Abstract P44: Final Outcomes in Patients With Ruptured Aneurysms From the SMART Registry

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Alejandro Spiotta ◽  
Reade A De Leacy ◽  
Bradley N Bohnstedt ◽  
David Fiorella ◽  
Clemens M Schirmer ◽  
...  
Keyword(s):  
Class Iii ◽  
Serious Adverse Events ◽  
Ruptured Aneurysms ◽  
Coil System ◽  
Post Procedure ◽  
Mean Size ◽  
Retreatment Rate ◽  
The Mean ◽  
Grade 3 ◽  
One Year

Introduction: We report the durability of treatment with SMART COIL System at one-year in patients with ruptured aneurysms enrolled in the SMART registry. Materials and Methods: The SMART Registry is a prospective, multi-center registry study. Procedures must employ ≥75% of the SMART, PC400, or POD coils to meet registry criteria. Patients with ruptured aneurysms presenting prior to the procedure were included in this analysis. SMART Registry endpoints include retreatment rates at one year, procedural device-related serious adverse events (SAE), and the ability to achieve adequate occlusion at immediate post-procedure. Results: Of the 905 enrolled patients with aneurysms, 31.8% (288/905) of patients had ruptured aneurysms (74.0% female; mean age 58.0 ± 13.5 years). Ruptured aneurysms were small (<4 mm) in 16.7% (48/288), medium (≥4mm to 10mm) in 68.4% (197/288), large (>10 to 25 mm) in 14.6% (42/288), giant (>25) in 0.3% (1/288), and the mean size was 6.9 mm (SD 3.5 ). Hunt and Hess grade ≥3 was reported in 43.8% (123/281) of patients. The anterior cerebral artery had 33.7% (97/288) of all ruptured aneurysms and the internal carotid artery had 30.6% (88/288). Stent-assisted coiling and balloon-assisted coiling were performed in 7.6% (22/288) and 31.3% (90/288) of patients, respectively. Mean packing density for ruptured aneurysms was 33.4% (SD 20.9). In patients with ruptured aneurysms, retreatment rate at one year was 16.5% (33/200). Procedural device-related SAEs were observed in 3.1% subjects (9/288). Raymond Class I or II was observed in 84.6% (242/286) at immediate post-procedure and in 84.3% (161/191) at one year. The multivariate analysis showed that neck width ≥4 mm (OR 2.56, 95% CI 1.21-5.44, P=0.0144) and male gender (OR 2.17 95% CI 1.05-4.49, P=0.0376) were predictors of Raymond Class III or retreatment at one year. Conclusion: This analysis suggests that the SMART COIL System achieves adequate embolization and retreatment rates in ruptured aneurysms at one year.

Sizes of ruptured and unruptured aneurysms in relation to their sites and the ages of patients

2002 ◽  
Vol 96 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Bryce Weir ◽  
Lew Disney ◽  
Theodore Karrison
Keyword(s):  
Cerebral Artery ◽  
Patient Age ◽  
Content Type ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Patient Âgé ◽  
Risk Of Rupture ◽  
Mean Size ◽  
The Mean ◽  
Fine Print

Object. The authors explore the risk of rupture in aneurysms categorized by size. Methods. A computerized database of 945 patients with aneurysms treated between 1967 and 1987 was retrospectively established. All available clinical and radiological studies were abstracted. Because of the recent interest in the size of intracranial aneurysms in relation to their likelihood of rupture, the database was searched with respect to this parameter. In 390 patients representing 41% of all cases, aneurysms were measured by neuroradiologists at the time of diagnosis. In 78% of the 945 patients there was only one aneurysm, and of the 507 aneurysms that were measured, 60% were solitary. Of all patients, 86% had ruptured aneurysms. The average age of all patients was 47 years, and for those with ruptured aneurysms it was 46 years. Of the ruptured aneurysms, 77% were 10 mm or smaller, compared with 85% of the unruptured aneurysms. It was found that 40.3% of the ruptured aneurysms were on the anterior cerebral artery or anterior communicating artery, compared with 13% of the unruptured aneurysms. None of the cavernous internal carotid artery (ICA) aneurysms were ruptured and 65% of the ophthalmic artery (OphA) aneurysms were. Of the unruptured aneurysms, 15% were located in the cavernous ICA or the OphA. Of the ruptured aneurysms, 29% were on the middle cerebral artery, compared with 36% of the unruptured aneurysms. The mean size of ruptured and unruptured aneurysms showed no statistically significant increase with patient age, although the difference in size between the ruptured and unruptured aneurysms decreased with increasing age. The mean size of all ruptured aneurysms (10.8 mm) was significantly larger than the mean size of all unruptured aneurysms (7.8 mm, p < 0.001); the median sizes were 10 mm and 5 mm, respectively. The size of ruptured aneurysms in patients who died in the hospital was significantly larger than those in the patients who survived (12 mm compared with 9.9 mm, p = 0.004). Symptomatic unruptured aneurysms were significantly larger than incidental unruptured aneurysms (14.6 mm compared with 6.9 mm, p = 0.032), which were, in turn, larger than aneurysms that were unruptured and part of a multiple aneurysm constellation. Both ruptured and unruptured aneurysms were larger in male than in female patients, but not significantly. Conclusions. Site and patient age, as well as lesion size, may affect the chance of rupture.

Geographical Variation in Corroboree Frogs, Pseudophryne Corroboree Moore (Anura: Myobatrachidae): a Reappraisal Supports Recognition of P-Pengilleyi Wells &Wellington

1996 ◽  
Vol 44 (6) ◽  
pp. 569 ◽  
Author(s):  
WS Osborne ◽  
RA Zentelis ◽  
M Lau
Keyword(s):  
Morphological Characters ◽  
Colour Pattern ◽  
Separate Species ◽  
Advertisement Calls ◽  
Form Analysis ◽  
Southern Form ◽  
Mean Size ◽  
The Mean ◽  
One Year ◽  
Breeding Seasons

The extent of divergence in morphology and colour-pattern between allopatric populations of the corroboree frog, Pseudophyrne corroboree, was assessed over three breeding seasons by examination of eggs, tadpoles and adults throughout the distributional range of the species. Advertisement calls of individuals from each of the populations also were recorded and analysed. The mean size of adults was found to vary considerably between years; however, within any one year individuals from the Snowy Mountains (southern form) were significantly larger than individuals from the Brindabella Range and Fiery Range (northern form), with the differences apparently not simply related to environmental influences. Multivariate analysis of quantitative morphological characters and colour-pattern separated the frogs into two distinct geographic groups corresponding with the northern form and southern form. Analysis of advertisement calls indicated that there were slight differences in the structure of the calls of the two forms, with the main differences being in call duration and number of pulses. These results, combined with the previously described genetic differences, support their recognition as separate species. It is recommended that the name P. corroboree be restricted to the southern form and that the northern form be referred to as P. pengilleyi Wells & Wellington.

scholarly journals Effectiveness and safety of 12-month certolizumab pegol treatment for axial spondyloarthritis in real-world clinical practice in Europe

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 113-124
Author(s):  
Xenofon Baraliakos ◽  
Torsten Witte ◽  
Luc De Clerck ◽  
Bruno Frediani ◽  
Eduardo Collantes-Estévez ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Adverse Events ◽  
Real World ◽  
Randomized Clinical Trials ◽  
Axial Spondyloarthritis ◽  
Certolizumab Pegol ◽  
Signs And Symptoms ◽  
Serious Adverse Events ◽  
The Mean ◽  
One Year

Abstract Objectives The efficacy and safety of certolizumab pegol (CZP), an Fc-free, PEGylated anti-TNF, in axial spondyloarthritis (axSpA) has been established in clinical trial settings. We report CZP effectiveness and safety in European clinical practice in patients with axSpA, including radiographic (r-) and non-radiographic (nr-) axSpA. Methods CIMAX (NCT02354105), a European non-interventional multicentre prospective study, observed CZP treatment response and safety over 12 months in a real-world axSpA cohort. The primary outcome was change from baseline in BASDAI to week 52, with additional outcomes pertaining to effectiveness and safety. Patients who received ≥1 dose CZP were followed up for adverse events, and those with baseline and ≥1 post-baseline BASDAI assessment were included in effectiveness analyses. Results A total of 672 patients (r-axSpA: 469; nr-axSpA: 201; unconfirmed diagnosis: 2) from 101 sites received ≥1 dose of CZP, of whom 564 (r-axSpA: 384; nr-axSpA: 179; unconfirmed: 1) were included in the effectiveness analyses. The mean baseline BASDAI was 6.1 in the overall axSpA population and r-axSpA and nr-axSpA subpopulations. At week 52, the mean (s.d.) change in BASDAI was −2.9 (2.3; n = 439); for r-axSpA and nr-axSpA, it was −2.9 (2.2; n = 301) and −2.8 (2.4; n = 137), respectively (P &lt;0.0001 for all). Similar improvements were seen across other axSpA disease measures. In total, 37.9% (255/672) patients experienced adverse events, and 1.8% (12/672) experienced ≥1 serious adverse events. Conclusion Improvements observed in signs and symptoms of axSpA following one year of CZP treatment in real-world clinical practice were similar to those from previous randomized clinical trials, with no new safety concerns.

Treatment of ruptured lenticulostriate artery aneurysms

2008 ◽  
Vol 109 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Chirag D. Gandhi ◽  
Ronit Gilad ◽  
Aman B. Patel ◽  
Abilash Haridas ◽  
Joshua B. Bederson
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Single Institution ◽  
Neurological Outcomes ◽  
Ruptured Aneurysms ◽  
Mean Size ◽  
Lenticulostriate Artery ◽  
The Mean ◽  
Associated Risk Factors ◽  
Surgical Treatments

Object Lenticulostriate artery (LSA) aneurysms are rarely reported in the literature, making management decisions challenging. Conservative, endovascular, and surgical treatments have been described primarily through case reports and reports of individual authors' experiences. The purpose of this study is to report neurological outcomes in a single-institution experience of ruptured lenticulostriate aneurysms treated surgically. Methods The authors have conducted a retrospective review of all cases involving patients with ruptured LSA aneurysms who presented to the Mt. Sinai Hospital neurosurgical service between September 2001 and January 2007. Results Over 5.4 years, the authors treated 6 patients with 7 LSA aneurysms—6 ruptured and 1 unruptured. The Hunt and Hess grade on admission ranged from I to IV, with subarachnoid hemorrhage in 5 of the 6 patients. Catheter angiography confirmed the presence of the aneurysms, and all patients underwent a pterional craniotomy and clipping or resection of the aneurysm, performed by a single surgeon. Associated risk factors in our series of patients included hypertension, cocaine abuse, and intracranial occlusive disease suggestive of moyamoya disease. Two types of LSA aneurysms were identified. The mean size of the 6 ruptured aneurysms was 3.2 mm. The LSA was preserved in 3 of 6 patients, but LSA preservation did not correlate with development of a postoperative infarct, clinically or radiologically. In patients with ruptured aneurysms, the mean modified Rankin Scale score at discharge was 1.7. The 3 patients in whom the LSA was sacrificed had good outcomes, suggesting that loss of the artery is clinically well tolerated. Conclusions This case series demonstrates that surgical treatment of ruptured LSA aneurysms can be an appropriate, effective, and safe therapy.

scholarly journals Hemorrhoidal artery ligation without using a doppler guide: Is it a feasible and safe technique?

2021 ◽  
Vol 62 (3) ◽  
pp. 230-235
Author(s):  
Mahmut Said Degerli ◽  
Dogan Yildirim ◽  
Mikail Cakir ◽  
Okan Murat Akturk ◽  
Orcun Alpay ◽  
...  
Keyword(s):  
Operating Time ◽  
Operation Time ◽  
Hemorrhoidal Disease ◽  
Artery Ligation ◽  
Simple Method ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
The Mean ◽  
Grade 3 ◽  
One Year

The objective of this work was to analyze the results of the hemorrhoidal artery ligation technique without using a doppler guide, in patients with grade 3 hemorrhoidal disease; by evaluating cost-effectiveness, operation time, recurrence rate, postoperative pain, and secondary outcomes. A hemorrhoidal artery ligation procedure, without using a doppler guide, was performed on 43 patients (15 females, 28 males) with grade 3 symptomatic hemorrhoidal disease, from June 2015 to June 2019, in the Haseki Training and Research Hospital, Istanbul, Turkey. Patients were followed up clinically for one month. They completed a questionnaire within one year after their procedure. The median age was 46 years (range: 24 to 82 years). The main complaints were bleeding in 27 patients, pain in 22 patients, and skin tag in 14 patients. The mean preoperative VAS score was 3.4. The mean operating time was 18 mins (range: 13 to 25 min). All patients remained hospitalized for 24 h. Reoperation was necessary for only one patient because of bleeding. One year after the surgery, the pain was resolved in 21 (95.4%) out of 22 patients with preoperative pain, and bleeding resolved in 25 (92.5%) out of 27 patients with preoperative bleeding. The hemorrhoidal artery ligation is a simple method with a shorter learning curve producing similar postoperative results to other surgical procedures. The surgical technique is cost-effective as it does not require any particular device (anoscope with Doppler ultrasound) to apply.

Thyroid cancer in Iceland 1955-1984

1988 ◽  
Vol 118 (4) ◽  
pp. 566-572 ◽  
Author(s):  
J. Hrafnkelsson ◽  
J. G. Jonasson ◽  
G. Sigurdsson ◽  
H. Sigvaldason ◽  
H. Tulinius
Keyword(s):  
Thyroid Cancer ◽  
Survival Rates ◽  
Multiple Covariates ◽  
Pathological Evaluation ◽  
Cox's Regression ◽  
Mean Size ◽  
The Mean ◽  
One Year ◽  
Papillary Type ◽  
Prognostic Power

Abstract. A retrospective study was carried out on the incidence of thyroid cancer in Iceland from 1955 to 1984. During this 30-year period 406 cases of thyroid cancer were registered. The incidence of 9.5 for females and 3.4 for males per 100 000 per year is at least twice as high as in the other Nordic countries and among the highest incidence figures reported anywhere. A considerable increase in the reported incidence of thyroid cancer was noted around 1965. The mean size of the cancer nodules at diagnosis decreased at the same time and survival rates of patients improved. The incidence decreased again during the last 5 years of the study period. Mortality rates remained similar during this 30-year period. The survival rate corrected for intercurrent death was similar for both papillary and follicular carcinomas. All patients with anaplastic carcinomas died within one year of diagnosis. Cox's regression analysis with multiple covariates revealed that age at diagnosis, anaplastic and medullary history type as compared with papillary type, pathological evaluation of tumour extent, and calendar period of diagnosis had significant prognostic power. Sex and follicular vs papillary histology type were not significant prognostic factors.

scholarly journals The SMART Registry: Long-Term Results on the Utility of the Penumbra SMART COIL System for Treatment of Intracranial Aneurysms and Other Malformations

2021 ◽  
Vol 12 ◽  
Author(s):  
Alejandro M. Spiotta ◽  
Min S. Park ◽  
Richard J. Bellon ◽  
Bradley N. Bohnstedt ◽  
Albert J. Yoo ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Vascular Lesions ◽  
Long Term Results ◽  
Adverse Event Rate ◽  
Serious Adverse Events ◽  
Smart System ◽  
Post Procedure ◽  
Bifurcation Aneurysm ◽  
Retreatment Rate

Introduction: Penumbra SMART COIL® (SMART) System is a novel generation embolic coil with varying stiffness. The study purpose was to report real-world usage of the SMART System in patients with intracranial aneurysms (ICA) and non-aneurysm vascular lesions.Materials and Methods: The SMART Registry is a post-market, prospective, multicenter registry requiring ≥75% Penumbra Coils, including SMART, PC400, and/or POD coils. The primary efficacy endpoint was retreatment rate at 1-year and the primary safety endpoint was the procedural device-related serious adverse event rate.Results: Between June 2016 and August 2018, 995 patients (mean age 59.6 years, 72.1% female) were enrolled at 68 sites in the U.S. and Canada. Target lesions were intracranial aneurysms in 91.0% of patients; 63.5% were wide-neck and 31.8% were ruptured. Adjunctive devices were used in 55.2% of patients. Mean packing density was 32.3%. Procedural device-related serious adverse events occurred in 2.6% of patients. The rate of immediate post-procedure adequate occlusion was 97.1% in aneurysms and the rate of complete occlusion was 85.2% in non-aneurysms. At 1-year, the retreatment rate was 6.8%, Raymond Roy Occlusion Classification (RROC) I or II was 90.0% for aneurysms, and Modified Rankin Scale (mRS) 0-2 was achieved in 83.1% of all patients. Predictors of 1-year for RROC III or retreatment (incomplete occlusion) were rupture status (P &lt; 0.0001), balloon-assisted coiling (P = 0.0354), aneurysm size (P = 0.0071), and RROC III immediate post-procedure (P = 0.0086) in a model that also included bifurcation aneurysm (P = 0.7788). Predictors of aneurysm retreatment at 1-year was rupture status (P &lt; 0.0001).Conclusions: Lesions treated with SMART System coils achieved low long-term retreatment rates.Clinical Trial Registration:https://www.clinicaltrials.gov/, identifier NCT02729740.

scholarly journals Häckningsbiologiska studier av smålommar Gavia stellata på Holmöarna, Norra Sverige

Ornis Svecica ◽  
2021 ◽  
Vol 31 ◽  
pp. 1-18
Author(s):  
Christer Olsson ◽  
Jan Pettersson ◽  
Frank Johansson
Keyword(s):  
Breeding Success ◽  
Water Surface ◽  
Average Distance ◽  
The Baltic Sea ◽  
Swedish Population ◽  
Mean Size ◽  
The Mean ◽  
One Year ◽  
The Baltic ◽  
Estimate Number

The aim of this study was to estimate number of breeding pairs, breeding success, and distance to fishing areas in a population of the Red-throated Loon Gavia stellata on two of the main islands in the Holmöarna Archipelago in the northern part of the Baltic Sea, Sweden. Potential breeding waters were surveyed during seven years, 2010–2015 and 2019. Red-throated Loons appeared in 43 of the 135 lakes of sufficient size on the islands, and the population was estimated to 25–35 pairs, or about 2% of the Swedish population. The mean size of lakes with breeding pairs was 1.6 ha, and these lakes had an average of 82% water surface without vegetation (18% vegetation cover). The mean breeding success was low, 0.30 chicks per pair and year, and at least during one year, chicks were produced in only 20 (47%) of the surveyed lakes. The average distance between the nesting waters and the fishing areas for 17 studied pairs was 1.8 km. We discuss the characteristics of suitable nesting waters as well as the factors contributing to the low reproduction. 

scholarly journals Spatial Pattern of Verticillium Wilt in Commercial Mint Fields

Plant Disease ◽  
2006 ◽  
Vol 90 (6) ◽  
pp. 789-797 ◽  
Author(s):  
Dennis A. Johnson ◽  
Hao Zhang ◽  
J. Richard Alldredge
Keyword(s):  
Spatial Patterns ◽  
Verticillium Wilt ◽  
Probability Distributions ◽  
Field Sampling ◽  
Cluster Data ◽  
Mean Size ◽  
The Mean ◽  
One Year ◽  
Disease Foci ◽  
Proximity Index

Spatial patterns of mint plants with symptoms of Verticillium wilt caused by Verticillium dahliae were characterized in 10 commercial mint fields in Washington using several spatial analysis methods. The disease was assessed in 0.76-by-0.76-m quadrats (width of mint rows was 0.76 m) in randomly selected study sections varying in size from 5 to 76 m wide by 57 to 396 m long. The variance-to-mean ratio identified aggregation of diseased stems within quadrats even though probability distributions associated with cluster data did not fit the data well. Generally, there was more clustering within than across rows according to both doublets and runs analyses. Total number of wilt foci ranged from 5 to 170 per field, and mean size of foci ranged from 1 to 2.7 quadrats. In one field observed repeatedly, total foci increased from 24 to 104, and the mean size of foci increased from 1.0 to 1.3 quadrats in the same section of the field from one year to the next. Size of foci increased to 2.7 quadrats in a third year of sampling the same field. Mean focus size was larger within than across crop rows in 10 of 13 field-sampling occasions. The proximity index ranged from 0.88 to 1.00, indicating highly compacted disease foci. The statistical methods employed were useful in describing, quantifying, and visualizing spatial patterns of infected mint in commercial fields. Verticillium wilt spread during the life of the perennial mint crop. Inoculum for much of the secondary increase likely did not directly originate from micro-sclerotia present in soil before the crop was planted or from infected rhizomes that originally were planted.

Sign in / Sign up

Export Citation Format

Share Document