Journal of neurosurgery
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Journal of neurosurgery · Sep 2024
Value of difference in diameters between Pipeline embolization device and parent artery in assessing aneurysm outcome.
In vitro trials have demonstrated that oversized stents are associated with reduced metal coverage and increased porosity. However, the relationship between stent selection and aneurysm outcome is inconclusive, and determination of this was the authors' purpose in conducting this study. ⋯ The authors' retrospective analysis demonstrated that the aneurysm occlusion rate declined when Dd increased within a certain range. The authors suggested that Dd with an interval of -0.25 to 0.5 mm may be proper in clinical practice.
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Journal of neurosurgery · Sep 2024
Does disease etiology matter in long-term patency in extracranial-intracranial bypass?
Extracranial-intracranial (EC-IC) bypass has been well described in chronic vaso-occlusive cerebrovascular diseases, including both moyamoya disease (MMD) and atherosclerotic disease (AD). This study aimed to compare factors associated with bypass occlusion between these two diseases. ⋯ Despite different disease etiologies treated with bypass, rates of occlusion at last follow-up did not vary between groups, although short-term follow-up would suggest earlier bypass failure in AD, and extended follow-up trended toward higher occlusion rates in MMD. Additionally, patients with AD were more likely to have further occurrences of stroke by last follow-up. Importantly, the bypass flow and cut flow index at the time of surgery predicted occlusion in both AD and MMD.