BACKGROUND AND PURPOSE: Recovery of oculomotor (cranial nerve [CN] III) palsy after surgery of posterior communicating artery (PcomA) aneurysms has been well documented, but recovery after coiling is poorly understood. In this study, we report the recovery after coiling of PcomA aneurysm-induced CN III palsy in 21 patients at follow-up ...

BACKGROUND: Although the incidence of patients presenting with concomitant colorectal cancer (CRC) and abdominal aortic aneurysm (AAA) is low, current treatment strategies in patients with both lesions remains controversial. Given recent advances in endovascular aortic aneurysm repair (EVAR), we sought to analyze the surgical outcomes of patients with concomitant CRC ...

AIM: The aim of this study was to describe the results and long-term follow-up of the Vanguard endovascular graft for infrarenal abdominal aortic aneurysm (AAA) repair. METHODS: Between February 1997 and October 1999, 76 patients were treated with a median aneurysm diameter of 52 mm (39-90 mm). All were followed ...

Prospective validation of prognostic scoring systems for ruptured abdominal aortic aneurysm (AAA) is lacking. This study assesses the validity of three established risk scores and a new prognostic index. Patients admitted with ruptured AAA during a 26-month period (August 2002-December 2004) were recruited prospectively. The Glasgow Aneurysm Score (GAS), Hardman ...

BACKGROUND: Three-dimensional rotational angiography has recently been implemented in many interventional neuroradiology practices and may assist the endovascular operator in case selection and planning. The end result may be improved safety. METHODS: We retrospectively searched our database for all aneurysms that were treated at our institution since February 1990. We ...

Randomized trials have shown that endovascular repair (EVAR) of an abdominal aortic aneurysm (AAA) has a lower perioperative mortality than conventional open repair (OR). However, this initial survival advantage disappears after 1 year. To make EVAR cost-effective, patient selection should be improved. The Glasgow Aneurysm Score (GAS) estimates preoperative risk ...

Infected aneurysm of the thoracic aorta is rare and can be fatal without surgical treatment. We review our experience with 32 patients during a 12-year period. Retrospective chart review. Between 1995 and 2007, 32 patients (24 men, 8 women) with infected aneurysms of thoracic aorta were treated at our hospital. ...

PURPOSE: To evaluate long-term results in patients undergoing elective endovascular aneurysm repair (EVAR) using the Talent LPS endograft to treat abdominal aortic aneurysm (AAA). METHODS: Fifty patients (49 men; median age 72 years, range 54-89) were treated electively between 1997 and 2001 with the Talent LPS endograft chosen for various ...

PURPOSE: To report a retrospective evaluation of the efficacy and midterm clinical results of the Anaconda stent-graft in the endovascular repair of infrarenal abdominal aortic aneurysms. METHODS: Fifty-one patients (48 men; mean age 71+/-8 years, range 62-89) were treated with the Anaconda stent-graft from January 2006 to September 2007. Six ...

Abdominal aortic aneurysm (AAA) is an age-related disease. In an aging population, the prevalence of AAA is likely to increase. Open AAA repair in patients aged >80 years is often not considered because of their advanced age as such or because of comorbidities. In addition, little is known about the ...

The purpose of our study was to evaluate the outcomes of neurosurgical and endovascular treatment of ruptured intracranial aneurysms over a lifetime, based on the results of the International Subarachnoid Aneurysm Trial. We performed a decision analysis, using a Markov model, to evaluate outcomes of neurosurgical and endovascular treatment of ...

OBJECTIVES: To assess the mortality of patients with ruptured abdominal aortic aneurysms undergoing open surgery and examine changes in mortality over time. METHODS: Literature databases were searched for relevant articles published between 1991 and 2006. Two reviewers independently performed study inclusion and data extraction. Primary outcome measure was 30 day ...

BACKGROUND AND PURPOSE: The purpose of this study was to analyze the 3-month outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH) treated from January 2005 to June 2006. This paper describes the outcomes after treatment of aneurysmal SAH and comparison between patients treated by clipping or coiling in a high ...

CONTEXT AND OBJECTIVE: Changes in pulmonary function commonly occur after general surgery. The aims were to evaluate vital capacity, tidal volume and respiratory frequency among patients undergoing elective craniotomy and to determine possible correlations of these parameters with surgery duration and etiology for neurosurgery. DESIGN AND SETTING: Prospective, open study ...

The need of an emergency bypass in hazardous situations during treatment of intracranial aneurysms has rarely been addressed in the literature. We report our 10 year experience with emergency bypass for aneurysm treatment. We retrospectively analyzed the data of patients who underwent emergency bypass surgery for the treatment of an ...

BACKGROUND: Historically, the prognosis for poor grade subarachnoid hemorrhage patients has been considered dismal. As a result, many hospitals have chosen conservative management over aggressive therapy. This guarded approach, however, is based on studies that do not take into account newer, more effective, management protocols and more recent long-term evidence ...

BACKGROUND: Eighty nine patients with established intracranial aneurysm (Hunt-Hess score 1 to 3), who were operated at The Department of Neurosurgery, University Hospital Brno in 2003-2006, were enrolled in to the study group. METHODS: After introduction of anesthesia, we started cooling with two circulating-water mattresses (Blanketrol III, Cincinnatti Sub Zero). ...

In the current era of early surgery, there has been little interest in the use of antifibrinolytic therapy to prevent rebleeding after aneurysmal subarachnoid hemorrhage (aSAH). Older studies demonstrated that antifibrinolytics can reduce rebleeding, but long-term therapy results in increased cerebral ischemia from vasospasm, leading to no appreciable effect on ...

Despite high initial technical success, the long-term durability of endovascular abdominal aortic aneurysm repair (EVAR) continues to be a concern. Following EVAR, patients can experience endoleaks, device migration, device fractures, or aneurysm growth that may require intervention. The purpose of this study was to review all patients treated with secondary ...

BACKGROUND: Recent studies suggest that high-dose MgSO4 therapy is safe and reduces the incidence of DIND and subsequent poor outcome after SAH. We intended to assess the safety and efficacy of high-dose MgSO4 therapy after SAH as means to prevent DIND and to evaluate the impact on clinical outcome. METHODS: ...

An abdominal aortic aneurysm (AAA) is an abnormal ballooning of the major abdominal artery. Some AAAs present as emergencies and require surgery; others remain asymptomatic. Treatment of asymptomatic AAAs depends on many factors, including size: risk of rupture increases with aneurysm size. Large asymptomatic AAAs (> 5.5 cm in diameter) ...

OBJECTIVE: The goals of this study were to characterize the clinical, radiological, treatment, and outcome data associated with patients diagnosed with spinal dural arteriovenous fistulae (SDAVFs) at a single tertiary care institution over a 20-year period. METHODS: A 20-year retrospective study was undertaken at our university hospital. Patients with mixed ...

PURPOSE: To define the indications for abdominal aortic aneurysm (AAA) surgery in octogenarians. METHODS: We reviewed septuagenarians and octogenarians with a nonspecific AAA diagnosed at our hospital between January, 1990 and June, 2006. RESULTS: Among a total 628 patients seen, 306 were in their 70s (group A) and 108 were ...

Further to the rapid enlargement of an aneurysm to 5.6 cm in diameter after 3 years of surveillance, a 79-year-old patient was fitted with a Vanguard modular stent graft and monitored on a regular basis for 6 years. Two years later, the aneurysmal sac ruptured. The patient died 1 month ...

Monitoring methods designed to assess cerebrovascular regulation and increased cerebrovascular resistance (CVR) of patients with subarachnoid hemorrhage (SAH) would facilitate therapeutic intervention and potentially reduce secondary complications. The aim of this study was to assess changes of cerebrovascular regulation and CVR by evaluating changes of cerebrovascular pressure transmission in patients ...

PURPOSE: To evaluate the complications after lower gastrointestinal system (GIS) operations, and to investigate the reasons for and outcomes of relaparotomy (RL), and the factors influencing its mortality rate. METHODS: The subjects of this retrospective study were 38 patients who underwent early RL for complications of lower GIS surgery. We ...

INTRODUCTION: Delayed ischemic deficit from vasospasm is a leading cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage. Although several treatment modalities have been used to reverse the deleterious effects of vasospasm, alternative therapies are needed, as conventional therapies are often ineffective or contraindicated. Intrathecal nicardipine has been suggested for ...

INTRODUCTION: Increased ICP is common and might precipitate cerebral vasospasm (VSP)-induced ischemic events in aneurysmal SAH (ASAH).Our objective was to determine if there is an association between increased ICP and transcranial colour coded Doppler-angiographic VSP (TCCD-A VSP) in relation to delayed neurological deficit (DND) and poor outcome. METHODS: A retrospective ...

BACKGROUND: There are no precise estimates of the rate of rupture of large abdominal aortic aneurysms (AAA). There is recent suspicion that anatomic suitability for endovascular repair may be associated with a decreased risk of AAA rupture. METHODS: Systematic literature review of rupture rates of AAA with initial diameter > ...

BACKGROUND AND AIMS: To investigate the durability of EVAR and to explore the evidence for follow-up investigations. Furthermore, to study the patients' impressions of followup investigations, and how complications and secondary procedures influence cost-effectiveness. MATERIAL AND METHODS: 263 patients were treated by EVAR from February 1995-February 2007. The series is ...

The management of patients with unruptured aneurysms remains controversial. Patients with unruptured aneurysms may suffer intracranial haemorrhage, but the incidence of this event is still debated; endovascular treatment may prevent rupture, but involves immediate risks. Hence, the balance of risks and benefits of endovascular treatment is uncertain. Here, we report ...

PURPOSE: This study was designed to describe and evaluate our preliminary results with a percutaneous arterial closure device as compared to those obtained with conventional femoral surgical cut down during endovascular repair of abdominal aortic aneurysms (AAA). MATERIAL AND METHODS: Between January 2004 and December 2006, 40 of 86 AAA ...

OBJECTIVE: To examine the long-term outcomes after entry closure and aneurysmal wall plication for type B chronic dissecting aortic aneurysm. This procedure uses no artificial graft and preserves all intercostal arteries. METHODS: We reviewed the records of 40 consecutive patients who underwent this procedure between September 1983 and December 2002. ...

OBJECTIVE: To investigate the feasibility and effects of preoperative inspiratory muscle training on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective abdominal aortic aneurysm surgery. DESIGN: Single-blind randomized controlled pilot study.Setting: Gelderse Vallei Hospital Ede, the Netherlands. SUBJECTS: Twenty high-risk patients undergoing ...

The purpose of the study was to analyze changes in in-hospital mortality of patients with ruptured abdominal aortic aneurysm (RAAA) during an 18-year period. A retrospective analysis of 246 patients with RAAA in the years 1987-2005 was performed. The patients were divided into groups that consisted of 111 patients treated ...

This study evaluated (1) elective open abdominal aortic aneurysm repair (OAR) in patients aged > or =80 years before and after stent graft devices for endovascular aneurysm repair (EVAR) became commercially available and (2) the effect on perioperative (30-day) outcome of the anatomic constraints that led to EVAR being excluded ...

BACKGROUND: Aneurysmal bone cysts (ABCs) are benign lesions that are usually treated with intralesional procedures. The clinical behavior of ABCs is reported to be more aggressive in younger patients, with high recurrence rates after surgical treatment by several authors. The purpose of this study was to review longitudinally the demographic ...

Preventative treatments for unruptured cerebral aneurysms include craniotomy, endovascular treatment, and follow up. Since there is no agreement as to the best procedure, it is important to provide adequate information so that the patient and physician can share in the decision-making process. A multi-media DVD was created to inform patients ...

AIM: The aim of this retrospective study was to demonstrate the difference in patient outcomes after treatment for bleeding endocranial aneurysms when evaluated with methods based on different assessment criteria. METHODS: The outcome of 237 patients, 141 of which were operated on for anterior communicating artery aneurysm and 96 embolized, ...

OBJECT: The authors of previous studies have shown that admission hyperglycemia or perioperative hyperglycemic events may predispose a patient to poor outcome after aneurysmal subarachnoid hemorrhage (SAH). The results of experimental evidence have suggested that hyperglycemia may exacerbate ischemic central nervous system injury. It remains to be clarified whether a ...

BACKGROUND: Surgical therapy for the thoracic aorta carries a high morbidity and mortality. Endovascular therapy for aneurysms and its adaptation to the thoracic aorta over the past 10 years is an exciting advance. This is a retrospective review of endovascular grafting of the thoracic aorta during the past decade at ...

The focus of aneurysm surgery is eliminating unnecessary operative manipulations and preparing the surgeon for any crises that might arise. With this concept in mind, we have tried resection of the gyrus rectus without routine sylvian fissure dissection in selected patients with anterior communicating artery (ACom) aneurysms, and compared these ...

BACKGROUND: Many surgeons adopt a selective policy of intervention for a ruptured abdominal aortic aneurysm (AAA). This study aimed to develop an objective method of identifying patients suitable for attempted repair. METHODS: Consecutive patients selected for attempted repair of ruptured AAA over a 31-month period (January 2000 to July 2002) ...

Current recommendations for follow-up after endovascular repair of abdominal aortic aneurysms (EVAR) include yearly computed tomographic (CT) scans after the first year. We hypothesize that this is unnecessary for patients who have aneurysm sacs that are stable or shrinking at 1 year and no evidence of endoleak. To explore this ...

Endovascular repair (EVAR) has been increasingly used for ruptured abdominal aortic aneurysms (rAAAs), especially in major academic centers. The goal of this article is to report our results with an EVAR-first approach for rAAA which we adopted in 2001 in our community hospital. All consecutive patients who underwent attempted repair ...

OBJECTIVE: Our goal was to assess the clinical and angiographic outcomes among patients undergoing treatment for distal anterior cerebral artery aneurysms at the Jefferson Hospital for Neuroscience (1997-2005). METHODS: Forty-one patients (1.5% of all aneurysms treated) with distal anterior cerebral artery aneurysms had undergone treatment. The clinical and angiographic outcomes ...

BACKGROUND AND PURPOSE: A prospective study was conducted to compare the neuropsychological outcome of surgical versus endovascular treatment in patients with cerebral aneurysms. METHODS: From April 2001 to 2005, 211 patients with ruptured cerebral aneurysms were treated at the senior author's institution. Of these 211 patients, 75 that were able ...

BACKGROUND: During the last decade endovascular therapy has been established as an alternative treatment for a variety of vascular diseases. Neither the classic operating room (OR), nor the conventional angiography suite is optimal for both open surgery and endovascular procedures. Important issues include: quality of the imaging equipment, radiation burden, ...

A regional cooperative data registry was organized for carotid endarterectomy (CEA), lower extremity bypass (LEB), and infrarenal abdominal aortic aneurysm (AAA) repair (open and endovascular) procedures in Northern New England to allow benchmarking among centers for quality assurance and improvement activities. Since January 2003, 48 vascular surgeons from nine hospitals ...

The mechanism of pseudoaneurysm formation caused by prolonged sepsis is thought to be related to the vascular endothelium being directly invaded and broken by bacteria. Moreover, matrix metalloproteinases (MMPs) which are up-regulated by chronic inflammation have been reported to be implicated in the pathogenesis of aneurysm development through increased proteolysis ...