World Neurosurg
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The flow diversion technique is increasingly used for reconstructive endovascular treatment of fusiform cerebral aneurysms. Double stenting with the Low-profile Visualized Intraluminal Support (LVIS) Blue stent is one of the flow diversion techniques. The aim of this study was to analyze the clinical and angiographic outcomes of LVIS Blue double stenting for fusiform cerebral aneurysms. ⋯ Double stenting using LVIS Blue stents for the treatment of fusiform cerebral aneurysms is effective and safe.
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Deep venous thrombosis (DVT) is considered the most common cause of preventable death among hospitalized patients. A few studies have investigated the risk of venous thromboembolic events in patients undergoing elective spine surgery and reported varying incidences. We aim to assess the incidence of preoperative lower limb DVT in patients with lumbar degenerative disease undergoing elective surgery. ⋯ Patients with LST or SPL with higher preoperative disability scores were at higher risk to have preoperative DVT. Further research is needed to evaluate the feasibility and value of preoperative LLVD to detect DVT in patients planned for lumbar degenerative surgery.
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Blood blister-like aneurysms (BBAs) usually arise from the anterior walls of the internal carotid artery, and such lesions at the junction of the internal carotid artery and posterior communicating artery (PCoA) have not been reported to date. Here, we report our experiences of BBAs at PCoA. We studied their clinical and angiographical characteristics including the internal carotid-PCoA angle, an indicator of hemodynamic stress at the bifurcation. ⋯ BBAs at PCoA were predominantly occurred as the small bulges at the origins of wide-angled fetal-type PCoAs in elderly females. Hemodynamic stress and atherosclerosis would contribute to the aneurysmal formation. Wrap-clipping or direct clipping with additional techniques would be useful for this rare condition.
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American College of Surgeons National Surgical Quality Improvement Program Participant Use File data from 2014 through 2019 were used to compare 1- and 2-level anterior cervical discectomy and fusion (ACDF) and cervical total disc replacement (cTDR) with respect to: patient demographics, comorbidities, adverse events, and 30-day morbidity rates. ⋯ Adjusting for demographics and comorbidities; ACDF has a higher average risk of adverse event. When ACDF and cTDR are equipoise, consideration for cTDR may be indicated in populations with higher rates of comorbid conditions.
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Cavernous sinus dural arteriovenous fistula (DAVF) was a special type of intracranial vascular malformation, and endovascular treatment was usually the first choice. However, sometimes it might fail for patients without the proper approach. Video 1 illustrates the case of a patient who presented with left exophthalmos and conjunctival hyperemia caused by cavernous sinus DAVF. ⋯ Endovascular treatment remained the optimal choice for cavernous sinus DAVF. However, for practical cases without accessible pathways, combined microsurgical and endovascular management in a hybrid neurovascular operating room was feasible, although challenging. The patient gave informed consent for the procedure and video production.