Neurosurgery
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Case Reports Multicenter Study
Balloon-in-stent technique for the constructive endovascular treatment of "ultra-wide necked" circumferential aneurysms.
Circumferential aneurysms, which incorporate >180 degrees of the circumference of the parent vessel, present a unique therapeutic challenge, particularly in circumstances in which a deconstructive treatment strategy is not feasible. We detail a novel technique for endovascular parent vessel reconstruction with aneurysm embolization. ⋯ The balloon-in-stent technique provides a practical and safe treatment strategy for the management of circumferential aneurysms that are not amenable to deconstructive embolization.
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Controversy exists about the indications and timing for surgery in head injured patients with an intradural mass lesion. The aim of this study was to survey contemporary approaches to the treatment of head injured patients with an intradural lesion, placing a particular focus on the utilization of decompressive craniectomy. ⋯ The results provide a contemporary picture of neurosurgical surgical approaches to the management of head injured patients with an intradural mass lesion and/or signs of raised intracranial pressure in some Neurosurgical Units across the world. The relative benefits of early versus delayed surgery in patients with intraparenchymal lesions and on the indications, technique and benefits of decompressive craniectomy could be topics for future head injury research.
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Multicenter Study Comparative Study Clinical Trial
Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial.
Heterotopic ossification (HO) is a well-known complication in joint replacements, but its occurrence and clinical effect on cervical artificial discs has not yet been studied. The purpose of this study was to investigate the incidence of HO in cervical disc replacement, to identify any associated risk factors for HO, and to examine the relationship of HO with clinical outcomes. ⋯ There is a strong association of the occurrence of HO with subsequent loss of movement of the implanted cervical artificial disc. We have found that sex and age are two possible risk factors in the development of HO after cervical disc replacement.
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Multicenter Study Comparative Study
Safety and feasibility of convection-enhanced delivery of Cotara for the treatment of malignant glioma: initial experience in 51 patients.
We report the safety and feasibility of using convection-enhanced delivery to administer Cotara (Peregrine Pharmaceuticals, Inc., Tustin, CA), a novel radioimmunotherapeutic agent, to patients with malignant glioma. ⋯ The majority of Cotara infusions delivered between 90 and 110% of the prescribed administered activity to the targeted region. This method of administration has an acceptable safety profile compared with literature reports of other therapeutics delivered by convection-enhanced delivery.
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Randomized Controlled Trial Multicenter Study
Analysis of cost related to clinical and angiographic outcomes of aneurysm patients enrolled in the international subarachnoid aneurysm trial in a North American setting.
The goal of this study was to compare, in a North American setting, the cost-effectiveness of neurosurgical clipping versus endovascular coiling treatment of ruptured intracranial aneurysms. A secondary goal was to assess the clinical outcomes of patients enrolled into the International Subarachnoid Aneurysm Trial (ISAT) from the largest contributing North American center. ⋯ The high procedure costs of endovascular coiling tended to offset apparent reductions in length of stay. Long-term follow-up is indicated both for costs incurred after initial treatment and for clinical outcome in patients with incompletely obliterated aneurysms.