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ABSTRACT


01 septiembre 2015

NEUROSURGERY. Feasibility, Safety, and Periprocedural Complications of Pipeline Embolization for Intracranial Aneurysm Treatment Under Conscious Sedation: University at Buffalo Neurosurgery Experience

Rangel-Castilla, Leonardo MD*,‡; Cress, Marshall C. MD*,‡; Munich, Stephan A. MD*,‡; Sonig, Ashish MD, MS, MCh*,‡; Krishna, Chandan MD*,‡; Gu, Eugene Y. MD*,§; Snyder, Kenneth V. MD, PhD*,‡,§,¶,‖; Hopkins, L. Nelson MD*,‡,¶,‖,#; Siddiqui, Adnan H. MD, PhD*,‡,¶,‖,#; Levy, Elad I. MD, MBA*,‡,¶,‖

BACKGROUND: Endovascular Pipeline Embolization Device (PED) placement for intracranial aneurysms is performed under general anesthesia at most centers because of perceived improved image quality and patient safety.

01 septiembre 2015

NEUROSURGERY. Transarterial N-Butyl-2-cyanoacrylate Embolization of an Intraosseous Dural Arteriovenous Fistula Associated With Acute Epidural Hematoma: Technical Case Report

Yoshioka, Shotaro MD; Kuwayama, Kazuyuki MD, PhD; Satomi, Junichiro MD, PhD; Nagahiro, Shinji MD, PhD

BACKGROUND AND IMPORTANCE: Intraosseous dural arteriovenous fistulae (DAVF) are rare, especially those with drainage into the diploic venous system. The clinical presentation depends on the location of the lesion. This is the first report of an intraosseous DAVF associated with acute epidural hematoma.

01 septiembre 2015

NEUROSURGERY. Direct Repair of Iatrogenic Internal Carotid Artery Injury During Endoscopic Endonasal Approach Surgery With Temporary Endovascular Balloon-Assisted Occlusion: Technical Case Report

Cobb, Mary In-Ping Huang MD*; Nimjee, Shahid MD‡; Gonzalez, L. Fernando MD*; Jang, David Woojin MD§; Zomorodi, Ali MD*

BACKGROUND AND IMPORTANCE: Iatrogenic internal carotid artery (ICA) injuries during endoscopic endonasal approach (EEA) surgeries are associated with a high morbidity and mortality, with few acceptable methods described for repair.

01 septiembre 2015

NEUROSURGERY. Proposal of Venous Drainage–Based Classification System for Carotid Cavernous Fistulae With Validity Assessment in a Multicenter Cohort

Thomas, Ajith J. MD*; Chua, Michelle BS‡; Fusco, Matthew MD*; Ogilvy, Christopher S. MD*; Tubbs, R. Shane PhD§; Harrigan, Mark R. MD¶; Griessenauer, Christoph J. MD¶

BACKGROUND: Carotid cavernous fistulae (CCFs) are most commonly classified based on arterial supply. Symptomatology and treatment approach, however, are largely influenced by venous drainage.

01 septiembre 2015

NEUROSURGERY. Effect of Prior Embolization on Cerebral Arteriovenous Malformation Radiosurgery Outcomes: A Case-Control Study

Oermann, Eric K. MD*; Ding, Dale MD‡; Yen, Chun-Po MD‡; Starke, Robert M. MD, MSc‡; Bederson, Joshua B. MD*; Kondziolka, Douglas MD, MSc§; Sheehan, Jason P. MD, PhD‡

BACKGROUND: Embolization before stereotactic radiosurgery (SRS) for cerebral arteriovenous malformations (AVM) has been shown to negatively affect obliteration rates, but its impact on the risks of radiosurgery-induced complications and latency period hemorrhage is poorly defined.

01 septiembre 2015

NEUROSURGERY. Added Benefit of Stent Retriever Technology for Acute Ischemic Stroke: A Pooled Analysis of the NINDS tPA, SWIFT, and STAR Trials

Saposnik, Gustavo MD, MSc, FAHA*,‡; Lebovic, Gerald PhD§; Demchuk, Andrew MD, FAHA, FRCPC¶; Levy, Elad I. MD, MBA, FAHA‖; Ovbiagele, Bruce MD, MSc, FAHA#; Goyal, Mayank MD, FRCPC¶; Johnston, S. Claiborne MD, PhD, FAHA**

BACKGROUND: Endovascular treatment is increasingly being used in acute stroke care. However, although stent retrievers show improved flow restoration rates, their clinical benefits have been uncertain.

01 septiembre 2015

NEUROSURGERY. Intrinsic, Transitional, and Extrinsic Morphological Factors Associated With Rupture of Intracranial Aneurysms

Ho, Allen L. MD*,‡; Lin, Ning MD§; Frerichs, Kai U. MD*,‡; Du, Rose MD, PhD*,‡

BACKGROUND: As diagnosis and treatment of unruptured intracranial aneurysms continues to increase, management principles remain largely based on size. This is despite mounting evidence that aneurysm location and other morphologic variables could play a role in predicting overall risk of rupture. Morphological parameters can be divided into 3 main groups, those that are intrinsic to the aneurysm, those that are extrinsic to the aneurysm, and those that involve both the aneurysm and surrounding vasculature (transitional).

30 abril 2015

THE LANCET. Neurology. Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial

Prof Gregory W Albers, MD, Prof Rüdiger von Kummer, Dr med*, Thomas Truelsen, MD, Jens-Kristian S Jensen, MSc, Gabriela M Ravn, MSc, Bjørn A Grønning, MD, Prof Hugues Chabriat, MD, Ku-Chou Chang, MD, Prof Antonio E Davalos, MD, Prof Gary A Ford, FRCP, James Grotta, MD, Prof Markku Kaste, MD, Prof Lee H Schwamm, MD, Prof Ashfaq Shuaib, MD for the DIAS-3 Investigators†

Background: Current treatment of ischaemic stroke with thrombolytic therapy is restricted to 3–4·5 h after symptom onset. We aimed to assess the safety and efficacy of desmoteplase, a fibrin-dependent plasminogen activator, given between 3 h and 9 h after symptom onset in patients with occlusion or high-grade stenosis in major cerebral arteries.

20 abril 2015

THE LANCET. Neurology. Stenting versus medical treatment in patients with symptomatic vertebral artery stenosis: a randomised open-label phase 2 trial

Annette Compter, MD, H Bart van der Worp, MD, Wouter J Schonewille, MD, Jan Albert Vos, MD, Jelis Boiten, MD, Paul J Nederkoorn, MD, Maarten Uyttenboogaart, MD, Rob T Lo, MD, Prof Ale Algra, MD, Prof L Jaap Kappelle, MD for the VAST investigators†

Background: Patients with a recent vertebrobasilar transient ischaemic attack or ischaemic stroke and vertebral artery stenosis of at least 50% have a high risk of future vertebrobasilar stroke. Stenting of vertebral artery stenosis is promising, but of uncertain benefit. We investigated the safety and feasibility of stenting of symptomatic vertebral artery stenosis of at least 50%, and assessed the rate of vascular events in the vertebrobasilar supply territory to inform the design of a phase 3 trial.

06 agosto 2015

STROKE. Clinical Sciences. Younger Stroke Patients With Large Pretreatment Diffusion-Weighted Imaging Lesions May Benefit From Endovascular Treatment

Marc D. Gilgen, MSc*; Dariusz Klimek*; Kai T. Liesirova, MD; Julia Meisterernst; Pascal P. Klinger-Gratz, MD; Gerhard Schroth, MD; Pasquale Mordasini, MD; Kety Hsieh, MD; Johannes Slotboom, PhD; Mirjam R. Heldner, MD; Anne Broeg-Morvay; Marie-Luise Mono, MD; Urs Fischer, MD; Heinrich P. Mattle, MD; Marcel Arnold, MD; Jan Gralla, MD; Marwan El-Koussy, MD*; Simon Jung, MD*

Background and Purpose: Lesion volume on diffusion-weighted magnetic resonance imaging (DWI) before acute stroke therapy is a predictor of outcome. Therefore, patients with large volumes are often excluded from therapy. The aim of this study was to analyze the impact of endovascular treatment in patients with large DWI lesion volumes (>70 mL).

28 julio 2015

STROKE. Clinical Sciences. Combined Multimodal Computed Tomography Score Correlates With Futile Recanalization After Thrombectomy in Patients With Acute Stroke

Mariano Espinosa de Rueda, MD; Guillermo Parrilla, PhD; Sergio Manzano-Fernández, PhD; Blanca García-Villalba, MD; Joaquín Zamarro, MD; Francisco Hernández-Fernández, PhD; Cristina Sánchez-Vizcaino, MD; Ester Carreón, MD; Ana Morales, PhD; Antonio Moreno, MD

Background and Purpose: Futile recanalization after acute ischemic stroke occurs in almost half of the patients despite optimal angiographic results. Multimodal neuroimaging may help to improve patient’s selection but is still dismissed by many interventionalists. Our aim was to evaluate the accuracy of each parameter of multimodal computed tomography (CT) and their combination for predicting futile recanalization after successful thrombectomy.

14 julio 2015

STROKE. Brief Report. Hypotension During Endovascular Treatment of Ischemic Stroke Is a Risk Factor for Poor Neurological Outcome

Pia Löwhagen Hendén, MD; Alexandros Rentzos, MD; Jan-Erik Karlsson, MD, PhD; Lars Rosengren, MD, PhD; Henrik Sundeman, MD, PhD; Björn Reinsfelt, MD, PhD; Sven-Erik Ricksten, MD, PhD

Background and Purpose: In retrospective studies, patients receiving general anesthesia for endovascular treatment for acute ischemic stroke have worse neurological outcome compared with patients receiving conscious sedation. It has been suggested that this is caused by general anesthesia–associated hypotension. We investigated the effect of intraprocedural hypotension on neurological outcome.

06 agosto 2015

STROKE. Clinical Sciences. Clipping and Coiling of Unruptured Intracranial Aneurysms Among Medicare Beneficiaries, 2000 to 2010

Jessica J. Jalbert, PhD; Abby J. Isaacs, MSc; Hooman Kamel, MD; Art Sedrakyan, MD, PhD

Background and Purpose: Endovascular coiling therapy is increasingly popular for obliteration of unruptured intracranial aneurysms, but older patients face higher procedural risks and shorter periods during which an untreated aneurysm may rupture causing subarachnoid hemorrhage (SAH). We assessed trends in clipping and coiling of unruptured intracranial aneurysms, outcomes after clipping and coiling of unruptured intracranial aneurysms, and in SAH among Medicare beneficiaries.

19 mayo 2015

STROKE. Brief Report. Site-Specific Relationship Between Intracranial Aneurysm and Aortic Aneurysm

Yong-Won Shin, MD; Keun-Hwa Jung, MD, PhD; Jangsup Moon, MD, PhD; Soon-Tae Lee, MD, PhD; Sang Kun Lee, MD, PhD; Kon Chu, MD, PhD; Jae-Kyu Roh, MD, PhD

Background and Purpose: The high prevalence of intracranial aneurysms (IAs) in patients with a bicuspid aortic valve or coarctation of the aorta suggests a link between IA and aortic pathology. However, studies reporting this link do not sufficiently address the heterogeneity of IAs arising from different anatomic locations. This study aimed to explore whether a location-specific relationship exists between the 2 kinds of aneurysms.

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