Journal of neurointerventional surgery
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Comparative Study
A single center comparison of coiling versus stent assisted coiling in 90 consecutive paraophthalmic region aneurysms.
Aneurysm recurrence is a principle limitation of endovascular coiling procedures, with recurrence rates reported of >30%. The adjunct use of self-expandable stents has revolutionized the treatment of intracranial aneurysms, especially for complex morphologies, wide necks or unfavorable dome to neck ratios. However, further investigation into the durability and outcomes of stent assisted coiling procedures is required. ⋯ Following endovascular coil embolization of paraophthalmic region aneurysms, recurrence rates at 2 years were significantly lower in patients who had stent assisted coiling (11.5%) compared with patients who had coiling procedures without the use of a stent (35.9%). Aneurysm size and coiling packing density did not significantly affect recurrence in our study population.
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Review Case Reports
Endovascular management of a giant aneurysm through saphenous vein graft after extracranial-intracranial bypass: case report and literature review.
It is known that giant intracerebral aneurysms have a high rupture and mortality rate. Furthermore, their optimal treatment method is not straightforward. While traditionally they have been managed with surgical clipping, it is not always possible. ⋯ Thus it was decided to go ahead with coiling of the aneurysm. The coils were delivered through the saphenous vein graft. The patient tolerated the procedure well and there were no procedural complications.
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Physicians generally have been affected by significant changes in the patterns of medical practice evolving over the past several decades. The Patient Protection and Affordable Care Act of 2010, also called ACA for short, impacts physician professional practice dramatically. Physicians are paid in the USA for their personal services. ⋯ Thus, in 1998, the sustainable growth rate system was introduced. In 2009, multiple unsuccessful attempts were made by Congress to repeal the formula. The mechanism of the sustainable growth rate includes three components that are incorporated into a statutory formula: expenditure targets, growth rate period and annual adjustments of payment rates for physician services.
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Case Reports
Unusual thromboembolic complication during an anterior communicating artery aneurysm coiling.
Thromboembolism during aneurysm coiling is a known complication with almost all thromboembolic phenomenon occurring ipsilateral to the side of vessel catheterization and sometimes bilaterally. A case is reported in which thromboembolism occurred exclusively on the opposite side of vessel catheterization, the first case to be reported, to our knowledge.
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The purpose of this study was to clarify the clinical predictors of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). ⋯ DCI was less frequently observed in the coiling group, and clinical outcomes were also superior in the coiling group, especially for patients with severe SAH. The results showed a significant correlation between DCI and hydrocephalus.