Acta neurochirurgica. Supplement最新文献

{"title":"The Forefront of Gamma Knife Radiosurgery for Brain Arteriovenous Malformations: Our History of Treatment Optimisation Over 30 Years and the Modern Outcomes.","authors":"Yuki Shinya, Hirotaka Hasegawa, Motoyuki Umekawa, Masahiro Shin, Mariko Kawashima, Satoshi Koizumi, Atsuto Katano, Yuichi Suzuki, Taichi Kin, Nobuhito Saito","doi":"10.1007/978-3-031-89844-0_6","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_6","url":null,"abstract":"<p><strong>Background: </strong>Brain arteriovenous malformations (AVMs) can cause cerebral haemorrhage, associated morbidity, and mortality if left untreated. Therefore, prophylactic interventions are essential to manage these lesions. The purpose of this study was to describe our experience of incorporating new technologies into gamma knife radiosurgery (GKRS) for AVMs, aiming to improve its effectiveness and safety.</p><p><strong>Methods: </strong>We conducted a retrospective observational study that included 1032 patients with AVMs who underwent GKRS at our institution from 1990 to 2022. We reviewed the detailed treatment techniques and updates on GKRS, including tractography-guided identification of critical white matter fibres for eloquent AVMs, GKRS with minimal targeting embolisation for high-haemorrhage risk AVMs, and rotational angiography based GKRS for all AVMs. We evaluated the GKRS outcomes for AVM obliteration, post-GKRS haemorrhage, survival, post-GKRS signal changes, and neurological preservation.</p><p><strong>Results: </strong>We collected data from 90 patients by using the most advanced techniques. The cumulative obliteration rates were 61.0% at 3 years and 81.6% at 4 years, and the cumulative post-GKRS haemorrhage rates were 2.2% at 2 years and 3.6% at 5 years. Post-GKRS haemorrhage resulted in mortality in one patient (1.1%). Post-GKRS signal change was observed in 31 patients (34%), but only one (1.0%) developed a neurological deficit. Therefore, the cumulative neurological preservation rate was 97.8% at 5 years.</p><p><strong>Conclusions: </strong>GKRS is a safe and effective treatment for AVMs. The continuous development and use of advanced techniques can lead to favourable outcomes for AVMs. However, further studies with larger samples and longer follow-ups, as well as an analysis of late adverse events, are necessary to better understand the efficacy and safety of GKRS for AVMs.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"47-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Augmented Reality in Vascular Neurosurgery.","authors":"Tristan van Doormaal, Elisa Colombo, Tim Fick, Jesse A M van Doormaal, Tessa M Kos, Mathijs de Boer, Pierre Robe, Eelco Hoving, Lambertus W Bartels, Luca Regli","doi":"10.1007/978-3-031-89844-0_20","DOIUrl":"10.1007/978-3-031-89844-0_20","url":null,"abstract":"<p><strong>Background: </strong>The increasing adoption of artificial intelligence (AI) and augmented reality (AR) within vascular neurosurgery has become a prominent trend. The primary challenge before us is seamlessly integrating these advanced concepts and developing them further to improve patient outcomes.</p><p><strong>Methods: </strong>We combined peer-reviewed publications of our research group over the past 5 years with current research projects to form the basis of a narrative discussion, aiming to better understand drawbacks, challenges, and the developmental steps to be followed.</p><p><strong>Results: </strong>Four developmental phases were identified: (1) the integration of AI and AR to create adequate three-dimensional (3D) segmentations; (2) adding flow and pulsatility data to create 5D segmentations; (3) treatment planning in these models; and (4) treatment guidance using these models. The main drawback described was the limited added value in the microscopic phase of neurovascular surgery due to view obstructions and a lack of accuracy. The main challenge described was the current limitation in computational and graphical processing capabilities.</p><p><strong>Conclusion: </strong>Although drawbacks and challenges still exist, AI and AR are rapidly developing topics within vascular neurosurgery. The research in this field could lay the groundwork for fully automatized treatment strategies in the future.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"157-163"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evidence for Intravenous Milrinone to Treat Secondary Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage-A Narrative Review.","authors":"Hans-Jakob Steiger, Lukas Andereggen, Serge Marbacher","doi":"10.1007/978-3-031-89844-0_1","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_1","url":null,"abstract":"<p><strong>Purpose: </strong>Intravenous and intra-arterial milrinone as a rescue measure for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) has been adopted by several groups, but so far, evidence for the clinical benefit is unclear and the effect on brain perfusion is contradictory. We recently published our experience with intravenous milrinone as a rescue strategy for DCI. The aim of the actual analysis was to contextualize our experience with the currently available evidence from clinical trials on the effect of intravenous milrinone in preventing or treating DCI following aneurysmal SAH.</p><p><strong>Methods: </strong>PubMed was searched for clinical studies using intravenous milrinone for the prevention or treatment of DCI after aneurysmal subarachnoid hemorrhage.</p><p><strong>Results: </strong>In our series, using intravenous milrinone as a rescue strategy together with using norepinephrine to elevate blood pressure, improvements in cerebral perfusion as measured by perfusion computed tomography (CT) and in clinical symptoms were seen after the induction of rescue therapy. At long-term follow-up, patients suffering DCI had only modestly worse outcomes than patients not suffering DCI. The PubMed search provided four comparative clinical studies. In a preventive setup, Soliman et al. compared intravenous milrinone with magnesium. The incidence of cerebral vasospasm was significantly lower and patients' neurological condition in terms of the Glasgow Coma Scale (GCS) better with magnesium compared to milrinone. Milrinone was associated with hypotension and the need for dopamine and norepinephrine. Rouanet et al. compared milrinone with norepinephrine as a rescue strategy. They found that transcranial Doppler (TCD) flow velocities decreased after milrinone therapy only, not after norepinephrine, whereas clinical improvement was achieved with both treatment strategies. Labeyrie et al. compared balloon angioplasty plus intravenous milrinone with induced hypertension alone. They did not find any significant differences regarding the outcomes. Finally, Lakhal and coauthors compared intravenous milrinone plus induced hypertension as a rescue strategy, where a historical control group received induced hypertension alone. Milrinone was associated with a lower rate of additional endovascular angioplasty and a positive impact on long-term neurological and radiological outcomes.</p><p><strong>Conclusion: </strong>Our study showed that cerebral perfusion in the setting of secondary cerebral ischemia following SAH is measurably improved via intravenous milrinone and norepinephrine-based hyperdynamic therapy. In the context of the available literature, when used as a rescue strategy, milrinone appears to be beneficial if additional norepinephrine is given to maintain adequate arterial pressure.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"3-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADC Threshold Indicating the Ischemic Region for Predicting Efficacy in Thrombectomy.","authors":"Hideyuki Ishihara, Fumiaki Oka, Takuma Nishimoto, Masatoshi Yamane, Kazutaka Sugimoto, Hirokazu Sadahiro","doi":"10.1007/978-3-031-89844-0_16","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_16","url":null,"abstract":"<p><strong>Purpose: </strong>The effectiveness of endovascular thrombectomy (EVT) has been proven in patients with large cerebral infarction. However, the size of the ischemic region before treatment is a significant factor in the outcome, and the optimal method for the evaluation of this region is uncertain. The goal of this study was to investigate apparent diffusion coefficient (ADC) values as a basis for an assessment of the ischemic region before treatment.</p><p><strong>Methods: </strong>A retrospective study was performed in 48 consecutive patients who underwent EVT for acute large vessel occlusion (LVO) with Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≤5 from 2014 to 2022. Associations of clinical characteristics and ADC-related ischemic region volumes with a favorable outcome (modified Rankin Scale (mRS) 0-3 at 90 days) were examined.</p><p><strong>Results: </strong>The 48 patients had a median age of 78 years and a median NIHSS score of 23 at admission. Occlusion sites were the internal carotid artery (46%), M1 segment (46%), and M2 segment (8%). Specifically, 18 cases (38%) were mRS 0-3 and 30 (62%) mRS 4-6 at 90 days. In receiver operating characteristic (ROC) analysis, an ischemic region defined as a volume with an ADC < 540 (ADC₅₄₀) had the highest area under the curve (AUC) value (AUC = 0.85). Multivariate analysis showed independent associations between onset to reperfusion time (OR 0.991, 95% CI 0.981-1.000, p = 0.013) and ADC₅₄₀ (OR 0.887, 95% CI 0.807-0.976, p = 0.001) with mRS 0-3 at 90 days.</p><p><strong>Conclusions: </strong>Earlier reperfusion and a smaller ischemic region defined by ADC₅₄₀ were related to a favorable outcome in patients with acute LVO with a large ischemic region.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"129-134"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Ischemic Complications of Surgical Treatment in Patients with Moyamoya Disease.","authors":"Anna A Shulgina, Vasily A Lukshin, Anton A Korshunov, Dmitry Yu Usachev","doi":"10.1007/978-3-031-89844-0_10","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_10","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to identify unfavorable prognostic factors for the development of cerebral ischemic complications of surgical treatment in patients with moyamoya disease.</p><p><strong>Methods: </strong>We analyzed 80 patients with moyamoya disease, who underwent 134 surgical revascularizations. Persistent complications (ischemic strokes) developed in seven cases (5.3%). In 36 cases (27%), there were short-term episodes of transient neurologic deficit.</p><p><strong>Results: </strong>The statistical analysis revealed factors associated with the development of transient and persistent ischemic complications: neuroradiological \"ivy sign\" (χ² = 4.078, p = 0.043), stenosis of the ICA proximal to the PComA or PCA (χ² = 20.085, p < 0.0001), decompensation of cerebral blood flow (χ² = 11.212, p < 0.001), recent CVA (less than 3 months before surgery) or instability of neurological symptoms (χ² = 6.146, p < 0.013). Significant factors of the development of persistent ischemic stroke were as follows: stenosis or occlusion of the ipsilateral PCA (increasing the risk of stroke by 9.7 times); signs of the decompensation of cerebral perfusion (increased risk by 5.4 times); and unstable clinical symptoms within 3 months before surgery (increased risk by 6.4 times). The presence of at least two signs defines a group of patients that has an increased risk of complications with a sensitivity of 80.7% and a specificity of 88.6%.</p><p><strong>Conclusion: </strong>The identified risk factors will enable predicting the risk of perioperative ischemic complications in patients with moyamoya disease and optimize management tactics and improve the results of surgical treatment.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Exoscopic and Microscopic Superficial Temporal Artery to Middle Cerebral Artery Bypass.","authors":"Takuma Maeda, Hidetoshi Ooigawa, Koki Onodera, Yushiro Take, Hiroki Sato, Kaima Suzuki, Hiroki Kurita","doi":"10.1007/978-3-031-89844-0_13","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_13","url":null,"abstract":"<p><strong>Purpose: </strong>Exoscopes have been used as a reliable surgical tool in the neurosurgical field. They could improve surgical field visibility with 4K three-dimensional (4K-3D) monitors and provide alleviation for the physical strain by allowing surgeons to maintain a neutral posture. In this study, we report our initial experience with exoscopic superficial temporal artery (STA)-middle cerebral artery (MCA) bypass compared to the conventional microscope at our institution.</p><p><strong>Methods: </strong>This study included 58 patients with ischemic status, including internal carotid artery (ICA) stenosis, ICA occlusion, MCA stenosis, MCA occlusion, and moyamoya disease with ischemic onset, who underwent STA-MCA bypass between January 2021 and August 2022. The baseline characteristics, setup time, operative time, duration of MCA occlusion, surgical complications, and clinical outcomes were retrospectively analyzed. Additionally, a total of 19 neurosurgeons evaluated the effects of exoscope on the cerebrovascular procedure by using a questionnaire.</p><p><strong>Results: </strong>36 patients (62.0%) underwent the procedure with the use of an exoscope. The patient's characteristics were similar between the two groups. No significant differences in the setup time (74 min vs. 73 min), operative time (382 min vs. 385 min), surgical complications (2.8% vs. 4.5%), or favorable outcomes (100% vs. 95.5%) were observed between the two groups. In the postoperative questionnaire evaluation, the exoscope received higher scores in \"image quality\" (78.9%), \"brightness\" (84.2%), \"operability\" (73.7%), and \"education\" (57.9%). In contrast, the conventional microscope received higher scores in \"assistant work\" (73.7%).</p><p><strong>Conclusion: </strong>The benefits of the exoscope were high image quality, an expanded view with digital zoom, and its compact body and comfortable resting position, which reduce the fatigue of neurosurgeons. On the basis of the findings of this study, the exoscope was found to be useful in STA-MCA bypass and demonstrated favorable outcomes comparable to those of the conventional microscope.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"105-112"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of Motor Function in Surgery for Cerebral Arteriovenous Malformations via 3-Tesla Magnetic Resonance Tractography.","authors":"Ayumi Akazawa, Yoshifumi Higashino, Makoto Isozaki, Takahiro Yamauchi, Satoshi Kawajiri, Munetaka Yomo, Ken Matsuda, Hidetaka Arishima, Shintaro Yamada, Miduki Oiwa, Tsutomu Okada, Yasutaka Fushimi, Nobuyuki Miki, Yoshiki Arakawa, Kenichiro Kikuta","doi":"10.1007/978-3-031-89844-0_5","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the role of magnetic resonance tractography (MRT) for the evaluation of motor function in surgery for brain arteriovenous malformations (AVMs).</p><p><strong>Methods: </strong>Of 112 patients with brain AVMs operated on by the senior author (K.K.) between 2000 and 2022, 22 consecutive patients with frontal, parietal, temporal, sylvian, and insular AVMs underwent an evaluation of neural tracts via 3-tesla (3 T) MRT before and after surgery. There were 12 men and 10 women (mean age 29.0 ± 13.6 years). Here, 14 patients presented with hemorrhage, five with epilepsy, and three with ischemic symptoms. Spetzler-Martin grade (SMG) assessments were I in six patients, II in nine, III in six, and IV in one. The microsurgical resection of the AVMs achieved total removal in all 22 patients.</p><p><strong>Results: </strong>The presence of preoperative motor dysfunction and the minimal distance between an AVM and the corticospinal tract (MDACST) was significantly related to transient motor deterioration. The presence of preoperative motor dysfunction, a tract injury on postoperative MRT, the presence of transient motor dysfunction, and the MDACST were significantly related to permanent motor dysfunction. Multivariate analysis also suggested that the MDACST was one of the most predictive factors of transient motor deterioration and permanent motor dysfunction. The cutoff value at the receiver operating characteristic analysis indicated that MDACST less than 16 mm and MDACST less than 8 mm could highly predict transient motor deterioration and permanent motor dysfunction, respectively.</p><p><strong>Conclusions: </strong>Surgery on an AVM with MDCT less than 16 mm would probably induce transient motor deterioration, and less than 8 mm would probably cause permanent motor dysfunction.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcome of Moyamoya Disease.","authors":"Peter Birkeland, Victoria Hansen, Vinosha Tharmabalan, Jens Lauritsen, Troels Nielsen, Thomas Truelsen, Sverre Rosenbaum, Paul von Weitzel-Mudersbach","doi":"10.1007/978-3-031-89844-0_11","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_11","url":null,"abstract":"<p><p>Moyamoya disease (MMD) is considered to run a progressive course, but little is known about its long-term outcomes. We conducted a structured phone interview to assess outcomes in a mixed cohort of conservatively and surgically treated patients a median of 9 years and up to 27 years after a diagnosis of MMD. We found that 60% of patients had a favorable outcome (modified Rankin Scale score <3), with only 16% of adult patients working full time. We conclude that MMD considerably impacts daily life in a substantial number of those affected, with only a minority able to provide for themselves.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"93-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of the Endovascular Approach for Difficult Cerebral Aneurysms.","authors":"Shigeru Miyachi","doi":"10.1007/978-3-031-89844-0_4","DOIUrl":"10.1007/978-3-031-89844-0_4","url":null,"abstract":"<p><p>The endovascular approach, as a less invasive method, has been used to deliver direct surgery for the treatment of cerebral aneurysms. With the rapid and evolutional improvement in imaging technology, devices, treatment skills, and perioperative managements, the success rates of endovascular treatments have been increasing annually. Particularly, endovascular treatments are highly expected for surgically difficult aneurysms, such as large aneurysms, or for those similar to tiny blood blisters. The flow diverter, one of the breakthrough devices, has improved the clinical results of these aneurysms. As another challenge, robotics may resolve the problems of radiation exposure for the operator by allowing remote telesurgery. Such a recent challenge with novel devices and technologies is introduced here, along with our own experiences.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences with and Practical Implications of Using a Hybrid Operating Room.","authors":"Matthias Gmeiner, Vanessa Mazanec, Michael Sonnberger, Andreas Gruber","doi":"10.1007/978-3-031-89844-0_19","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_19","url":null,"abstract":"<p><p>PurposeThe purpose of this chapter is to present our initial results of the use of a hybrid operating room (OR) in cerebrovascular procedures.MethodsIn this retrospective study, 152 patients who suffered from cerebrovascular pathology and were treated at the hybrid OR at the Department of Neurosurgery at Kepler University Hospital from April 2020 to October 2022 were included. Vascular pathologies and hybrid interventions were analyzed. Additionally, the number of residual aneurysms and vessel stenosis/occlusions was assessed.ResultsSpecifically, 106 patients were treated because of a cerebral aneurysm. In six cases, a residual aneurysm was identified. In another three cases, a stenosis/occlusion was found, and in three patients, a hybrid intervention was performed. These results indicate that about 10% of the patients might benefit from the treatment in a hybrid OR. Furthermore, 49 patients were treated for carotid stenosis/occlusion and 12 had an arteriovenous malformation or fistula.ConclusionNo procedure-related complications occurred in the observed cohort. The hybrid OR provided readily available, high-quality intraoperative imaging. Hybrid procedures increase the quality of care and patient safety. Furthermore, they might contribute to the reduction of intraoperative complications.</p>","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"153-156"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}