Journal of neurointerventional surgery
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Benchmarking of complications is necessary in the context of the developing path to accountable care. We attempted to create a predictive model of negative outcomes in patients undergoing cerebral aneurysm coiling (CACo). ⋯ The presented model can aid in the prediction of the incidence of postoperative complications, and can be used as an adjunct in tailoring the treatment of cerebral aneurysms.
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Human placenta is a convenient resource for biomedical research, and has not yet been used for neurointerventional surgery research. ⋯ It is feasible to adopt the human placenta as an ex vivo vascular model in neurointerventional surgery research due to the fact that its vessels resemble the brain vasculature.
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Treatment of non-saccular vertebrobasilar aneurysms remains highly challenging despite significant recent advances in endovascular techniques. Establishing the natural history of this heterogeneous disease, as best as currently available data allows, is crucial to help guide counseling and management. ⋯ Initial clinical presentation is a strong predictor of subsequent disease course. Although overall prognosis is poor, nearly half of all deaths resulted from non-neurologic causes, underscoring the importance of comprehensive medical management. Aneurysms characterized by expansion, established mass effect, or hemorrhage have a poor natural history, and may be considered for invasive treatment, which is increasingly endovascular in nature. Lesions presenting with ischemia or incidentally are likely best addressed with aggressive neurologic and overall medical management.
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Comparative Study
Dexmedetomidine: a safe alternative to general anesthesia for endovascular stroke treatment.
There have been reports that general anesthesia (GA) is associated with worse clinical outcomes during intra-arterial treatment (IAT) for stroke. Since traditional sedatives carry the risk of respiratory depression, this retrospective study was designed to compare sedation with the α2 adrenergic agonist dexmedetomidine (DEX) and with GA for IAT procedures. ⋯ DEX can be safely administered in patients undergoing endovascular reperfusion therapies. Further study is required to determine if outcomes are different among sedatives used during such procedures.