Woven Endobridge Embolization Versus Microsurgical Clipping for Unruptured Anterior Circulation Aneurysms: A Propensity Score Analysis

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S113-S113
Author(s):  
Lukas Goertz ◽  
Thomas Liebig ◽  
Eberhard Siebert ◽  
Lenhard Pennig ◽  
Kai Roman Laukamp ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Analysis ◽  
Anterior Circulation ◽  
Microsurgical Clipping ◽  
Score Analysis ◽  
Woven Endobridge ◽  
Anterior Circulation Aneurysms

Woven Endobridge Embolization Versus Microsurgical Clipping for Unruptured Anterior Circulation Aneurysms: A Propensity Score Analysis

Neurosurgery ◽  
2020 ◽  
Author(s):  
Lukas Goertz ◽  
Thomas Liebig ◽  
Eberhard Siebert ◽  
Lenhard Pennig ◽  
Kai Roman Laukamp ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Outcomes ◽  
Technical Success ◽  
Anterior Circulation ◽  
Microsurgical Clipping ◽  
Aneurysm Occlusion ◽  
Woven Endobridge ◽  
Major Adverse Events ◽  
Anterior Circulation Aneurysms ◽  
The Web

Abstract BACKGROUND Intrasaccular flow-disruption represents a new paradigm in endovascular treatment of wide-necked bifurcation aneurysms. OBJECTIVE To retrospectively compare Woven Endobridge (WEB) embolization with microsurgical clipping for unruptured anterior circulation aneurysms using propensity score adjustment. METHODS A total of 63 patients treated with WEB and 103 patients treated with clipping were compared based on the intention-to-treat principle. The primary outcome measures were immediate technical treatment success, major adverse events, and 6-mo complete aneurysm occlusion. RESULTS The technical success rates were 83% for WEB and 100% for clipping. Procedure-related complications occurred more often in the clipping group (13%) than the WEB group (6%, adjusted P < .01). However, the rates of major adverse events were comparable in both groups (WEB: 3%, clip: 4%, adjusted P = .53). At the 6-mo follow-up, favorable functional outcomes were achieved in 98% of the WEB embolization group and 99% of the clipping group (adjusted P = .19). Six-month complete aneurysm occlusion was obtained in 75% of the WEB group and 94% of the clipping group (adjusted P < .01). CONCLUSION Microsurgical clipping was associated with higher technical success and complete occlusion rates, whereas WEB had a lower complication rate. Favorable functional outcomes were achieved in ≥98% of both groups. The decision to use a specific treatment modality should be made on an individual basis and in accordance with the patient's preferences.

General Anesthesia may have Similar Outcomes with Conscious Sedation in Thrombectomy Patients with Acute Ischemic Stroke: A Real-World Registry in China

2018 ◽  
Vol 80 (1-2) ◽  
pp. 7-13 ◽  
Author(s):  
Wanying Shan ◽  
Dong Yang ◽  
Huaiming Wang ◽  
Liang Xu ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Endovascular Treatment ◽  
General Anesthesia ◽  
Real World ◽  
Conscious Sedation ◽  
Propensity Score Analysis ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Score Analysis ◽  
Symptomatic Intracranial Hemorrhage

Background and Purpose: Clinical trials showed that anesthesia may not influence the functional outcome in stroke patients with endovascular therapy; however, data are lacking in China. Using real-world registry data, our study aims to compare the effects of general anesthesia or conscious sedation on functional outcomes in stroke patients treated with thrombectomy in China. Methods: Consecutive patients with acute anterior circulation stroke receiving thrombectomy in 21 stroke centers between January 2014 and June 2016 were included in this study. The propensity score analysis with 1: 1 ratio was used to match the baseline variables between patients with general anesthesia and the conscious sedation. The 90-day modified Rankin Scale (mRS), symptomatic intracranial hemorrhage (sICH), and death were compared between groups. Results: Of the 698 patients undergoing endovascular treatment, 138 were treated with general anesthesia and 560 with conscious sedation. After propensity score matching, 114 general anesthesia and 114 conscious sedation patients were matched. The proportions of patients with 90-day mRS 0–2 were not significantly different between general anesthesia and conscious sedation groups (41.2% [47/114] vs. 46.5% [53/114], p = 0.470), nor were the rates of sICH (21.9% [25/114] vs. 12.3% [14/114], p = 0.072) and 90-day mortality (31.6% [36/114] vs. 21.9% [25/114], p = 0.145). Conclusion: Anesthesia patterns may have no significant impacts on clinical outcomes in patients with acute anterior circulation occlusion stroke undergoing endovascular treatment in the real-world practice in China.

Efficacy of variceal embolisation in patients with TIPS implantation: a propensity score analysis

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
M Giesler ◽  
D Bettinger ◽  
M Rössle ◽  
R Thimme ◽  
M Schultheiss
Keyword(s):  
Propensity Score ◽  
Propensity Score Analysis ◽  
Score Analysis

scholarly journals Morbidity and mortality of lobectomy or pneumonectomy after neoadjuvant treatment: an analysis from the ESTS database

2019 ◽  
Author(s):  
Alessandro Brunelli ◽  
Gaetano Rocco ◽  
Zalan Szanto ◽  
Pascal Thomas ◽  
Pierre Emmanuel Falcoz
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Bronchopleural Fistula ◽  
Neoadjuvant Treatment ◽  
Mortality Rates ◽  
Induction Treatment ◽  
Score Analysis ◽  
Cardiopulmonary Complications ◽  
Lung Resections

Abstract OBJECTIVES To evaluate the postoperative complications and 30-day mortality rates associated with neoadjuvant chemotherapy before major anatomic lung resections registered in the European Society of Thoracic Surgeons (ESTS) database. METHODS Retrospective analysis on 52 982 anatomic lung resections registered in the ESTS database (July 2007–31 December 2017) (6587 pneumonectomies and 46 395 lobectomies); 5143 patients received neoadjuvant treatment (9.7%) (3993 chemotherapy alone and 1150 chemoradiotherapy). To adjust for possible confounders, a propensity case-matched analysis was performed. The postoperative outcomes (morbidity and 30-day mortality) of matched patients with and without induction treatment were compared. RESULTS 8.2% of all patients undergoing lobectomies and 20% of all patients undergoing pneumonectomies received induction treatment. Lobectomy analysis: propensity score analysis yielded 3824 pairs of patients with and without induction treatment. The incidence of cardiopulmonary complications was higher in the neoadjuvant group (626 patients, 16% vs 446 patients, 12%, P < 0.001), but 30-day mortality rates were similar (71 patients, 1.9% vs 75 patients, 2.0%, P = 0.73). The incidence of bronchopleural fistula and prolonged air leak >5 days were similar between the 2 groups (neoadjuvant: 0.5% vs 0.4%, P = 0.87; 9.2% vs 9.9%, P = 0.27). Pneumonectomy analysis: propensity score analysis yielded 1312 pairs of patients with and without induction treatment. The incidence of cardiopulmonary complications was higher in the treated patients compared to those without neoadjuvant treatment (neoadjuvant 275 cases, 21% vs 18%, P = 0.030). However, the 30-day mortality was similar between the matched groups (neoadjuvant 68 cases, 5.2% vs 5.3%, P = 0.86). Finally, the incidence of bronchopleural fistula was also similar between the 2 groups (neoadjuvant 1.8% vs 1.4%, P = 0.44). CONCLUSIONS Neoadjuvant chemotherapy is not associated with an increased perioperative risk after either lobectomy or pneumonectomy, warranting a more liberal use of this approach for patients with locally advanced operable lung cancer.

scholarly journals Procedural times in early non-intubated VATS program - a propensity score analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabella Metelmann ◽  
Johannes Broschewitz ◽  
Uta-Carolin Pietsch ◽  
Gerald Huschak ◽  
Uwe Eichfeld ◽  
...  
Keyword(s):  
Propensity Score ◽  
Surgical Procedure ◽  
Recovery Time ◽  
Propensity Score Analysis ◽  
Wedge Resection ◽  
University Hospital ◽  
Implementation Phase ◽  
Score Analysis ◽  
Significant Difference ◽  
Procedural Time

Abstract Background Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. Methods This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Results Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Conclusions Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

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