scholarly journals Robotics in neurointerventional surgery: a systematic review of the literature

2021 ◽  
pp. neurintsurg-2021-018096
Author(s):  
William Crinnion ◽  
Ben Jackson ◽  
Avnish Sood ◽  
Jeremy Lynch ◽  
Christos Bergeles ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Success Rate ◽  
Cerebral Angiography ◽  
Clinical Success ◽  
Robotic Systems ◽  
Occupational Hazards ◽  
Review Of The Literature ◽  
Neurointerventional Procedures ◽  
Manual Assistance

BackgroundRobotically performed neurointerventional surgery has the potential to reduce occupational hazards to staff, perform intervention with greater precision, and could be a viable solution for teleoperated neurointerventional procedures.ObjectiveTo determine the indication, robotic systems used, efficacy, safety, and the degree of manual assistance required for robotically performed neurointervention.MethodsWe conducted a systematic review of the literature up to, and including, articles published on April 12, 2021. Medline, PubMed, Embase, and Cochrane register databases were searched using medical subject heading terms to identify reports of robotically performed neurointervention, including diagnostic cerebral angiography and carotid artery intervention.ResultsA total of 8 articles treating 81 patients were included. Only one case report used a robotic system for intracranial intervention, the remaining indications being cerebral angiography and carotid artery intervention. Only one study performed a comparison of robotic and manual procedures. Across all studies, the technical success rate was 96% and the clinical success rate was 100%. All cases required a degree of manual assistance. No studies had clearly defined patient selection criteria, reference standards, or index tests, preventing meaningful statistical analysis.ConclusionsGiven the clinical success, it is plausible that robotically performed neurointerventional procedures will eventually benefit patients and reduce occupational hazards for staff; however, there is no high-level efficacy and safety evidence to support this assertion. Limitations of current robotic systems and the challenges that must be overcome to realize the potential for remote teleoperated neurointervention require further investigation.

Carotid artery and cerebral blood flow during experimental cardiopulmonary resuscitation: A systematic review of the literature

Resuscitation ◽  
2019 ◽  
Vol 138 ◽  
pp. 46-52
Author(s):  
Luca Lucchetta ◽  
Timothy N. Kwan ◽  
Junko Kosaka ◽  
Aiko Tanaka ◽  
Glenn M. Eastwood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Cardiopulmonary Resuscitation ◽  
Review Of The Literature

scholarly journals Endovascular Stenting of Extracranial Carotid and Vertebral Artery Dissections: A Systematic Review of the Literature

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 856-866 ◽  
Author(s):  
Martin H. Pham ◽  
Rudy J. Rahme ◽  
Omar Arnaout ◽  
Michael C. Hurley ◽  
Richard A. Bernstein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Artery ◽  
Success Rate ◽  
Artery Dissection ◽  
Endovascular Management ◽  
Review Of The Literature ◽  
Technical Success ◽  
Endovascular Stenting ◽  
Technical Success Rate

Abstract BACKGROUND: Carotid and vertebral artery dissections are a leading cause of stroke in young individuals. OBJECTIVE: To examine the published safety and efficacy of endovascular stenting for extracranial artery dissection. METHODS: We conducted a systematic review of the literature to identify all cases of endovascular management of extracranial carotid and vertebral artery dissections. RESULTS: For carotid dissections, our review yielded 31 published reports including 140 patients (153 vessels). Reported etiologies were traumatic (48%, n = 64), spontaneous (37%, n = 49), and iatrogenic (16%, n = 21). The technical success rate of stenting was 99%, and the procedural complication rate was 1.3%. Mean angiographic follow-up was 12.8 months (range, 2-72 months) and revealed in-stent stenosis or occlusion in 2% of patients. Mean clinical follow-up was 17.7 months (range, 1-72 months), and neurological events were seen in 1.4% of patients. For vertebral artery dissections, our review revealed 8 reports including 10 patients (12 vessels). Etiologies were traumatic (60%, n = 6), spontaneous (20%, n = 2), and iatrogenic (20%, n = 2). There was a 100% technical success rate. The mean angiographic follow-up period was 7.5 months (range, 2-12 months). No new neurological events were reported during a mean clinical follow-up period of 26.4 months (range, 3-55 months). CONCLUSION: Endovascular management of extracranial arterial dissection continues to evolve. Current experience shows that this treatment option is safe and technically feasible. Prospective randomized trials compared with medical management are needed to further elucidate the role of stenting.

scholarly journals The Role of Angioembolization In the Management of Blunt Renal Injuries: A Systematic Review

2021 ◽  
Author(s):  
Giovanni Liguori ◽  
Giacomo Rebez ◽  
Andrea Salonia
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Operative Management ◽  
Low Grade ◽  
High Grade ◽  
Contrast Extravasation ◽  
Renal Injuries

Abstract Background Non-operative management is established for low-grade (I-III) blunt renal injuries but it is getting increasingly popular even in high grade BRI thanks to angioembolization of active bleedings. To date a systematic review to assess the role of Angioembolization (RAE) in Blunt Renal Injuries (BRI) is not yet present in the literature. Methods a literature search was performed, 169 unilateral BRI were included; 124 high grade BRI (92 grade IV and 32 grade V renal injuries, respectively). Most common indication was hemodynamically stable patients with BRI grades II to IV and active contrast extravasation. Results Overall, the clinical success rate of RAE was 90% (range 73% − 100%). The rate of re-do embolization was 4.5% gaining a 100% success rate with a second attempt. Some authors reported successful RAE even in patients with grade V BRI, without major abdominal organ injuries and no pelvic fractures. RAE was performed also as adjunctive therapy prior to surgery. Most used agent was micro coils. Nephrectomy rate was 5.8%, mortality rate was 3.2%. Conclusions A multidisciplinary approach between interventional radiology and urology should be pursued to make every effort to perform endovascular therapy unless there are multiple visceral injuries or renal pedicle avulsion or expanding retroperitoneal hematoma necessitating surgery.

scholarly journals Mycotic Extracranial Carotid Artery Aneurysms: Systematic Review of the Literature

2021 ◽  
Vol 50 ◽  
pp. 44
Author(s):  
Pedro N. Lima ◽  
Mário Moreira ◽  
Mafalda Correia ◽  
Joana Silva ◽  
Vânia Constâncio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Review Of The Literature ◽  
Extracranial Carotid Artery

Cognitive disorders in patients with occlusive disease of the carotid artery: a systematic review of the literature

2000 ◽  
Vol 247 (9) ◽  
pp. 669-676 ◽  
Author(s):  
Floor C. Bakker ◽  
Catharina J. M. Klijn ◽  
Aagje Jennekens-Schinkel ◽  
L. Jaap Kappelle
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Cognitive Disorders ◽  
Occlusive Disease ◽  
Review Of The Literature

Clinical outcomes and efficacy of endoscopic ultrasound guided ablation of pancreatic cancer a systematic review and a meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16261-e16261
Author(s):  
Hamid Ehsan ◽  
Muhammad Nadeem Yousaf ◽  
Ahsan Wahab ◽  
Karun Neupane ◽  
Muhammad Khawar Sana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Clinical Outcome ◽  
Success Rate ◽  
Clinical Success ◽  
Meta Analysis ◽  
Clinical Success Rate ◽  
Unresectable Pancreatic Cancer ◽  
Technical Success ◽  
Ultrasound Guided

e16261 Background: Endoscopic ultrasound-guided ablation therapy (EUS-A) is a minimally invasive technique increasingly used for the management of surgically unresectable pancreatic cancer. The data on the efficacy and clinical outcome of EUS-A for unresectable pancreatic cancer is lacking. We conducted this systematic review and meta-analysis to evaluate the safety, technical and clinical success of EUS-A therapies specifically for unresectable pancreatic cancer. Methods: Studies were identified with a comprehensive search for EUS-A and pancreatic cancer on PubMed, Google Scholar, Web of Science and Embase data search as of October 2020. The technical and clinical success rates of EUS-A were primary outcomes while adverse events (AEs) rate was secondary outcome. We defined technical success as successful placement of probe within tumor and able to perform ablation regardless of tumor outcome. Clinical success was defined as symptomatic improvement and/or any reduction in tumor size or evidence of necrosis on radiological imaging after EUS-A. A compute pooled analysis was performed using the ‘meta’ package by Schwarzer et al. in the R programming language (version 4.0.2) using random effect model. Results: Nineteen studies including 192 patients (54% females) were included. Common pancreatic tumors were nonfunctional neuroendocrine tumor (NNET) 43.5% (97), followed by locally advanced pancreatic ductal adenocarcinoma (LAPDAC) 27.3% (61), insulinoma 17.9% (40), cystic neoplastic lesions 8.5% (19). The pancreatic head was the most common site of tumor 49.8% (111), followed by body, neck and tail 44.8% (100). EUS-RFA was the most commonly used ablative therapy 63% (12/19 studies), followed by EUS-EA (ethanol ablation) 26% (5/19 studies) while EUS-A using laser and lauromacrogol injection was used in one study each. The mean number of ablation sessions per patient was 1.4 based on the total 243 sessions in 176 patients. The pooled technical success rate of EUS-A was 99.5% [95% CI = 0.90-0.97, I2 = 0%]. The pooled clinical success rate calculated out of total number of pancreatic lesions was 91.1% [95% CI = 0.79-0.92, I2 = 16%]. Clinical improvement in symptoms was reported in 11 studies and a complete resolution or decrease in tumor size was reported in 16 studies. The pooled AEs rate was 22.9% [95% CI = 0.17-0.37, I2 = 43%]. Common AEs were abdominal pain 7.8% (15), pancreatitis 5.2% (10) and pancreatic pseudocyst 2.1% (4). The median follow-up was 9.5 months. Conclusions: EUS-A is a safe and promising modality in the management of unresectable pancreatic cancer with a high technical and clinical success rate. Large prospective studies and clinical trials are required for comparison of clinical outcome of different EUS-A therapies and its widespread application for unresectable pancreatic cancer.

Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options

2008 ◽  
Vol 2 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Roukoz B. Chamoun ◽  
Michel E. Mawad ◽  
William E. Whitehead ◽  
Thomas G. Luerssen ◽  
Andrew Jea
Keyword(s):  
Carotid Artery ◽  
Antiplatelet Therapy ◽  
Cerebral Angiography ◽  
Mr Angiography ◽  
Pediatric Trauma ◽  
Anticoagulation Therapy ◽  
Diagnosis And Treatment ◽  
Artery Dissection ◽  
Review Of The Literature ◽  
Extracranial Carotid Artery

Object Currently, no diagnostic or treatment standards exist for extracranial carotid artery dissection (CAD) in children after trauma. The purpose of this study was to review and describe the characteristics, diagnosis, and treatment of this rather uncommon sequelae of pediatric trauma. Methods A systematic review of the literature was performed to examine the pertinent studies of traumatic extracranial carotid artery (CA) injuries in children. Results No randomized trials were identified; however, 19 case reports or small case series consisting of 34 pediatric patients were found in the literature. The diagnosis of CAD was made in 33 of 34 patients only after the onset of ischemic symptomatology. Twenty-four of 34 patients underwent cerebral angiography to confirm diagnosis; MR angiography affirmed the diagnosis in 6 of 34 patients. There was little published experience with CA ultrasonography or CT angiography for diagnosis. Thirty of 34 patients were treated with medical therapy or observation; 2 of 4 patients treated with observation alone died. There was little experience with open surgical treatment of CAD in the pediatric population, and there were no studies on the endovascular treatment of traumatic CAD in children. The literature does not support anticoagulation therapy over antiplatelet therapy. Conclusions As a result of this review of the literature, the authors propose the algorithms for the evaluation and treatment of traumatic extracranial CADs in children. These recommendations include utilizing MR angiography as a screening tool in cases in which the clinical suspicion of CAD is high, using conventional cerebral angiography to confirm the diagnosis, implementing antiplatelet therapy as initial medical management, and reserving endovascular stenting in cases of failed medical treatment.

scholarly journals Efficacy of EUS-RFA in pancreatic tumors: Is it ready for prime time? A systematic review and meta-analysis

2020 ◽  
Vol 08 (10) ◽  
pp. E1243-E1251
Author(s):  
Amaninder Dhaliwal ◽  
Sindhura Kolli ◽  
Banreet Singhg Dhindsa ◽  
Jacqueline Choa ◽  
Harmeet Singh Mashiana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Clinical Success ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Clinical Success Rate ◽  
Pancreatic Tumors ◽  
Secondary Outcome ◽  
Manual Search ◽  
Number Of Patients

Abstract Background and study aims Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) can be used in patients with unresectable pancreatic ductal adenocarcinoma (PDAC). We performed a systematic review and meta-analysis to evaluate the efficacy of EUS-RFA in treatment of locally advanced unresectable PDAC and other pancreatic tumors. Patients and methods A comprehensive search was done of multiple electronic databases and conference proceedings including PubMed, EMBASE, Web of Science databases, Google Scholar and manual search of references (from inception through May 2019) to identify the studies reporting use of EUS-RFA for pancreatic lesions. The primary outcome was to evaluate technical and clinical success of the procedure. The secondary outcome was to study overall adverse events (AEs). Results Thirteen studies reporting 165 EUS-RFA procedures on 134 patients were included. Of 134 patients, 27.94 % (38) had unresectable locally advanced PDAC, 40 % (53) had PNETs, 3 % (4) had metastasis to the pancreas and 30 % (41) had other lesions. The pooled technical success rate calculated out of the total number of procedures was 100 % (95 % CI [99.18 – 100], I2 = 0 %). The pooled clinical success rate calculated out of the total number of patients was 91.58 % (95 % CI [82.5 – 98.08], I2 = 21.5 %). The pooled overall AE rates were 14.67 % (95 % CI [4.77 – 27.46], I2 = 56.19 %) out of which abdominal pain was the most common with 9.82 % (95 % CI [3.34 – 18.24], I2 = 23.76 %). Low to moderate heterogeneity was noted. Conclusion EUS-RFA has high technical (100 %) and clinical success (91.5 %) rates. Further multicenter trials are needed to further validate our findings.

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