Journal of neurosurgery
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Journal of neurosurgery · Oct 2023
Femoral access site complications following neurointerventional procedures: economic implications at a single center.
Transfemoral access (TFA) has been the traditional route of arterial access for neurointerventional procedures. Femoral access site complications may occur in 2%-6% of patients. Management of these complications often requires additional diagnostic tests or interventions, each of which may increase the cost of care. The economic impact of a femoral access site complication has not yet been described. The objective of this study was to evaluate the economic consequences of femoral access site complications. ⋯ Although occurring relatively infrequently, femoral artery access site complications increase the cost of care for patients undergoing neurointerventional procedures; how this influences the cost effectiveness of neurointerventional procedures warrants further investigation.
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Journal of neurosurgery · Oct 2023
Combined subtarsal contralateral transmaxillary retroeustachian and endoscopic endonasal approaches to the infrapetrous region.
The eustachian tube (ET) limits endoscopic endonasal access to the infrapetrous region. Transecting or mobilizing the ET may result in morbidities. This study presents a novel approach in which a subtarsal contralateral transmaxillary (ST-CTM) corridor is coupled with the standard endonasal approach to facilitate access behind the intact ET. ⋯ Combining the EEA with the more laterally and superiorly originating ST-CTM approach allows greater exposure of the infrapetrous and ventral JF regions while obviating the need for mobilizing the ET. The surgical freedom afforded by the combined approaches is greater than that obtained by EEA alone.
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Journal of neurosurgery · Oct 2023
Randomized Controlled TrialCryopreserved human umbilical cord as a meningeal patch during in utero spina bifida repair in a modified ovine model.
Despite in utero spina bifida (SB) repair, more than two-thirds of patients with SB are unable to ambulate independently, and 1 in 4 children need surgery for tethered cord by school age. The objective of this study was to test the cryopreserved human umbilical cord (HUC) as an antiscarring material to reduce tethering and improve function in a modified in utero SB repair model. ⋯ In a modified ovine SB model, the HUC as a meningeal patch allows regeneration of the arachnoid layer, prevents spinal cord tethering, and improves spinal cord function after in utero SB repair.
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Journal of neurosurgery · Oct 2023
Observational StudyInterrupted intraarterial selective cooling infusion combined with mechanical thrombectomy in patients with acute ischemic stroke: a prospective, nonrandomized observational cohort study.
The authors aimed to explore the feasibility and efficiency of an interrupted intraarterial selective cooling infusion (IA-SCI) combined with mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS). ⋯ Interrupted IA-SCI for patients with intracranial large vessel occlusion AIS symptoms treated with MT seems to be safe and associated with favorable functional outcomes.