Journal of neurointerventional surgery
-
The pending federal healthcare reform legislation includes Physician Payment Sunshine provisions that would mandate public disclosure of virtually all payments by industry to US physicians on government websites. The requirements reflect a growing trend toward public disclosure of payments following high-profile government investigations of allegedly improper payments and undisclosed conflicts of interests. The pending law world require broad disclosure and will affect most physicians. Industry and physicians groups have offered qualified support to the legislation.
-
Comparative Study
Acutely ruptured intracranial saccular aneurysms treated with stent assisted coiling: complications and outcomes in 42 consecutive patients.
Antiplatelet agents are required to prevent thromboembolic complications from recently deployed intracranial stents, yet they carry a risk of bleeding complications that may be serious in patients with recent subarachnoid hemorrhage. ⋯ These data suggest that higher grade hemorrhage patients, especially those with EVDs, are at greater risk for ischemic stroke and/or bleeding complications than lower grade patients. However, the complications had a small impact on mid-term disability outcomes in this cohort.
-
Comparative Study
Endovascular treatment of unruptured intracranial aneurysms in the elderly: analysis of procedure related complications.
The management of unruptured intracranial aneurysms in the elderly remains controversial. Treatment risks are thought to be higher in this group. Large series assessing endovascular treatment of unruptured intracranial aneurysms in the elderly are lacking. Our single center endovascular experience in treating unruptured intracranial aneurysms in the elderly is presented. ⋯ With only a 4% permanent rate of neurological morbidity and mortality, endovascular treatment of unruptured aneurysms can be performed safely in the elderly. Age should not be the limiting factor when considering endovascular therapy.
-
We present the use of the Pipeline embolization device (PED) to achieve reconstruction of the right anterior circulation in a patient with a dolichoectatic internal carotid artery (ICA) and middle cerebral artery (MCA) and an associated symptomatic, large, carotid-ophthalmic segment aneurysm. ⋯ Extensive cerebrovascular reconstructions that are not possible using commercially available endovascular devices can be achieved with Pipeline. The safety, efficacy and long term implications of such reconstructions are currently being defined.