Minimally Invasive Surgery For Treatment Of Unruptured Intracranial Aneurysms (Misian): A Prospective, Randomized, Single Center Clinical Trial With Long-Term Follow-Up Comparing Different Minimally Invasive Surgery Techniques To Standard Open Surgery

OBJECTIVELong-term follow-up results of the treatment of unruptured intracranial aneurysms (UIAs) by means of coil embolization remain unclear. The aim of this study was to analyze the frequency of rupture, retreatment, stroke, and death in patients with coiled UIAs who were followed for up to 20 years at multiple stroke centers.METHODSThe authors retrospectively analyzed data from cases in which patients underwent coil embolization between 1995 and 2004 at 4 stroke centers. In collecting the late (≥ 1 year) follow-up data, postal questionnaires were used to assess whether patients had experienced rupture or retreatment of a coiled aneurysm or any stroke or had died.RESULTSOverall, 184 patients with 188 UIAs were included. The median follow-up period was 12 years (interquartile range 11–13 years, maximum 20 years). A total of 152 UIAs (81%) were followed for more than 10 years. The incidence of rupture was 2 in 2122 aneurysm-years (annual rupture rate 0.09%). Nine of the 188 patients with coiled UIAs (4.8%) underwent additional treatment. In 5 of these 9 cases, the first retreatment was performed more than 5 years after the initial treatment. Large aneurysms were significantly more likely to require retreatment. Nine strokes occurred over the 2122 aneurysm-years. Seventeen patients died in this cohort.CONCLUSIONSThis study demonstrates a low risk of rupture of coiled UIAs with long-term follow-up periods of up to 20 years. This suggests that coiling of UIAs could prevent rupture for a long period of time. However, large aneurysms might need to be followed for a longer time.

Download Full-text

Neurointerventional procedures for unruptured intracranial aneurysms under procedural sedation and local anesthesia: a large-volume, single-center experience

Journal of Neurosurgery ◽

10.3171/2010.3.jns091384 ◽

2011 ◽

Vol 114 (1) ◽

pp. 120-128 ◽

Cited By ~ 21

Author(s):

Christopher S. Ogilvy ◽

Xinyu Yang ◽

Osama A. Jamil ◽

Erik F. Hauck ◽

L. Nelson Hopkins ◽

...

Keyword(s):

Hospital Stay ◽

Local Anesthesia ◽

Intracranial Aneurysms ◽

Conscious Sedation ◽

Modified Rankin Scale ◽

Unruptured Intracranial Aneurysms ◽

Long Term Follow Up ◽

Neurointerventional Procedures

Object In this paper, the authors' goal was to report the outcome of patients with unruptured intracranial aneurysms undergoing endovascular treatment under conscious sedation (local anesthesia). Methods Between November 5, 2001, and February 5, 2009, the authors treated 340 patients with 358 unruptured aneurysms by using neurointerventional procedures at Millard Fillmore Gates Hospital (Buffalo, New York). The data were retrospectively reviewed for periprocedural safety and long-term follow-up. Results A total of 496 procedures were performed under local anesthesia. Of those, 370 procedures (74.6%) were completed successfully. In 82 procedures (16.5%), an associated medical or technical event occurred. Forty-four procedures (8.9%) were aborted. Rates of overall procedure-related morbidity and mortality were 1.2% (6 of 496) and 0.6% (3 of 496), respectively. The average hospital stay was 1.5 ± 2.5 days. Long-term follow-up was available in 261 (82.1%) of 318 patients whose procedures were performed with local anesthesia. Of those, 246 patients (94.3%) had a good outcome (modified Rankin Scale score ≤ 2), 6 patients (2.3%) had an unfavorable outcome, not related to the procedure, and 9 patients (3.4%) had a poor outcome (modified Rankin Scale score > 2) as a result of the intervention. Conclusions Interventional treatment under conscious sedation (local anesthesia) can be effectively performed in most patients with unruptured intracranial aneurysms and is associated with a short hospital stay and low morbidity and mortality.

Download Full-text

Long-Term Follow-Up after Treatment of Intracranial Aneurysms with the Pipeline Embolization Device: Results from a Single Center

American Journal of Neuroradiology ◽

10.3174/ajnr.a2790 ◽

2011 ◽

Vol 33 (3) ◽

pp. 481-486 ◽

Cited By ~ 60

Author(s):

H.A. Deutschmann ◽

M. Wehrschuetz ◽

M. Augustin ◽

K. Niederkorn ◽

G.E. Klein

Keyword(s):

Intracranial Aneurysms ◽

Single Center ◽

Pipeline Embolization Device ◽

Long Term Follow Up

Download Full-text

Minimally invasive surgery for gallbladder cancer at an expert center

Mini-invasive Surgery ◽

10.20517/2574-1225.2021.139 ◽

2021 ◽

Author(s):

Jun-Suh Lee ◽

Ho-Seong Han ◽

Yoo-Seok Yoon ◽

Jai-Young Cho ◽

Hae-Won Lee ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Gallbladder Cancer ◽

Invasive Surgery ◽

Open Surgery ◽

Term Survival ◽

Extended Cholecystectomy ◽

Short And Long Term ◽

Expert Center

In this article, we reviewed the techniques and outcomes of minimally invasive surgery for gallbladder cancer performed at an expert center. The techniques of laparoscopic extended cholecystectomy with the short- and long-term outcomes at our center were described. The short- and long-term survival outcomes of laparoscopic extended cholecystectomy are comparable to open surgery. Laparoscopic surgery is a safe, effective alternative for open surgery in the treatment of gallbladder cancer. The benefits of robotic surgery should be proven with further research.

Download Full-text