World Neurosurg
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With increasing oversight of postoperative outcomes with the Patient Protection and Affordable Care Act, the reduction of readmissions is necessary to avoid financial penalties. This article provides a multi-institutional, multivariate analysis of the pre- and postoperative patient factors associated with readmission after carotid endarterectomy (CEA). ⋯ Readmission after CEA occurs at a comparatively high rate. Preoperative bleeding disorders, diabetes, cerebrovascular accidents, and age and postoperative surgical-site infection, myocardial infarction, sepsis/septic shock, pneumonia, and cerebrovascular accident were associated with readmission. These findings may help guide the surgical management of patients and prevent costly readmissions.
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Multicenter Study
Multicenter registry of liquid embolic treatment of cerebral aneurysms.
The Cerebral Aneurysm Multicenter European Onyx trial was the first multicenter prospective case series using liquid embolization for cerebral aneurysms. It suggested a possible decreased risk for recanalization of smaller aneurysms compared with coil embolization. After publication of that trial, the Onyx HD embolic agent, injection devices, and treatment protocols have all been updated and improved to increase efficacy and decrease adverse events. We present the results from a multicenter registry of liquid embolization treatments using the current method and materials. We hypothesize that the evolution of this technique will result in lower complication and recanalization rates when compared with earlier series. ⋯ Recent advances in liquid embolization have led to decreased recanalization and complications. Liquid embolization is more likely to achieve a durable result in smaller aneurysms that have not been previously treated.