World Neurosurg
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Distal ophthalmic artery (OpA) aneurysms are a rare subset of vascular lesions with lack of optimal treatment. The management of these aneurysms may require complete occlusion of the parent vessel, carrying a risk of permanent visual impairment due to individual variations of extracranial collateral flow to the intraorbital ophthalmic artery (iOpA). ⋯ This study demonstrates the feasibility of a novel revascularization technique of the iOpA using 2 different transorbital approaches. These techniques can be used in the management of intraorbital lesions such as OpA aneurysms, tumoral infiltrations, or intraoperative injuries.
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Giant aneurysms at carotid arteries are typically treated with flow diverter (FD) stents in the clinic. Although the goal of an FD stent is to direct most of the blood flow into the main artery, not much is known regarding the effects of wire number an FD possesses on the hemodynamics inside the aneurysm. ⋯ Furthermore, FTLE and hyperbolic time field plots are in good agreement with the patient's digital subtraction angiography image captured 3.5 minutes after 72-wire Surpass brand FD stent implantation.
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Recent studies have confirmed the effectiveness of minimally invasive endoscopic surgery for intracerebral hematoma (ICH). However, improvements are needed because incomplete hematoma removal may offset the surgical benefits of the technique. We describe a technique of neuroendoscopic surgery using an image detectable sheath, intraoperative computed tomography (iCT) scan, and a navigation system. ⋯ The combination of our techniques improves accuracy and safety of minimally invasive surgical evacuation of hematoma. Performing surgery with iCT scan also improves the spatial recognition of surgeons and therefore may be of educational value.
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To investigate the factors associated with futile recanalization after stent retriever thrombectomy in patients with acute ischemic stroke due to large vessel occlusion. ⋯ Improving technical expertise with mechanical thrombectomy and shortening the therapeutic time window may improve the prognosis of patients with acute ischemic stroke due to large vessel occlusion.
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More than 120,000 anterior cervical discectomy and fusions (ACDFs) are performed annually. Pseudarthrosis is a potential delayed adverse event that affects up to 33% of patients. The degree to which this adverse event affects both patient quality-of-life (QOL) outcomes and health care costs is poorly understood. ⋯ This is the first study to characterize the effect of surgical revision for pseudarthrosis on both QOL outcomes and care costs after ACDF. Patients requiring revision experienced significantly poorer QOL outcomes and higher care costs relative to controls.