.03.010
Elarjani Turki, Othman T Almutairi, Alhussinan Modhi, Bafaquh Mohammed, Abdulrahman Y Alturki
{"title":"A bibliometric analysis on the most-cited publications on carotid endarterectomy throughout history.","authors":"Elarjani Turki,&nbsp;Othman T Almutairi,&nbsp;Alhussinan Modhi,&nbsp;Bafaquh Mohammed,&nbsp;Abdulrahman Y Alturki","doi":"10.7461/jcen.2021.E2021.03.010","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.03.010","url":null,"abstract":"<p><strong>Objective: </strong>Carotid endarterectomy (CEA) is the gold standard surgical procedure for managing carotid stenosis due to atherosclerosis and reducing the risk of ischemic stroke. This bibliometric analysis summarizes the most-cited articles on CEA and highlights the contributing articles to today's evidence-based practice.</p><p><strong>Methods: </strong>A title-specific search using the Scopus database was used to perform the search. Pertinent article-based, journal-based, and author-based parameters were obtained for review.</p><p><strong>Results: </strong>A total of 6,824 articles were published between 1970 and 2020. The top 100 most-cited articles accumulated a total of 54,153 citations with an average citation count (CC) of 541, with only a 4.53% self-citation rate for all authors. The publication trends peaked between 1997 and 2010, in which two-third of the highly cited works were published. The most prolific categories with top citations are the clinical, indications, and management, in a descending order. There were 41 published Randomized Controlled Trials (RCT) in the most-cited list.</p><p><strong>Conclusions: </strong>Citation analysis on carotid endarterectomy has witnessed a marked shift in the publication trends from studying the outcome and complications to comparing carotid stenting with endarterectomy. This analysis is a good introductory article to physicians interested in this topic, as it summarizes the highly impactful articles and enlists the most-cited RCT on CEA.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"314-326"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/7f/jcen-2021-e2021-03-010.PMC8743826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39950415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Flow recovery after posterior clinoidectomy for surgical clipping of anterior choroidal aneurysm. 前脉络膜动脉瘤夹闭手术后斜突切除术后血流恢复。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-12-17 DOI: 10.7461/jcen.2021.E2021.05.004
Federico Carlos Gallardo, Juan Santiago Bottan, Clara Martin, Aylen Andrea Targa Carcia, Roman Pablo Arevalo, Pablo Augusto Rubino
{"title":"Flow recovery after posterior clinoidectomy for surgical clipping of anterior choroidal aneurysm.","authors":"Federico Carlos Gallardo,&nbsp;Juan Santiago Bottan,&nbsp;Clara Martin,&nbsp;Aylen Andrea Targa Carcia,&nbsp;Roman Pablo Arevalo,&nbsp;Pablo Augusto Rubino","doi":"10.7461/jcen.2021.E2021.05.004","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.05.004","url":null,"abstract":"<p><p>Inadvertent flow alterations in the parent artery during microsurgical clipping might produce postoperative ischemic complications. Intraoperative recognition of such alterations and its correction might improve operative outcomes in these patients. We present the case of a thirty-five-year-old male with an incidental small left anterior choroidal aneurysm. Microsurgical clipping induced an external compression of the anterior choroidal artery against the posterior clinoidal process which was identified in situ through surgical exploration and the loss of arterial doppler signal in the vessel. After failed attempts at clip repositioning, a posterior clinoidectomy was performed to decompress the artery. This resulted in arterial flow recovery. The aneurysm was successfully treated, and a severe ischemic complication was likely avoided. This intraoperative phenomenon has not yet been described in the literature.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"343-347"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/d8/jcen-2021-e2021-05-004.PMC8743822.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39844146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Staged hybrid treatment for giant thrombosed fusiform aneurysm. 巨大血栓性梭状动脉瘤的分期混合治疗。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-12-29 DOI: 10.7461/jcen.2021.E2021.06.004
Yunho Noh, Sung Ho Lee, Seok Mann Yoon, In Hag Song, Jae Sang Oh
{"title":"Staged hybrid treatment for giant thrombosed fusiform aneurysm.","authors":"Yunho Noh,&nbsp;Sung Ho Lee,&nbsp;Seok Mann Yoon,&nbsp;In Hag Song,&nbsp;Jae Sang Oh","doi":"10.7461/jcen.2021.E2021.06.004","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.06.004","url":null,"abstract":"<p><p>Partially thrombosed intracranial aneurysm was difficult to treat because of higher recurrence rate compared to non-thrombosed saccular aneurysm. The author reports a case of partially thrombosed intracranial aneurysm causing transient ischemic symptom. A 40-year-old man presented with transient right hemiparesis. Brain magnetic resonance imaging (MRI) depicted low-signal intensity target-like mass lesion on left sylvian fissure, and magnetic resonance angiography (MRA) showed aneurysm on left middle cerebral artery bifurcation (MCBF), suggested thrombosed aneurysm. On operative finding, aneurysm wall had thick and atherosclerotic change, and it was fusiform aneurysm not saccular type. We initially planned direct clip for the aneurysm, but it was failed due to collapse of parent artery after clipping on aneurysm neck. To prevent ischemia, extracranial-intracranial bypass was performed and then thrombectomy with clip reconstruction. To remodeling the fusiform aneurysm, stent-assisted coiling was performed for remnant portion of aneurysm. With staged hybrid technique, giant thrombosed fusiform aneurysm was completely obliterated and the patient did not suffer any neurologic symptoms no longer.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"359-364"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/c9/jcen-2021-e2021-06-004.PMC8743827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Transvenous injection of n-butyl 2-cyanoacrylate to obliterate the pathologic cavernous sinus as a salvage technique for incompletely obliterated complex cavernous sinus dural arteriovenous fistula after transvenous coil embolization. 经静脉注射2-氰基丙烯酸丁酯闭塞病理性海绵窦作为经静脉栓塞后不完全闭塞的复杂海绵窦硬膜动静脉瘘的抢救技术。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-10-26 DOI: 10.7461/jcen.2021.E2021.05.008
Joo Young Jung, Jong Young Lee
{"title":"Transvenous injection of n-butyl 2-cyanoacrylate to obliterate the pathologic cavernous sinus as a salvage technique for incompletely obliterated complex cavernous sinus dural arteriovenous fistula after transvenous coil embolization.","authors":"Joo Young Jung,&nbsp;Jong Young Lee","doi":"10.7461/jcen.2021.E2021.05.008","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.05.008","url":null,"abstract":"<p><p>A Barrow type D of complex cavernous sinus dural arteriovenous fistula (CS-dAVF) was completely obliterated by using coils, n-butyl 2-cyanoacrylate (NBCA) and Onyx via transvenous approach. Especially in this case, after transvenous coil embolization of the pathologic cavernous sinus (CS), transvenous injection of NBCA was done to obliterate residual shunts recruited into CS. The complex CS-dAVF was completely obliterated without periprocedural complications. Transvenous injection of NBCA could be considered as a feasible option for obliteration of pathologic CS in a case of incompletely obliterated complex CS-dAVF after transvenous coil embolization.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"348-353"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/d5/jcen-2021-e2021-05-008.PMC8743828.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39559107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Readmission into intensive care unit in patients with aneurysmal subarachnoid hemorrhage. 动脉瘤性蛛网膜下腔出血患者再次入住重症监护病房的分析。
Journal of Cerebrovascular and Endovascular Neurosurgery Pub Date : 2021-12-01 Epub Date: 2021-11-12 DOI: 10.7461/jcen.2021.E2021.06.001
Hye Seok Park, Sung Ho Lee, Kang Min Kim, Won-Sang Cho, Hyun-Seung Kang, Jeong Eun Kim, Eun Jin Ha
{"title":"Readmission into intensive care unit in patients with aneurysmal subarachnoid hemorrhage.","authors":"Hye Seok Park,&nbsp;Sung Ho Lee,&nbsp;Kang Min Kim,&nbsp;Won-Sang Cho,&nbsp;Hyun-Seung Kang,&nbsp;Jeong Eun Kim,&nbsp;Eun Jin Ha","doi":"10.7461/jcen.2021.E2021.06.001","DOIUrl":"https://doi.org/10.7461/jcen.2021.E2021.06.001","url":null,"abstract":"<p><strong>Objective: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event; patients are routinely admitted to the intensive care unit (ICU) for initial management. Because complications may be delayed, unplanned ICU readmissions can occur. Therefore, in this study we evaluate the rate of and factors associated with readmission after aSAH and identify if readmission is associated with poor clinical outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of all patients receiving surgical or endovascular treatment for aSAH and admitted to the ICU between January 2008 and December 2019. We categorized patients by readmission and analyzed their clinical parameters.</p><p><strong>Results: </strong>Of the 345 patients who transferred to ward-level care after an initial ICU stay (Group 2), 27 (7.3%) were readmitted to the ICU (Group 1). History of hypertension (HTN), initial Glasgow Coma Scale (GCS) score, modified Fisher grade, and vasospasm therapy during first ICU stay were significantly different between the groups. The most common reason for readmission was delayed cerebral ischemia (DCI; 70.3%; OR 5.545; 95% CI 1.25-24.52; p=0.024). Comorbid HTN (OR 5.311; 95% CI 1.75-16.12; p=0.03) and vasospasm therapy during first ICU stay (OR 7.234; 95% CI 2.41-21.7; p<0.01) also were associated with readmission. Readmitted patients had longer hospital stay and lower GCS scores at discharge (p<0.01).</p><p><strong>Conclusions: </strong>DCI was the most common cause of ICU readmission in patients with aSAH. Readmission may indicate clinical deterioration, and patients who are at a high risk for DCI should be monitored to prevent readmission.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"23 4","pages":"327-333"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/7c/jcen-2021-e2021-06-001.PMC8743824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39700234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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