Utility of P2Y12 Reactive Unit Assessment on Ticagrelor in Cerebral Aneurysms Treated with Intracranial Stenting and Flow Diversion: Cohort Study and Case Report From Two Neurovascular Centers

2020 ◽  
Vol 142 ◽  
pp. e445-e452
Author(s):  
Christian O. Bohan ◽  
Mirja M. Wirtz ◽  
Philipp Hendrix ◽  
Oded Goren ◽  
Clemens M. Schirmer ◽  
...  
2017 ◽  
Vol 102 ◽  
pp. 1-5 ◽  
Author(s):  
Christoph J. Griessenauer ◽  
Hussain Shallwani ◽  
Nimer Adeeb ◽  
Raghav Gupta ◽  
Leonardo Rangel-Castilla ◽  
...  

1994 ◽  
Vol 34 (12) ◽  
pp. 821-824 ◽  
Author(s):  
Shinjitsu NISHIMURA ◽  
Michiyasu SUZUKI ◽  
Kazuo MIZOI ◽  
Takashi YOSHIMOTO

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jason Rampengan ◽  
Johnny Rompis ◽  
Valentine Umboh

Abstract: COVID-19 is spreading at an extremely rapid rate and can affect all age groups, albeit, information about clinical symptoms and laboratory examinations of COVID-19 I in neonates is still quite limited. This study was aimed to determine the clinical symptoms, radiographic examinations especially CT-scans, and laboratory tests that could appear in neonates suffering from COVID-19. This was a literature review study using three databases, namely Pubmed, Clinical Key, and Google Scholar. The keywords used were Covid-19 / SARS-CoV-2 AND Neonatus AND sign and symptoms AND laboratory. The selection based on inclusion and exclusion criteria, obtained 15 case report studies, three retrospective studies, one observational study, and one cohort study. The review revealed that the most frequent clinical features that appeared were fever (54.8%), dyspnoea (35.4%), and cough (29%). Meanwhile, for CT-Scan radiographs, there were 14 of 31 neonates (45.2%) did not show any abnormalities or normal. The most frequent abnormal image was ground glass opacity (GGO) (29%). Among laboratory examinations, lymphopenia was the most common abnormality (32.2%). Moreover, leukocytosis, leukopenia, thrombocytopenia, increased PCT, AST, etc. could also occur. Of all the reviewed literatures, there were no death cases of neonates died due to COVID-19. In conclusion, fever, dyspnea, cough, and lymphopenia are the most common findings as well as GGO in the CT-Scan radiograph.Keywords: COVID-19, neonates Abstrak: COVID-19 menyebar dengan sangat pesat dan dapat menjangkiti semua kelompok usia namun informasi mengenai gejala klinis dan pemeriksaan laboratorium terhadap kelompok neonatus masih terbatas. Penelitian ini bertujuan untuk mengetahui gambaran klinis, pemeriksaan radiografi khususnya CT-Scan, dan pemeriksaan laboratorium yang bisa muncul pada neonatus dengan COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, Clinical Key, dan Google Scholar. Kata kunci yang digunakan yaitu Covid-19/ SARS-CoV-2 AND Neonatus AND sign and symptom AND laboratory. Hasil seleksi berdasarkan kriteria inklusi dan ekslusi mendapatkan 15 penelitian case report, tiga retrospective study, satu observational study, dan satu cohort study. Hasil kajian menunjukkan bahwa gambaran klinis yang paling sering muncul ialah demam (54,8%), sesak (35,4%), dan batuk (29%). Pemeriksaan radiografi CT-Scan, neonatus yang tidak menunjukkan kelainan (normal) terdapat pada 14 dari 31 neonatus diamati (45,2%), sedangkan kelainan yang sering muncul ialah ground glass opacity/GGO (29%). Pada pemeriksaan laboratorium, limfopenia merupakan kelainan tersering (32,2%), sedangkan leukositosis, leukopenia, trombositopenia, peningkatan PCT, AST, dll juga bisa terjadi. Dari semua literatur yang dikaji, tidak ditemukan kasus kematian neonatus akibat COVID-19. Simpulan penelitian ini ialah gambaran klinis yang paling sering muncul pada neonatus ialah demam, sesak, dan batuk, limfopenia, dan GGO pada CT-Scan.Kata kunci: COVID-19, neonatus


1997 ◽  
Vol 6 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Atsushi Fukunaga ◽  
Masayuki Ishihara ◽  
Hikaru Sasaki ◽  
Takeshi Kawase

2018 ◽  
Vol 7 (5) ◽  
pp. 218-232 ◽  
Author(s):  
Li-Mei Lin ◽  
Bowen Jiang ◽  
Jessica K. Campos ◽  
Narlin B. Beaty ◽  
Matthew T. Bender ◽  
...  

Background: Flow diversion with the Pipeline embolization device (PED) is an effective neuro­endovascular method and increasingly accepted for the treatment of cerebral aneurysms. Acute in situ thrombosis is a known complication of PED procedures. There is limited experience in the flow diversion literature on the use of abciximab (ReoPro) for the management of acute thrombus formation in PED cases. Methods: Data were collected retrospectively on patients who received intra-arterial (IA) ReoPro with or without subsequent intravenous (IV) infusion during PED flow diversion treatment of intracranial aneurysms. Results: A total of 30 cases in patients with a mean age of 56.7 years (range 36–84) and a mean aneurysm size of 8.6 mm (range 2–25) were identified to have intraprocedural thromboembolic complications during PED treatment. IA ReoPro was administered in all cases, with 20 cases receiving increments of 5-mg boluses and 10 cases receiving a 0.125 mg/kg IA bolus (half cardiac dosing). Complete or partial recanalization was achieved in 100% of the cases. IV ReoPro infusion at 0.125 μg/kg/min for 12 h was administered postprocedurally in 22 cases with a residual thrombus. Postprocedurally, 18 patients were transitioned from clopidogrel (Plavix) to prasugrel (Effient). The majority of the cases (23/30; 77%) were discharged home. Periprocedural intracranial hemorrhage was noted in 2 cases (7%) and radiographic infarct was noted in 4 cases (13%), with an overall mortality of 0% at the time of initial discharge. Clinical follow-up was available for 28/30 patients. The average duration of follow-up was 11.7 months, at which time 23/28 (82%) of the patients had a modified Rankin Scale score of 0. Conclusions: IA ReoPro administration is an effective and safe rescue strategy for the management of acute intraprocedural thromboembolic complications during PED treatment. Using a dosing strategy of either 5-mg increments or a 0.125 mg/kg IA bolus (half cardiac dosing) can provide high rates of recanalization with low rates of hemorrhagic complications and long-term morbidity.


Neurosurgery ◽  
2019 ◽  
Vol 86 (Supplement_1) ◽  
pp. S36-S45 ◽  
Author(s):  
Bree Chancellor ◽  
Eytan Raz ◽  
Maksim Shapiro ◽  
Omar Tanweer ◽  
Erez Nossek ◽  
...  

Abstract Flow diverters (FDs) have changed the management of brain aneurysms; not only for complex aneurysms (giant, fusiform and blister) refractory to conventional therapies, but also for unruptured lesions previously managed by traditional surgical or coil-based endovascular methods. Since 2011 when the PipelineTM Embolization Device (Medtronic) was cleared by the Food and Drug Administration for adults with large or giant wide-neck intracranial aneurysms of the internal carotid artery proximal to the posterior communicating segment, the role of flow diversion for aneurysm treatment has expanded—supported by favorably low complication and high cure rates compared with alternative treatments. Here we review the key clinical trials and the long term outcomes that have demonstrated safety and efficacy of minimized porosity endoluminal devices in the treatment of cerebral aneurysms.


Author(s):  
Wayan Niryana ◽  
Aslesa Wangpathi Pagehgiri ◽  
Putu Eka Widyadharma

Objective: Ruptured saccular aneurysms are a common and serious medical problem. The prevalence of aneurysms is low during the first two decades of life and increases steadily after the third decade. Anterior communicating artery (AComA) aneurysms are regarded as the most complex of all intracranial aneurysms.Methods: Here, we report a case of an aneurysm of AComA patient with the development of microsurgical technique and intraoperative monitoring technique.Results: Permanent clipping was successfully performed in the neck of an aneurysm of AComA.Conclusion: Microsurgical clipping still remains a definitive treatment of ruptured cerebral aneurysms.


2019 ◽  
Vol 128 ◽  
pp. e209-e216
Author(s):  
Daniel M.S. Raper ◽  
Ching-Jen Chen ◽  
Jeyan Kumar ◽  
M. Yashar Kalani ◽  
Min S. Park

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