Neurosurgery
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Multicenter Study
Frequency and factors associated with unsuccessful lead (first) coil placement in patients undergoing coil embolization of intracranial aneurysms.
There is limited knowledge about associated rates, aneurysm characteristics, technical factors, and immediate impact of unsuccessful placement of the lead (first) coil during endovascular embolization of intracranial aneurysms. ⋯ Lead coil placement failure is not infrequent during embolization of intracranial aneurysms and may increase the risk of complications. Appropriate coil selection, particularly coil length in small aneurysms, may reduce the rate of lead coil placement failure and associated complications.
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Multicenter Study
Culture of olfactory ensheathing cells for central nerve repair: the limitations and potential of endoscopic olfactory mucosal biopsy.
Autotransplantation of olfactory ensheathing cells (OECs) into the damaged central nervous system is a potential therapeutic strategy for spinal cord and root cord injuries. One limiting factor has been the poor OEC yields from human mucosal biopsies. Previous studies have only commented on their success in obtaining mucosal specimens containing olfactory mucosa, but have not commented on the yield of OECs from those specimens. ⋯ We have provided evidence that biopsies closer to the cribriform plate can produce larger yields of OECs, and that patient factors like age and mucosal disease adversely affect the culture yield.
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Multicenter Study
Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: a U.S. multicenter experience.
The pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment. ⋯ Unlike conventional coil embolization, aneurysm occlusion with PED is not immediate. Early complications include both thromboembolic and hemorrhagic events and appear to be significantly more frequent in association with treatment of vertebrobasilar aneurysms.
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Multicenter Study
Meningiomas in pregnancy: a clinicopathologic study of 17 cases.
Dramatic growth of meningiomas is occasionally encountered during pregnancy. While cell proliferation is often assumed, hemodynamic changes have also been touted as a cause. ⋯ Our series suggests that pregnancy-associated meningiomas located in the skull base are likely to require surgical intervention for visual complaints and cranial nerve palsies. The rapid tumor growth is more often due to potentially reversible hemodynamic changes rather than hormone-induced cellular proliferation.
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Multicenter Study Clinical Trial
Spine patient outcomes research trial: do outcomes vary across centers for surgery for lumbar disc herniation?
Lumbar discectomy is the most commonly performed spine procedure. Academic spine centers with potentially differing caseloads and experience may have different outcomes. ⋯ Although mean blood loss, risk of durotomy, length of stay, and rate of reoperation vary among academic spine centers performing lumbar discectomy, there appears to be no difference in long-term functional outcomes.