Favorable survival even with high disease‐specific complication rates in lymphangioleiomyomatosis after lung transplantation—long‐term follow‐up of a Japanese center

Background The objective of this study was to present the long-term safety and effectiveness of strand remodelling with a hypercompliant balloon. Methods Patients with complex wide-neck bifurcation aneurysms (WNBAs) who underwent strand remodelling with a hypercompliant balloon via Y-stent-assisted coil embolization (Y-SACE) between September 2016 and January 2020 were included in the study. The feasibility, safety, effectiveness, and complication rates of the strand remodelling technique were investigated. Results A total of 12 patients (6 females, 6 males) were included in this study. Significant expansion was obtained in the intersection zone after remodelling. No regression was observed in the expansion rates during follow-up. There was no additional morbidity or mortality. No delayed thromboembolic complications occurred in our patients during long-term follow-up. Conclusions Performing strand remodelling to reduce thromboembolic complications triggered by structural faults caused by the Y-stent configuration is feasible, safe, and effective. This new approach can aid in the prevention of thromboembolic complications in Y-SACE.

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Management of Canine Y-T Humeral Fractures Using Titanium Polyaxial Locking Plates in 17 Dogs

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-7155 ◽

2022 ◽

Vol 58 (1) ◽

pp. 7-16

Author(s):

Claudio Motta ◽

Philip Witte ◽

Andrew Craig

Keyword(s):

Functional Impairment ◽

Complication Rates ◽

Load Testing ◽

Inclusion Criteria ◽

Long Term Outcomes ◽

Long Term Follow Up ◽

Mild Impairment ◽

Condylar Fractures

ABSTRACT The objective of this study was to document the short- and medium-to-long-term outcomes and complication rates of Y-T humeral condylar fractures fixed using titanium polyaxial locking plate (T-PLP). A retrospective review was performed of the medical records and radiographs of dogs with a Y-T humeral condylar fracture treated with T-PLP at a single veterinary referral center (2012–2018). Seventeen cases met the inclusion criteria. Medium- to long-term follow-up (.6 mo) information was derived using the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Recorded complications were catastrophic (1/17) and minor (2/17). Gait at 10–12 wk following surgery was subjectively assessed as good or excellent for 13 cases. Radiographic bone union was achieved in 7/12 cases at 4–6 wk. LOAD scores obtained a mean of 15 mo (range 6–29 mo) following surgery and indicated no or mild impairment in 15/16 and moderate functional impairment in 1. The application of T-PLP for the treatment of Y-T humeral condylar fractures resulted in adequate stabilization allowing successful fracture healing and medium- to long-term outcomes comparable to previous reports. According to results of LOAD testing, the medium- to long-term follow-up suggests that clients were aware of mild to moderate functional impairment in all cases.

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Long Term Follow-Up of 103 Untreated Adult Patients with Type 1 Gaucher Disease

Journal of Clinical Medicine ◽

10.3390/jcm8101662 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1662 ◽

Cited By ~ 10

Author(s):

Dinur ◽

Zimran ◽

Becker-Cohen ◽

Arkadir ◽

Cozma ◽

...

Keyword(s):

Gaucher Disease ◽

Substrate Reduction Therapy ◽

Type I ◽

Specific Therapy ◽

Substrate Reduction ◽

Long Term Follow Up ◽

Disease Specific

The introduction of disease-specific therapy for patients with type I Gaucher disease (GD1) was a revolution in the management of patients, but not without cost. Thus, the management of mildly affected patients is still debated. We herein report a long-term follow-up (median (range) of 20 (5–58) years) of 103 GD1 patients who have never received enzymatic or substrate reduction therapy. The median (range) platelet count and hemoglobin levels in last assessment of all but six patients who refused therapy (although recommended and approved) were 152 (56–408) × 103/mL and 13.1 (7.6–16.8) g/dL, respectively. Most patients had mild hepatosplenomegaly. Nine patients were splenectomized. No patient developed clinical bone disease. The median (range) lyso-Gb1 levels at last visit was 108.5 (8.1–711) ng/mL; lowest for patients with R496H/other and highest for patients refusing therapy. This rather large cohort with long follow-up confirms that mildly affected patients may remain stable for many years without GD-specific therapy. The challenge for the future, when newborn screening may detect all patients, is to be able to predict which of the early diagnosed patients is at risk for disease-related complications and therefore for early treatment, and who may remain asymptomatic or minimally affected with no need for disease-specific therapy.

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Bilateral sequential lung transplantation in Jehovah’s Witnesses

Perfusion ◽

10.1177/0267659120939364 ◽

2020 ◽

pp. 026765912093936

Author(s):

Ernest G Chan ◽

Matthew R Morrell ◽

Patrick G Chan ◽

Pablo G Sanchez

Keyword(s):

Lung Transplantation ◽

Organ Transplantation ◽

Solid Organ Transplantation ◽

Limited Resource ◽

Solid Organ ◽

Jehovah’S Witness ◽

Jehovah's Witness ◽

Long Term Follow Up

The ethical concerns of refusing lifesaving treatments after receiving an already limited resource such as a solid organ transplantation in a Jehovah’s Witness patient have been discussed in the literature. Many of these studies have concluded that with a multidisciplinary approach, solid organ transplantation is possible in the setting of Jehovah’s Witness patients. To date, there are no reported cases of bilateral sequential lung transplantation in the literature. We report two successful cases of bilateral sequential lung transplantation in Jehovah’s Witness patients with excellent long-term follow-up.

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Endovascular management of intracranial blister aneurysms: spectrum and limitations of contemporary techniques

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2014-011443 ◽

2014 ◽

Vol 8 (1) ◽

pp. 30-37 ◽

Cited By ~ 10

Author(s):

Ramsey Ashour ◽

Stephen Dodson ◽

M Ali Aziz-Sultan

Keyword(s):

Complication Rates ◽

Endovascular Techniques ◽

Parent Vessel ◽

Endovascular Interventions ◽

Scale Scores ◽

Long Term Follow Up ◽

Surgical Bypass ◽

Endovascular Approach

BackgroundIntracranial blister aneurysms are rare lesions that are notoriously more difficult to treat than typical saccular aneurysms. High complication rates associated with surgery have sparked considerable interest in endovascular techniques, though not well-studied, to treat blister aneurysms.ObjectiveTo evaluate our experience using various endovascular approaches to treat blister aneurysms.MethodsAll consecutive blister aneurysms treated using an endovascular approach by the study authors over a 3-year period were retrospectively analyzed. A literature review was also performed.ResultsNine patients with blister aneurysms underwent 11 endovascular interventions. In various combinations, stents were used in 8/11, coils in 5/11, and Onyx in 3/11 procedures. At mean angiographic follow-up of 200 days, 8/9 aneurysms were completely occluded by endovascular means alone requiring no further treatment and 1/9 aneurysms required surgical bypass/trapping after one failed surgical and two failed endovascular treatments. At mean clinical follow-up of 416 days, modified Rankin Scale scores were improved in six patients, stable in two, and worsened in one patient. One complication occurred in 11 procedures (9%), resulting in a permanent neurologic deficit. No unintended endovascular parent vessel sacrifice, intraprocedural aneurysmal ruptures, antiplatelet-related complications, post-treatment aneurysmal re-ruptures, or deaths occurred.ConclusionThis series highlights both the spectrum and limitations of endovascular techniques currently used to treat blister aneurysms, including a novel application of stent-assisted Onyx embolization. Long-term follow-up and experience in larger studies are required to better define the role of endovascular therapy in the management of these difficult lesions.

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Stereotactic amygdalotomy in the management of severe aggressive behavioral disorders

Neurosurgical FOCUS ◽

10.3171/foc/2008/25/7/e6 ◽

2008 ◽

Vol 25 (1) ◽

pp. E6 ◽

Cited By ~ 26

Author(s):

Maria Mpakopoulou ◽

Haralambos Gatos ◽

Alexandros Brotis ◽

Konstantinos N. Paterakis ◽

Kostas N. Fountas

Keyword(s):

Surgical Treatment ◽

Behavioral Disorders ◽

Complication Rate ◽

Clinical Studies ◽

Behavioral Disorder ◽

Complication Rates ◽

Clinical Series ◽

Long Term Follow Up

Object Stereotactic amygdalotomy has been utilized as a surgical treatment for severe aggressive behavioral disorders. Several clinical studies have been reported since the first description of the procedure. In the current study, the authors reviewed the literature and evaluated the surgical results, neuropsychological outcome, and complication rate in patients who had undergone stereotactic amygdalotomy for severe aggressive behavioral disorders. Methods The PubMed database was searched using the following terms: “amygdalotomy,” “amygdalectomy,” “amygdaloidectomy,” “psychosurgery,” “aggressive disorder,” and “behavioral disorder.” Clinical series with more than 5 patients undergoing stereotactic amygdalotomy for aggressive or other behavioral disorders were included in this review. The surgical technique, anatomical target, improvement in psychiatric symptomatology, postoperative employment and social rehabilitation, postoperative neurocognitive function, procedure-related complications, and long-term follow-up were evaluated. Results Thirteen clinical studies met our inclusion criteria. Reported postoperative improvement in aggressive behavior varied between 33 and 100%. Procedure-related complication rates ranged from 0 to 42%, whereas the mortality rate was as high as 3.8%. In the majority of the reviewed clinical series, the performance of stereotactic amygdalotomy did not compromise a patient’s learning, language, and intellectual capabilities. The long-term follow-up, although very limited, revealed that initially observed improvement was maintained in most cases. Conclusions Stereotactic amygdalotomy can be considered a valid surgical treatment option for carefully selected patients with medically refractory aggressive behavioral disorders. Recent advances in imaging and stereotactic navigation can further improve outcome and minimize the complication rate associated with this psychosurgical procedure.

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Long-term follow-up of living-donor single-lobe lung transplantation for bronchiolitis obliterans in a four-year-old male: improvement of over-sized lung allograft

Interactive Cardiovascular and Thoracic Surgery ◽

10.1510/icvts.2010.249870 ◽

2011 ◽

Vol 13 (1) ◽

pp. 114-116 ◽

Cited By ~ 1

Author(s):

Masafumi Hiratsuka ◽

Takeshi Shiraishi ◽

Takao Higuchi ◽

Akinori Iwasaki

Keyword(s):

Lung Transplantation ◽

Bronchiolitis Obliterans ◽

Living Donor ◽

Long Term Follow Up

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Lung transplantation with donation after cardiac death donors: Long-term follow-up in a single center

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2010.02.004 ◽

2010 ◽

Vol 139 (5) ◽

pp. 1306-1315 ◽

Cited By ~ 95

Author(s):

Nilto C. De Oliveira ◽

Satoru Osaki ◽

James D. Maloney ◽

Keith C. Meyer ◽

Takushi Kohmoto ◽

...

Keyword(s):

Lung Transplantation ◽

Cardiac Death ◽

Donation After Cardiac Death ◽

Single Center ◽

Long Term Follow Up

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Endoscopic Treatment of Intracranial Arachnoid Cysts: A Retrospective Analysis of a 25-Year Experience

Operative Neurosurgery ◽

10.1093/ons/opaa292 ◽

2020 ◽

Vol 20 (1) ◽

pp. 32-44 ◽

Cited By ~ 1

Author(s):

Joachim Oertel ◽

Stefan Linsler ◽

Wolfgang Wagner ◽

Michael Gaab ◽

Henry Schroeder ◽

...

Keyword(s):

Endoscopic Treatment ◽

Arachnoid Cysts ◽

Invasive Technique ◽

Complication Rates ◽

Patients Âgés ◽

Endoscopic Techniques ◽

Long Term Follow Up ◽

Shunt Dependency

Abstract BACKGROUND Since the development of neuroendoscopy, pure endoscopic fenestration for intracranial arachnoid cysts (ACs) became more and more popular and is actually preferred by many neurosurgeons. OBJECTIVE To explore their techniques and experiences with endoscopic treatment of intracranial ACs over a 25-yr period. METHODS A total of 95 endoscopic procedures in 87 patients with 88 intracranial ACs performed at the authors’ departments between February 1993 and October 2018 were retrospectively analyzed. Particular respect was given to surgical technique, complications, patients’ outcome, and radiological benefit in relation to cyst location. RESULTS Patients’ ages ranged from 23 d to 81 yr (mean: 29.9 yr). Cysts were located temporobasal (n = 31; 35.2%), paraxial supratentorial (n = 14; 15.9%), suprasellar/prepontine (n = 14; 15.9%), quadrigeminal (n = 12; 13.6%), infratentorial (n = 11; 12.5%), and supratentorial intraventricular (n = 6; 6.8%). Four different endoscopic techniques were applied: cystocisternostomies (n = 48; 50.5%), ventriculocystostomies (n = 23; 24.2%), cystoventriculostomies (n = 14; 14.7%), and ventriculocystocisternostomies (n = 10; 10.5%). Pure endoscopic technique was feasible in 89 of the 95 surgeries (93.7%). Clinical improvement was documented after 82 surgeries (86.3%) and radiological benefit after 62 surgeries (65.3%). Recurrences developed in 8 cases (8.4%). Overall complication rate was 21.1% (n = 20), postoperative new shunt dependency was observed in 4.2% of the cases (n = 4). CONCLUSION Pure endoscopic AC fenestration is a safe, effective, and less invasive technique providing high success and low permanent complication rates. The most frequent temporobasal cysts are the most difficult to treat endoscopically. A long-term follow-up is recommended because recurrences may occur many years after first treatment.

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Flow diverters for ruptured posterior circulation perforator aneurysms: multicenter experience and literature review

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2019-015558 ◽

2020 ◽

Vol 12 (7) ◽

pp. 688-694

Author(s):

Valerio Da Ros ◽

Francesco Diana ◽

Federico Sabuzi ◽

Emanuele Malatesta ◽

Antioco Sanna ◽

...

Keyword(s):

Perioperative Complications ◽

Treatment Options ◽

Flow Diverter ◽

Posterior Circulation ◽

Complication Rates ◽

Lower Complication ◽

Long Term Follow Up ◽

Ischemic Complication

BackgroundThe management of ruptured posterior circulation perforator aneurysms (rPCPAs) remains unclear. We present our experience in treating rPCPAs with flow diverter stents (FDs) and evaluate their safety and efficacy at mid- to long-term follow-up. A diagnostic and therapeutic algorithm for rPCPAs is also proposed.MethodsWe retrospectively analyzed data from all consecutive patients with rPCPAs treated with FDs at our institutions between January 2013 and July 2019. Clinical presentations, time of treatments, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with a mid- to long-term follow-up. A systematic review of the literature on rPCPAs treated with FDs was also performed.ResultsSeven patients with seven rPCPAs were treated with FDs. All patients presented with an atypical subarachnoid hemorrhage distribution and a low to medium Hunt–Hess grade. In 29% of cases rPCPAs were identified on the initial angiogram. In 57% of cases, FDs were inserted within 2 days of the diagnosis. Immediate aneurysm occlusion was observed in 14% of the cases and in 71% at the first follow-up (mean 2.4 months). At mean follow-up of 33 months (range 3–72 months) one case of delayed ischemic complication occurred. Six patients had a modified Rankin Scale (mRS) score of 0 and one patient had an mRS score of 4 at the latest follow-up.ConclusionsThe best management for rPCPAs remains unclear, but FDs seem to have lower complication rates than other treatment options. Further studies with larger series are needed to confirm the role of FDs in rPCPA.

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