World neurosurgery最新文献

{"title":"Extracranial Carotid Artery Aneurysms: A Comprehensive Analysis of its Epidemiology, Pathogenesis, Diagnosis, and Management: A Scoping Review.","authors":"Hector R Martinez, Carlos D Acevedo-Castillo, Hannia M Macias-Cruz, Uriel A Bautista-Coronado, Omar R Ortega-Ruiz, Alan Cornejo-Hernandez, Patricio Naranjo-Hernández, Paulo M Tabera-Tarello, Jose A Moran-Guerrero, Jose A Figueroa-Sanchez","doi":"10.1016/j.wneu.2024.11.111","DOIUrl":"10.1016/j.wneu.2024.11.111","url":null,"abstract":"<p><strong>Background: </strong>Extracranial carotid artery aneurysms (ECAAs) are extraordinarily rare, representing approximately 0.4%-4% of all extracranial artery aneurysms. As medical technology has advanced, new approaches for ECAAs treatment can be performed. Nevertheless, there is currently no consensus on the best therapeutic approach due to the information scarcity.</p><p><strong>Methods: </strong>We performed a systematic review of all published ECAA cases in Scopus, Medline, Web of Science, and Google Scholar to retrieve all available studies up to March 2024.</p><p><strong>Results: </strong>Eighty-eight studies reporting on a total of 359 patients presenting ECAAs were included. The mean age at diagnosis was 53 years. Most patients were male (58.4%). The primary presenting symptoms were pulsatile mass (31.2%), ischemia (24.7%), pain (9.75%), and dizziness (8.36%). Overall, the leading etiologies of aneurysms were atherosclerosis (34.2%), trauma (10%), and vasculitis (5.57%). Surgery was performed in 68.5% of patients, 26.7% underwent endovascular procedures, and 3.9% received conservative management.</p><p><strong>Conclusions: </strong>ECAAs are a rare clinical condition. However, a great percentage of patients could present with ischemic symptoms. Similarly, cardiovascular risk factors present as the most prevalent comorbid conditions associated with these vascular aberrancies. With this systematic review, we seek to provide insight into extracranial carotid aneurysms, identifying areas of opportunity in both the diagnosis and management of this pathology and the standardization of clinical reporting and case classification. These findings underscore the need for future research to improve the understanding and approach to this complex clinical condition.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123528"},"PeriodicalIF":1.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke-Related Outcomes in Moyamoya Disease Compared with Moyamoya Syndromes: A Propensity-Matched Analysis.","authors":"Aryan Wadhwa, Kimberly Han, Felipe Ramirez-Velandia, Omar Alwakaa, Coleman Riordan, Evan McNeil, Justin H Granstein, Philipp Taussky, Alejandro Enriquez-Marulanda, Christopher S Ogilvy","doi":"10.1016/j.wneu.2024.11.104","DOIUrl":"10.1016/j.wneu.2024.11.104","url":null,"abstract":"<p><strong>Objective: </strong>Moyamoya syndrome (MMS) is a subset of moyamoya disease (MMD) with a systemic comorbidity. Due to the lack of direct comparisons between various MMS subgroups and their MMD counterparts, we aimed to analyze differences in stroke-related outcomes between MMS subgroups and patients with MMD through propensity score matching (PSM).</p><p><strong>Methods: </strong>We analyzed the National Inpatient Sample (NIS) from 2011 to 2020 for patients with MMD and common MMS-related comorbidities: Down syndrome (DS), sickle-cell disease (SCD), and type 1 neurofibromatosis (NF1). PSM was performed to match patients of each MMS subgroup to patients with MMD only, controlling for stroke risk factors. Rates of ischemic strokes, hemorrhagic strokes, and transient ischemic attacks (TIAs) were evaluated after matching.</p><p><strong>Results: </strong>A total of 10,652 patients with a moyamoya diagnosis were identified: 7971 with MMD only, 2202 with MMS-SCD, 162 with MMS-NF1, and 317 with MMS-DS. PSM for MMD only and MMS-SCD resulted in 630 matched pairs. After matching, univariate analysis showed that patients with MMS-SCD had significantly lower rates of ischemic strokes (8.9% vs. 17.9%; P = 0.001), hemorrhagic strokes (5.1% vs. 8.1%; P = 0.031), and TIAs (2.2% vs. 4.6%; P = 0.020) than did patients with MMD only. For the MMS-DS subgroup, 92 matched pairs showed significantly lower rates of TIAs than did patients with MMD only (0% vs. 6.5%; P = 0.013). Comparing 54 matched pairs of patients with MMD only and patients with MMS-NF1 showed no significant differences in stroke-related outcomes.</p><p><strong>Conclusions: </strong>Patients with MMS-SCD had significantly lower rates of acute ischemic stroke, hemorrhagic stroke, and TIA compared with patients with MMD only. Future research should consider the source of these differences in improving stroke prevention in patients with MMD.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123521"},"PeriodicalIF":1.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Subgroups with Rapid Tumor Growth Rate in Adult Pituitary Neuroendocrine Tumors: A Comprehensive Analysis of Clinical and Imaging Features.","authors":"Zhe Zhang, Peng Li, Xiaojie Yang, Jie Yin, Junhua He, Yanan Hu, Pinan Liu","doi":"10.1016/j.wneu.2024.11.103","DOIUrl":"10.1016/j.wneu.2024.11.103","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively investigate the clinical and imaging features associated with the tumor growth rate (TGR) of pituitary neuroendocrine tumors (PitNETs).</p><p><strong>Methods: </strong>The tumor volume was assessed using magnetic resonance imaging. The potential growth-related parameters were compared among different TGR subgroups. Logistic regression analysis and receiver operating characteristic curves were used to identify risk factors and evaluate their diagnostic accuracy for rapid TGR, respectively.</p><p><strong>Results: </strong>The study included 81 patients with PitNETs who met the inclusion criteria. Receiver operating characteristic curves were used to determine the optimal cut-off values for age and tumor volume at initial diagnosis. The factors significantly associated with rapid TGR were age <55 years, T2 heterogeneity, and Knosp grade ≥3 (P < 0.05). No significant differences were found among other clinical and imaging subgroups. Multivariate regression analysis confirmed that these factors increased the risk of rapid TGR (P < 0.05). The area under the curve for predicting rapid TGR using age <55 years, T2 heterogeneity, Knosp grade ≥3, and a combined model of these factors were 0.677 (95% confidence interval [CI], 0.564-0.777), 0.705 (95% CI, 0.593-0.801), 0.680 (95% CI, 0.567-0.780), and 0.834 (95% CI, 0.735-0908), respectively. Additionally, the expression of cell lineage-specific transcription factors and Ki-67 exhibited a significant correlation with age <55 years and T2 heterogeneity; however, no association was observed with Knosp grade.</p><p><strong>Conclusions: </strong>The TGR of PitNETs is associated with age, T2 heterogeneity, and Knosp grade. Integrating these factors improves the accuracy of prediction for TGR. Therefore, understanding the TGR in PitNETs can provide valuable evidence for tailoring individualized treatment strategies for patients.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123520"},"PeriodicalIF":1.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Surgical Education for Medical Students Through Virtual Reality: The Digital Surgical Operating Theatre Tour.","authors":"Daniel Dubinski, Sae-Yeon Won, Constantin Hardung, Artem Rafaelian, Kaja Paschke, Milos Arsenovic, Bedjan Behmanesh, Matthias Schneider, Thomas M Freiman, Florian Gessler, Bernd Romeike","doi":"10.1016/j.wneu.2024.11.106","DOIUrl":"10.1016/j.wneu.2024.11.106","url":null,"abstract":"<p><strong>Objective: </strong>Although the operating theatre offers unique didactic opportunities, it can be perceived as an uncomfortable environment by medical students due to the lack of theatre etiquette, time pressure and parallel work of different disciplines. We investigated whether virtual reality (VR) training can significantly reduce some of these fears and improve surgical education for medical students.</p><p><strong>Methods: </strong>We randomly divided a group of 24 medical students and investigated the effects of a VR application (digitally recreated operating theatre tour) and compared it with currently-in-use written instructions for operational tasks in the operating theatre. The parameters analyzed in this study included timekeeping, orientation, and the error rate.</p><p><strong>Results: </strong>Medical students who received a preparational VR training for tasks in the operating theatre showed a statistically significant lower rate of getting stuck (P < 0.03), time to find the operation room (P < 0.01), correct gowning (P < 0.05) and better identification of surgical equipment (P < 0.01). The use of a digitally reconstructed operating theatre using VR led to a significant improvement in orientation and error rate in the behavior of medical students in the operating theatre.</p><p><strong>Conclusions: </strong>Routine VR use as part of clinical training could be beneficial in future medical education.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123523"},"PeriodicalIF":1.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study Between Unilateral Biportal Endoscopic Discectomy and Percutaneous Interlaminar Endoscopic Discectomy for the Treatment of L5/S1 Disc Herniation.","authors":"Jianjian Yin, Gongming Gao, Senlin Chen, Tao Ma, Luming Nong","doi":"10.1016/j.wneu.2024.11.109","DOIUrl":"10.1016/j.wneu.2024.11.109","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes of unilateral biportal endoscopic discectomy (UBED) and percutaneous interlaminar endoscopic discectomy (PIED) for treating L5/S1 disc herniation.</p><p><strong>Methods: </strong>Patients with L5/S1 disc herniation treated with UBED (n = 46) and PIED (n = 50) in our hospital during the same period were retrospectively reviewed. Clinical outcome, radiographic parameters, and complications of each group were collected and evaluated.</p><p><strong>Results: </strong>The mean follow-up period was 14.11 ± 3.47 months in the UBED group and 14.52 ± 5.37 months in the PIED group. There was no significant difference in visual analog scale score for the leg (P = 0.836) or lumbar scores (P = 0.335) between PIED and UBED group at preoperative, 1-day postoperative, and last follow-up point. Within the same group, there were significant differences in visual analog scale score for the leg (P < 0.001) and lumbar scores (P < 0.001) compared pairwise at 3 time points. Oswestry Disability Index scores of both groups showed significant improvement at the last follow-up (P < 0.001, P < 0.001), and there was no significant difference in patient satisfaction rates (97.8% vs. 96%) between the 2 groups on the basis of the MacNab criteria. The percentage of facet joint preservation was 96.74 ± 9.10% in the UBED group and 99.22 ± 1.52% in the PIED group. The total blood loss and hospitalization cost was greater in the UBED group. One patient in both groups showed postoperative hematoma. A dural tear occurred in UBED group and a never root injury occurred in the PIED group.</p><p><strong>Conclusions: </strong>UBED indicates similar short-term efficacy compared with PIED for treating L5/S1 disc herniation. No difference was found in facet joint preservation between the 2 groups. We believe the increased cost of UBED as the result of surgical consumables will decrease in the future.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123526"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigated Osteosynthesis for Unstable Atlas Fractures: Technical Note and Case Series.","authors":"John D Arena, Yohannes Ghenbot, Samuel B Tomlinson, Connor A Wathen, Andrea L C Schneider, H Isaac Chen, Zarina S Ali, James M Schuster, Dmitriy Petrov","doi":"10.1016/j.wneu.2024.11.107","DOIUrl":"10.1016/j.wneu.2024.11.107","url":null,"abstract":"<p><strong>Objective: </strong>Fractures of the atlas are typically considered stable or unstable based on the integrity of the transverse ligament. Whereas stable Jefferson burst fractures can be treated nonoperatively, unstable fractures with disruption of the transverse ligament often require surgical intervention. Atlas osteosynthesis has been proposed as a motion-preserving alternative to atlantoaxial fusion. Intraoperative navigation may facilitate safe placement of C1 instrumentation.</p><p><strong>Methods: </strong>Cases of patients with unstable atlas fractures treated with navigated osteosynthesis at a single level I trauma center were identified and retrospectively reviewed. Clinical presentation, surgical management, and postoperative outcomes were assessed.</p><p><strong>Results: </strong>Eight patients underwent navigated posterior atlas osteosynthesis for unstable C1 fractures between December 2015 and January 2024. All patients demonstrated injury to the transverse ligament (Dickman type I [n = 1] and type II [n = 7]). Patients were followed with serial radiographs showing preserved alignment, with no significant change in postoperative atlantodental interval at the most recent follow-up (+0.2 ± 0.87 mm [mean change ± standard deviation]; P = 0.53). Six patients obtained follow-up computed tomography, all of which demonstrated evidence of osseous union across fractures without hardware complication. No patients developed postoperative instability requiring fusion.</p><p><strong>Conclusions: </strong>Atlas osteosynthesis is an attractive motion-preserving approach to the treatment of unstable atlas fractures, avoiding the morbidity of atlantoaxial fusion. Classically reserved for Jefferson fractures with Dickman type II transverse ligament injury, atlas osteosynthesis may also be a viable option for type I transverse ligament injuries. Intraoperative navigation can be particularly useful for screw placement in the setting of traumatically distorted anatomy with lateral mass displacement.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123524"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Neuroanatomical measurement on Photogrammetric model: Validation study.","authors":"Amedeo Piazza, Jacopo Bellomo, Sergio Corvino, Edoardo Agosti, Simona Serioli, Alice Campeggi, Francesco Corrivetti, Luca Regli, Carlo Serra, Matteo de Notaris","doi":"10.1016/j.wneu.2024.123574","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.123574","url":null,"abstract":"<p><strong>Objective: </strong>To scrutinize and compare the accuracy of measurements obtained from photogrammetric models against direct measurements taken on dry skulls, with the aim to verify the feasibility of photogrammetry for quantitative analysis in microsurgical neuroanatomy.</p><p><strong>Methods: </strong>Two dry human skulls were used. Each was scanned using the dual camera system of a smartphone The selected photos were separately processed two different software to create 3D models. Subsequently, 41 anatomical measures (both linear and curvilinear) based on common anatomical landmarks, were taken both directly on dry skulls and on photogrammetric models and compared. Analyzed factors included measurement error, intra- and inter-rater reliability and, the intermodality agreement.</p><p><strong>Results: </strong>Four photogrammetric models were created. Our analysis revealed similar errors when comparing the photogrammetric and direct measurements. Measurements from digital models exhibited robust reliability among repeated measures and different observers, supported by very high Intraclass Correlation Coefficient (ICC) values. Mean measurement difference between Agisoft Metashape software-generated models and direct measurement was 0.01 cm with no systematic bias observed. Conversely, the Metascan app-derived models showed a mean measurement difference of -0.35 cm compared to direct measurement, displaying good agreement for smaller measurements and a systematic proportional bias with increasing measurement size.</p><p><strong>Conclusions: </strong>The role of two photogrammetric models is validated as quantitative analysis technique for laboratory neuroanatomical studies showing acceptable measurement error, high intra- and inter-rater reliability as well as good to very good agreement compared to direct measurement on dry skulls, replacing the expensive and time-consuming methods like CT scans and neuronavigation system.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123574"},"PeriodicalIF":1.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting the Readmission of Patients with Stroke.","authors":"Wei Cun, Ke Xu, Qi Chai, Lijuan Duan","doi":"10.1016/j.wneu.2024.123572","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.123572","url":null,"abstract":"<p><strong>Background: </strong>Incidence of stroke is increasing annually in China, the readmission rate of patients with stroke remains high.</p><p><strong>Method: </strong>In total, 441 patients were enrolled in this study. We described the incidence of stroke readmissions. Furthermore, we used the Andersen-Gill (AD) model to explore the factors affecting all-cause readmission and cardio-cerebrovascular-related readmission of patients with stroke. Identification of these predictors can help reduce the readmission rate of patients with stroke.</p><p><strong>Results: </strong>(1) In total, 441 patients with stroke were included. Among them, 163 (40%) had readmission records. Among them, 44 patients had readmission due to cardiovascular and cerebrovascular diseases, accounting for 10.70%. (2) The Modified Rankin Scale (mRs scale) score affected all-cause readmission of patients with stroke. Patients with stroke and a score of 5 were 5.46 times more likely to be readmitted than those with a score of 0 (HR=5.46, 95% CI: 1.59∼18.7, PPP CONCLUSION: The readmission of patients with stroke may be related to their physical activity function, chronic diseases, and socioeconomic status. When considering the factors predicting the re-admission of patients with stroke, we cannot blindly draw on the results of relevant foreign studies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123572"},"PeriodicalIF":1.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Cerebral Oxygen Saturation Monitoring for Perioperative Neurocognitive Disorder in Adult Non-cardiac Surgical Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Lingqin Qiu, Yabing Ma, Li Ge, Haijiao Zhou, Wenqin Jia","doi":"10.1016/j.wneu.2024.123570","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.123570","url":null,"abstract":"<p><strong>Background: </strong>Perioperative neurocognitive disorders (PND) are common perioperative complications associated with various poor outcomes. Regional cerebral oxygen saturation (rSO2) monitoring is a non-invasive technique based on near-infrared spectroscopy detection. Due to the considerable controversy among currently published studies on the application of intraoperative rSO2 monitoring in adult patients undergoing elective non-cardiac surgery, this study aims to conduct a systematic review and meta-analysis to provide more comprehensive and robust evidence to support clinical decision-making.</p><p><strong>Materials and methods: </strong>This study conducted a systematic literature search of databases including PubMed, Embase, CENTRAL, and Web of Science, from their inception to May 1, 2024. The eligible randomized controlled trials included adult patients undergoing elective non-cardiac surgery under general anesthesia who received optimized anesthesia management guided by rSO2 monitoring and those in the control group who received routine anesthesia management under standard monitoring or blinded rSO2 monitoring. The primary outcomes were the incidence of PND, including postoperative delirium (POD) and postoperative cognitive dysfunction (POCD), and Mini-Mental State Examination (MMSE) scores. Secondary outcomes included the incidence of intraoperative cerebral desaturation and length of hospital stay (LOS).</p><p><strong>Results: </strong>The pooled results showed that compared to the control group, optimized anesthesia management guided by intraoperative rSO2 monitoring significantly reduced the incidence of POCD within 7 days postoperatively and may reduce the incidence of POCD at 3 months and longer periods postoperatively. However, it may not reduce the incidence of POD within 7 days or longer periods postoperatively, improve MMSE scores, reduce the incidence of intraoperative cerebral desaturation, or shorten LOS. Given the substantial heterogeneity in the pooled results for MMSE scores within 7 days postoperatively and LOS, and the limited number of studies reporting the incidence of POD, POCD, and MMSE scores after 7 days postoperatively, the related results should be interpreted with caution.</p><p><strong>Conclusions: </strong>Despite the presence of heterogeneity and the inclusion of a limited number of studies for some outcomes, it is still recommended that clinical anesthesiologists routinely perform intraoperative rSO2 monitoring and optimize intraoperative anesthesia management based on the monitoring results to maximize rSO2 and improve cerebral perfusion, thereby improving patients' neurocognitive outcomes. Further large-scale high-quality studies are needed to confirm the conclusions of this study.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123570"},"PeriodicalIF":1.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surpass Streamline Flow Diverter for the Treatment of Craniocervical Unruptured Dissecting Aneurysms: A multi-institutional retrospective study.","authors":"Dan Lu, Hui Lei, Wei Fang, Naibing Wang, Hu Chen, Guoqiang Luo, Zhenwei Zhao, Tao Zhang, Jianping Deng","doi":"10.1016/j.wneu.2024.123568","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.123568","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there is no established treatment consensus for craniocervical unruptured dissecting aneurysms (UDAs). This study aimed to assess the safety and efficacy of the Surpass Streamline Flow Diverter (SSFD) for treating craniocervical UDAs.</p><p><strong>Methods: </strong>A retrospective review of three centers' databases was conducted to identify patients with craniocervical UDAs treated with SSFDs from January 2021 to December 2023. Data, including patient and aneurysm characteristics, procedure details, imaging findings, and follow-up data, were analyzed.</p><p><strong>Results: </strong>The study included 35 patients with 35 craniocervical UDAs. The mean maximal length of the UDAs was 13.0 ± 6.0 mm, with 57% ranging from 10 to 25 mm. At a mean follow-up of 8.7 ± 2.5 months, the complete occlusion rate was 71% (25/35), with no recurrences detected. Perioperative complications occurred in 3 patients (9%), comprising ischemic stroke in 2 patients (6%) and hemorrhagic stroke in 1 patient (3%). All patients had a good clinical outcome at the 6-month follow-up (mRS < 3). Multivariate logistic regression analysis revealed that aneurysmal dilation with stenosis (OR=0.034, 95% CI: 0.001 - 0.845; p=0.04) was a significant predictive factor for incomplete occlusion of treated aneurysms.</p><p><strong>Conclusion: </strong>Our findings suggest that SSFD is a safe and effective tool for craniocervical UDAs, demonstrating a high occlusion rate, acceptable complication rate, and good clinical outcome.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123568"},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}