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REVIEW
Ah Young Lee, Joo Young Cho
Upper gastrointestinal (GI) hemorrhage presents a substantial clinical challenge. Initial management typically involves resuscitation and endoscopy within 24 h, although the benefit of very early endoscopy (< 12 h) for high-risk patients is debated. Treatment goals include stopping acute bleeding, preventing rebleeding, and using a multimodal approach encompassing endoscopic, pharmacological, angiographic, and surgical methods. Pharmacological agents such as vasopressin, prostaglandins, and proton pump inhibitors are effective, but the increase in antithrombotic use has increased GI bleeding morbidity...
April 21, 2024: World Journal of Gastroenterology: WJG
#2
JOURNAL ARTICLE
Ilya V Kolobaev, Denis Baranovskii, Vladimir Usachev, Grigoriy Afonin, Oleg Aleksandrov, Anna Usacheva, Ilya D Klabukov, Peter Shegay, Sergei Ivanov, Andrey Kaprin
Extensive chest wall defects occur in 28% of all sternal resection cases and are a major challenge in thoracic surgery. These cases are generally considered "critical defects" requiring primary or secondary reconstruction using various types of flaps, mesh repairs, bone autografts, or endoprosthesis. The past decade witnessed rapid advances in the application of personalized endoprostheses in thoracic surgery. Surgeons began to use carbon or titanium grafts for personalized sternum replacement. The main advantages of these implants are superior cosmetic effect, biocompatibility, and low risk of infection...
April 2024: Iranian Journal of Medical Sciences
#3
REVIEW
Laís Silva Santana, Marcia Harumy Yoshikawa, Miguel Bertelli Ramos, Eberval Gadelha Figueiredo, João Paulo Mota Telles
Ruptured anterior communicating artery (ACoA) aneurysms are frequently associated with neuropsychological deficits. This review aims to compare neuropsychological outcomes between surgical and endovascular approaches to ACoA. We systematically searched PubMed, Embase, and Web of Science for studies comparing the endovascular and surgical approaches to ruptured ACoA aneurysms. Outcomes of interest were the cognitive function, covered by memory, attention, intelligence, executive, and language domains, as well as motor and visual functions...
April 27, 2024: Neurosurgical Review
#4
JOURNAL ARTICLE
Akio Teranishi, Hidetoshi Ooigawa, Yushiro Take, Aoto Shibata, Kaima Suzuki, Hiroki Kurita
BACKGROUND: Surgical clipping is a valuable treatment option for unruptured intracranial aneurysms in patients with chronic kidney disease (CKD). However, the comprehensive impact of clipping and perioperative three-dimensional computed tomography angiography (3D-CTA) on renal function remains unclear. This study aimed to evaluate the effects of perioperative 3D-CTA and surgical clipping on renal function in patients with CKD. METHODS: We retrospectively analyzed 529 patients who underwent surgical clipping and perioperative 3D-CTA...
April 24, 2024: World Neurosurgery
#5
JOURNAL ARTICLE
Corneliu Toader, Cristian Kakucs, Nicolaie Dobrin, Razvan-Adrian Covache-Busuioc, Bogdan-Gabriel Bratu, Andrei Adrian Popa, Luca-Andrei Glavan, Antonio-Daniel Corlatescu, Matei George Nicolae Grama, Horia-Petre Costin, Alexandru Vladimir Ciurea
This comprehensive study analyzes 346 surgically treated intracranial aneurysms, emphasizing the importance of understanding risk factors and prevalent characteristics in patients. Intracranial aneurysms, primarily of the saccular or berry type, significantly contribute to nontraumatic subarachnoid hemorrhages and demonstrate a rising incidence due to advances in imaging techniques. The study highlights a gender discrepancy in aneurysm occurrence and a higher prevalence in individuals over 30 years old. The research delves into various aspects, including aneurysm localization, diameter, neck dimensions, and rupture status, with a focus on the anterior communicating artery and middle communicating artery as predominant locations...
March 2024: Curēus
#6
JOURNAL ARTICLE
Giacomo Montagna, Mary M Mrdutt, Susie X Sun, Callie Hlavin, Emilia J Diego, Stephanie M Wong, Andrea V Barrio, Astrid Botty van den Bruele, Neslihan Cabioglu, Varadan Sevilimedu, Laura H Rosenberger, E Shelley Hwang, Abigail Ingham, Bärbel Papassotiropoulos, Bich Doan Nguyen-Sträuli, Christian Kurzeder, Danilo Díaz Aybar, Denise Vorburger, Dieter Michael Matlac, Edvin Ostapenko, Fabian Riedel, Florian Fitzal, Francesco Meani, Franziska Fick, Jacqueline Sagasser, Jörg Heil, Hasan Karanlik, Konstantin J Dedes, Laszlo Romics, Maggie Banys-Paluchowski, Mahmut Muslumanoglu, Maria Del Rosario Cueva Perez, Marcelo Chávez Díaz, Martin Heidinger, Mathias K Fehr, Mattea Reinisch, Mustafa Tukenmez, Nadia Maggi, Nicola Rocco, Nina Ditsch, Oreste Davide Gentilini, Regis R Paulinelli, Sebastián Solé Zarhi, Sherko Kuemmel, Simona Bruzas, Simona di Lascio, Tamara K Parissenti, Tanya L Hoskin, Uwe Güth, Valentina Ovalle, Christoph Tausch, Henry M Kuerer, Abigail S Caudle, Jean-Francois Boileau, Judy C Boughey, Thorsten Kühn, Monica Morrow, Walter P Weber
IMPORTANCE: Data on oncological outcomes after omission of axillary lymph node dissection (ALND) in patients with breast cancer that downstages from node positive to negative with neoadjuvant chemotherapy are sparse. Additionally, the best axillary surgical staging technique in this scenario is unknown. OBJECTIVE: To investigate oncological outcomes after sentinel lymph node biopsy (SLNB) with dual-tracer mapping or targeted axillary dissection (TAD), which combines SLNB with localization and retrieval of the clipped lymph node...
April 25, 2024: JAMA Oncology
#7
REVIEW
Chun-Yan Li, Yi-Feng Wang, Li-Kang Luo, Xiao-Jun Yang
Minimally invasive surgery is a kind of surgical operation, which is performed by using professional surgical instruments and equipment to inactivate, resect, repair or reconstruct the pathological changes, deformities and wounds in human body through micro-trauma or micro-approach, in order to achieve the goal of treatment, its surgical effect is equivalent to the traditional open surgery, while avoiding the morbidity of conventional surgical wounds. In addition, it also has the advantages of less trauma, less blood loss during operation, less psychological burden and quick recovery on patients, and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients...
April 15, 2024: World Journal of Gastrointestinal Oncology
#8
JOURNAL ARTICLE
Danielle Golub, Daniel G Lynch, Shyle H Mehta, Hayley Donaldson, Kevin A Shah, Timothy G White, Eric T Quach, Kyriakos Papadimitriou, Alexander F Kuffer, Henry H Woo, Thomas W Link, Athos Patsalides, Amir R Dehdashti
BACKGROUND: Pial arteriovenous fistulas (pAVFs) are rare vascular malformations characterized by high-flow arteriovenous shunting involving a cortical arterial supply directly connecting to venous drainage without an intermediate nidus. Dural arteriovenous fistulas (dAVFs) can infrequently involve additional pial feeders which can introduce higher flow shunting and increase the associated treatment risk. In the posterior fossa, arteriovenous fistula (AVF) angioarchitecture tends to be particularly complex, involving either multiple arterial feeders-sometimes from both dural and pial origins-or small caliber vessels that are difficult to catheterize and tend to be intimately involved with functionally critical brainstem or upper cervical cord structures...
April 25, 2024: Neurosurgical Review
#9
Artur Eduardo Martio, Daniel Marchi Kieling, Luciano Bambini Manzato, José Ricardo Vanzin
Nickel and cobalt are frequently found in metallic alloys used in the manufacture of aneurysm clips and endovascular prostheses, such as the pipeline embolization device (PED). Nickel hypersensitivity can affect up to 15% of the population, however, it is very rarely overt in patients who undergo endovascular stent placement. Here, we present the case of a 35-year-old woman who developed allergic symptoms after PED placement and was later confirmed to be allergic to both nickel and cobalt by patch testing. Fortunately, she responded well to pharmacologic treatment, rendering surgical intervention unnecessary...
2024: Brain Circulation
#10
JOURNAL ARTICLE
Takahiro Tsuchiya, Yuki Shinya, Yoshiaki Shiokawa, Takeo Tanishima, Akira Tamura, Hideaki Ono
Salvage treatment of postclipping recurrent aneurysms remains challenging.1,2 The salvage microsurgical clipping is a possible intervention but sometimes difficult because of tissue adhesions around the aneurysm and previously installed clips; therefore, salvage coil embolization may have certain advantages.1-5 However, when coil embolization is not applicable,6 microsurgical clipping is a stand-alone curative treatment, requiring proficient and reliable microsurgical techniques. This article describes a unique case of a 70-year-old female patient complaining of a severe headache with subarachnoid hemorrhage due to a recurrent ruptured left internal carotid-posterior communicating artery aneurysm after microsurgical clipping 23 years ago...
April 23, 2024: Operative Neurosurgery (Hagerstown, Md.)
#11
JOURNAL ARTICLE
Yuichiro Tsuji, Yuzo Kuroda, Ryokichi Yagi, Ryo Hiramatsu, Masahiko Wanibuchi
The azygos anterior cerebral artery (ACA) is a rare anatomical anomaly. Clipping surgery has been conducted in approximately 30 reported cases because it is frequently associated with aneurysms. However, few cases in which coil embolization was performed have been reported. We report three cases of coil embolization for distal ACA aneurysms with distal azygos ACA at our institution in 7 years. All patients were over 65-year-old women with saccular aneurysms larger than 7 mm; two with subarachnoid hemorrhage and one with an unruptured aneurysm...
May 12, 2023: Turkish Neurosurgery
#12
JOURNAL ARTICLE
Wei Qian, Yanming Chen, Qing Zhu, Ailin Chen, Qing Lan
BACKGROUND: Keyhole surgery has been widely used to clip various intracranial aneurysms. Here, the feasibility of microsurgical clipping of multiple intracranial aneurysms via the keyhole approach was further investigated. METHODS: The clinical data of 80 patients with multiple intracranial aneurysms treated with keyhole surgery were retrospectively analyzed. The patients included 25 males and 55 females, with an average age of 57.5 years. There were 13 patients with unruptured aneurysms, 67 patients with ruptured aneurysms (small aneurysms accounted for 52...
April 18, 2024: World Neurosurgery
#13
JOURNAL ARTICLE
Michael G Brandel, Jillian H Plonsker, Robert C Rennert, Gautam Produturi, Megana Saripella, Arvin R Wali, Carson McCann, Vijay M Ravindra, David R Santiago-Dieppa, J Scott Pannell, Jeffrey A Steinberg, Alexander A Khalessi, Michael L Levy
INTRODUCTION: Pediatric intracranial aneurysms (IAs) are rare and have distinct clinical profiles compared to adult IAs. They differ in location, size, morphology, presentation, and treatment strategies. We present our experience with pediatric IAs over an 18-year period using surgical and endovascular treatments and review the literature to identify commonalities in epidemiology, treatment, and outcomes. METHODS: We identified all patients < 20 years old who underwent treatment for IAs at our institution between 2005 and 2020...
April 18, 2024: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
#14
Kei Harada, Daibo Kojima, Ippei Yamana, Hirotaka Seike, Takahisa Fujikawa
Due to the advances in endoscopic technology, surgery for duodenal ulcer (DU) bleeding has decreased, although surgery is still necessary for more complicated cases. The concept of damage control surgery (DCS) has been established in the field of trauma, and a simple surgical approach may be preferable in serious cases such as uncontrolled DU bleeding. We present a successful case of bleeding with massive hematoma and perforation of the duodenum due to an over-the-scope clip that was treated by a less invasive surgical approach with consideration of the DCS...
March 2024: Curēus
#15
JOURNAL ARTICLE
William N Doyle, Alexander Netzley, Rahul Mhaskar, Abdul-Rahman F Diab, Samer Ganam, Joseph Sujka, Christopher DuCoin, Salvatore Docimo
BACKGROUND: Leaks following bariatric surgery, while rare, are potentially fatal due to risk of peritonitis and sepsis. Anastomotic leaks and gastro-gastric fistulae following Roux-En-Y gastric bypass (RYGB) as well as staple line leaks after sleeve gastrectomy have historically been treated multimodally with surgical drainage, aggressive antibiotic therapy, and more recently, endoscopically. Endoscopic clipping using over-the-scope clips and endoscopic suturing are two of the most common approaches used to achieve full thickness closure...
April 17, 2024: Surgical Endoscopy
#16
JOURNAL ARTICLE
Visish M Srinivasan, Mohamed A Labib, Joshua S Catapano, Michael T Lawton
Galenic dural arteriovenous fistulas account for 1 of the 6 types of tentorial dural arteriovenous fistulas (type I). These fistulas are located around the great cerebral vein of Galen, with dural arterial supply through the tentorial arteries of Bernasconi and Cassinari or other posterior fossa branches, such as the posterior meningeal artery. In this case, a man in his 60s presented with a headache and was found to have this high-risk lesion, which was Borden grade III and Cognard grade IV. The lesion persisted despite embolization through the middle meningeal artery...
April 17, 2024: Operative Neurosurgery (Hagerstown, Md.)
#17
Catherine Peterson, Nina Yu, Huy T Duong
BACKGROUND: Giant internal carotid artery (ICA) aneurysms are usually treated through flow diversion, coiling, or a combination of both. However, certain cases that fail the endovascular treatment pose a technical challenge. CASE DESCRIPTION: A 68-year-old male presented with gradual visual changes affecting his right eye and was found to have a giant unruptured right paraophthalmic aneurysm. The aneurysm showed growth, and the patient's symptoms worsened despite coiling and flow diversion...
2024: Surgical Neurology International
#18
JOURNAL ARTICLE
Alejandro Serrano-Rubio, Rodrigo López-Rodríguez, Ambar Elizabeth Riley-Moguel, Camilo Armando Benavides-Burbano, Janeth N Nuñez-Lupaca, Alejandro Becerril-Mejía, Rodolfo Villalobos-Diaz, Edgar Nathal
BACKGROUND: Microsurgical treatment of paraclinoid aneurysms is a complex task that generally requires anterior clinoid process (ACP) removal to obtain adequate surgical exposure. This procedure poses a considerable technical difficulty due to the association of the ACP to critical neurovascular structures. Furthermore, anatomical variations in the parasellar region, such as the caroticoclinoid foramen (CCF) or an interclinoid bridge (ICB), may impose additional challenges and increase surgical complications...
2024: Surgical Neurology International
#19
JOURNAL ARTICLE
Amit Kumar Sharma, Ruhi Mamualiya, Atul Agrawal
BACKGROUND: Various clinical symptoms and variables have been suggested as potential indicators of outcomes in patients with subarachnoid hemorrhage (SAH) resulting from ruptured intracranial aneurysms. The detailed discussion of the consequences of intraventricular hemorrhage (IVH), frequently reported in cases of anterior communicating artery (ACoA) aneurysms, is still pending. The study aimed to assess the results of aneurysm surgery performed early versus delayed in patients with SAH, specifically focusing on the occurrence of IVH...
2024: Surgical Neurology International
#20
JOURNAL ARTICLE
Atsushi Hashio, Hiroki Sato, Milan Lepić, Kaima Suzuki, Tsugumi Satoh, Shin Nemoto, Seiji Kuribara, Yuhei Ito, Shun Suzuki, Ichi Lee, Akio Teranishi, Taro Yanagawa, Toshiki Ikeda, Hidetoshi Ooigawa, Hiroki Kurita
BACKGROUND: Surgery is effective for extracranial internal carotid artery (EICA) aneurysms. However, the risk of cranial nerve injury associated with surgical repair, such as graft-assisted resection and extracranial-intracranial bypass techniques, is relatively high. Here, we report two cases of surgical treatment for EICA aneurysms and describe the surgical techniques and strategies to avoid cranial nerve injury. METHODS: Two patients presented to our facility with an increasing cervical pulsatile mass and no neurological symptoms...
2024: Surgical Neurology International
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