Articles: cations.
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The authors studied the anatomic importance of the endoscopic prelacrimal recess approach (PLRA) to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). ⋯ Use of the PLRA to the PPF and ITF offers a clear visual field, wide range of exposure, as well as preservation of the integrity of nasal structures.
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Cervical disc disease is a common and occasionally disabling condition, occurring as a natural consequence of aging in the vast majority of the adult population. Percutaneous epidural neuroplasty (PEN) has been used to deliver highly concentrated drugs for chronic neck pain and to prevent scarring in cases refractory to conventional epidural blocks. However, the clinical course after PEN in cervical disc disease is not well-documented. ⋯ Cervical PEN was shown to be a safe and effective treatment for neck and arm pain in single-level disc disease during 12 months of follow-up. Key words: Neck pain, cervical disc disease, pain management, percutaneous epidural neuroplasty, adhesiolysis, clinical course.
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One disadvantage of carotid artery stenting (CAS) is a high incidence of distal embolism (DE) during or after the procedure. Patients with unstable plaque are considered at high risk for DE and plaque protrusion (PP) after stent placement, which can cause postprocedural ischemic complications. This study was conducted to compare the rate and size of PP between the CASPER stent, a new-generation double-layer micromesh stent, and conventional stents as assessed by optical frequency domain imaging (OFDI), and also to evaluate the efficacy of CAS with the CASPER stent in cases with unstable plaque. ⋯ On OFDI evaluation after CAS, the degree of PP was significantly smaller in the CASPER stent group compared with the conventional stent group. This result provides new insight into the use of CAS to treat carotid artery stenosis with unstable plaque.
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Hemodynamics in cerebral aneurysms are currently investigated toward clinical efficacy using nonstandardized computational simulation techniques. At the same time, flow patterns and velocities are accessible by 4-dimensional phase contrast magnetic resonance imaging (4D pcMRI). Complexity of protocol design and imaging duration has limited the use of this technique in clinical imaging. A new approach is presented to overcome these limitations. ⋯ 4D pcMRI flow imaging in cerebral aneurysms within a time frame suitable for clinical imaging applications is feasible with optimized acquisition parameters, thereby enabling quantification of intra-aneurysmal flow changes after flow diverter device treatment.