World Neurosurg
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Up to 20% of patients fail to achieve reperfusion with modified Thrombolysis in Cerebral Infarction (mTICI) scores of 0-1 after mechanical thrombectomy (MT). Furthermore, underlying intracranial atherosclerotic disease, particularly when associated with >70% residual or flow limiting stenosis, is associated with higher rates of failed MT and high failure risk MT. The aim of this study was to systematically review the procedural and clinical outcomes in patients with failed MT and high failure risk MT. We also explored differences between patients receiving acute rescue stenting compared with medical management alone. ⋯ In patients who fail initial attempts at MT or are high risk for acute reocclusion, rescue intracranial stenting could be considered with the aim to improve functional outcomes. Antiplatelet agents do not increase the risk of hemorrhage in these patients.
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Review Meta Analysis Comparative Study
Comparative of complication and revision after sacral 2 alar iliac screw and iliac screw fixation for sacropelvic fixation in pediatric and adult population: systematic review and meta-analysis.
This systematic review and meta-analysis aims to assess and compare the postoperative outcomes of iliac screw (IS) fixation versus sacral 2 alar iliac (S2AI) screw fixation in the adult and pediatric populations. ⋯ Sacropelvic fixation with IS screw fixation had more postoperative complications and revisions and lower AS than did S2AI fixation.
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The long-term durability of different modalities of intracranial aneurysm repair remains unclear. The aim of this study was to conduct a meta-analysis comparing long-term rates of intracranial aneurysm recurrence, retreatment, and rebleeding after surgical clipping or endovascular treatment (EVT). ⋯ These results indicate better long-term durability of clipping compared with coiling-based EVT. The relatively high incidence of recurrence and retreatment after coiling should be considered when determining treatment strategy.
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Review Meta Analysis
Complications Associated with Surgery for Thoracic Disc Herniation: A Systematic Review and Network Meta-Analysis.
A systematic review and network meta-analysis (Prospero ID CRD42018106936) were performed. ⋯ Surgery for TDH is associated with minimal mortality but significant morbidity, with large variations among the available approaches. An understanding of the perioperative complications rates is important to develop complication avoidance strategies and to aid accurate patient-to-doctor communication.
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Review Meta Analysis
Visual and Endocrine Recovery Following Conservative and Surgical Treatment of Pituitary Apoplexy: A Meta-Analysis.
Pituitary apoplexy (PA) can manifest with visual and endocrine defects. The literature lacks strong support for either surgical or conservative management with respect to symptomatic improvement of these deficits. This meta-analysis compared visual and endocrine outcomes in conservative and surgical treatment of PA. ⋯ Both surgical intervention and conservative management of PA can lead to visual and endocrine recovery, although the management decision may heavily rely on severity of initial deficits. Treatment of PA can be multifaceted and tailored to the individual case and clinical judgment. Further investigation into appropriate intervention based on longitudinal outcome data is warranted.