Donor Selection in Flow Replacement Bypass Surgery for Cerebral Aneurysms: Quantitative Analysis of Long-term Native Donor Flow Sufficiency

Neurosurgery ◽  
2015 ◽  
Vol 78 (3) ◽  
pp. 332-342 ◽  
Author(s):  
Oriela Rustemi ◽  
Sepideh Amin-Hanjani ◽  
Sophia F. Shakur ◽  
Xinjian Du ◽  
Fady T. Charbel
Keyword(s):  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Cerebral Aneurysms ◽  
Temporal Artery ◽  
Donor Selection ◽  
Flow Data ◽  
Bypass Flow ◽  
Long Term Follow Up

Abstract BACKGROUND: Graft selection in extracranial-intracranial bypass surgery for cerebral aneurysms has traditionally been based on clinical impression and operator preference. However, decision making can be optimized with a donor selection algorithm based on intraoperative flow data. OBJECTIVE: To present long-term follow-up and quantitative assessment of flow sufficiency for native donors selected in this manner. METHODS: Patients with bypass for anterior circulation intracranial aneurysms using only a native donor (superficial temporal artery) selected on the basis of an intraoperative flow algorithm over a 10-year period were retrospectively studied. Intracranial hemispheric and bypass flows were assessed preoperatively and postoperatively when available with quantitative magnetic resonance angiography. RESULTS: Twenty-two patients with flow data were included (median aneurysm size, 22 mm). The intraoperative flow offer (cut flow) of the superficial temporal artery was sufficient in these cases relative to the flow demand in the sacrificed vessel (59 vs 28 mL/min) to warrant its use. Bypass flow averaged 81 mL/min postoperatively (n = 19). Bypass flows were highest in the immediate postoperative period but remained stable between the intermediate and final follow-up (40 vs 52 mL/min; P = .39; n = 8). Mean ipsilateral hemisphere flows were maintained after bypass (299 vs 335 mL/min; P = .42; n = 7), and remained stable over intermediate and long-term follow-up. Ipsilateral hemispheric flows remained similar to contralateral flows at all time points. CONCLUSION: Despite a relative reduction in bypass flow over time, hemispheric flows were maintained, indicating that simple native donors can carry sufficient flow for territory demand long term when an intraoperative flow-based algorithm is used for donor selection.

Long-term-follow-up of patients with gastric bypass surgery secondary to craniopharyngioma associated hypothalamic obesity

2020 ◽  
Author(s):  
Hannes Beiglböck ◽  
Paul Fellinger ◽  
Tamara Ranzenberger-Haider ◽  
Greisa Vila ◽  
Anton Luger ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Hypothalamic Obesity ◽  
Long Term Follow Up

scholarly journals Long Term Angiographical Follow-up of Cerebral Aneurysms after Coil Embolization

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 149-154 ◽  
Author(s):  
Y. Kaku ◽  
K. Hayashi ◽  
M. Sawada ◽  
N. Sakai
Keyword(s):  
Special Reference ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Complete Obliteration ◽  
Long Term Follow Up ◽  
Platinum Coils

We evaluated long-term angiographical follow-up of cerebral aneurysms treated with detachable platinum coils with special reference to the long-term morphological outcomes of incompletely obliterated aneurysms. Serial long-term follow-up cerebral angiograms (>1 year) were obtained in 47 cases out of 134 cases treated with GDCs or IDCs from 1994 to 1999. In 47 patients, intial angiographical results demonstrated ten complete aneurysmal occlusion, seven aneurysms with a small neck remnant, twenty aneurysms with body filling and ten aneurysms with both of neck remnant and body filling. In the ten completely obliterated aneurysms, follow-up angiograms revealed no aneurysmal recanalization. In seven aneurysms with neck remnant, three remained unchanged, four showed enlargement of contrast filling in the part of the neck of the aneurysm. In twenty aneurysms with body filling, five had developed into complete obliteration, three remained unchanged, 11 had recanalization, and one aneurysm displayed regrowth. In ten aneurysms with both of neck remnant and body filling, two remained unchanged, five had recanalization, and three aneurysms displayed regrowth. Long-term angiographical follow-up results are less satisfactory in cases involving incompletely obliterated lesions. A higher incidence of recanalizations were promoted in cases with neck remnant and/or body filling. Strict follow-up angiography is mandatory when a complete obliteration is not achieved.

The Long-Term Follow-Up of Patients Undergoing Saphenous Vein Bypass Surgery

Circulation ◽  
1974 ◽  
Vol 49 (1) ◽  
pp. 77-85 ◽  
Author(s):  
DAVID S. CANNOM ◽  
D. CRAIG MILLER ◽  
NORMAN E. SHUMWAY ◽  
THOMAS J. FOGARTY ◽  
PAT O. DAILY ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Bypass Surgery ◽  
Saphenous Vein Bypass ◽  
Long Term Follow Up ◽  
Vein Bypass

scholarly journals Pitfalls with long-term follow-up of postoperative choledochal cysts: significance of identifying patients with abandoned bypass surgery (cysto-duodenostomy)

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e466
Author(s):  
Y. Fujimoto ◽  
T. Takayanagi ◽  
S. Horitani ◽  
T. Kobayashi ◽  
D. Konishi ◽  
...  
Keyword(s):  
Bypass Surgery ◽  
Choledochal Cysts ◽  
Long Term Follow Up

scholarly journals 8-Isoprostanes and Asymmetric Dimethylarginine as Predictors of Mortality in Patients Following Coronary Bypass Surgery: A Long-Term Follow-Up Study

2022 ◽  
Vol 11 (1) ◽  
pp. 246
Author(s):  
Aleksandra Gołąb ◽  
Dariusz Plicner ◽  
Anna Rzucidło-Hymczak ◽  
Lidia Tomkiewicz-Pająk ◽  
Bogusław Gawęda ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Mortality ◽  
Bypass Surgery ◽  
Asymmetric Dimethylarginine ◽  
Prostaglandin F2α ◽  
Cardiovascular Death ◽  
Long Term Follow Up ◽  
Nitric Oxide Bioavailability

Background: We previously demonstrated that enhanced oxidative stress and reduced nitric oxide bioavailability are associated with unfavorable outcomes early after coronary artery bypass grafting. It is not known whether these processes may impact long-term results. We sought to assess whether during long-term follow-up, markers of oxidative stress and nitric oxide bioavailability may predict cardiovascular mortality following bypass surgery. Methods: We studied 152 consecutive patients (118 men, age 65.2 ± 8.3 years) who underwent elective, primary, isolated on-pump bypass surgery. We measured plasma 8-iso-prostaglandin F2α and asymmetric dimethylarginine before surgery and twice after surgery (18–36 h and 5–7 days). We assessed all-cause and cardiovascular death in relation to these two biomarkers during a mean follow-up time of 11.7 years. Results: The overall mortality was 44.7% (4.7 per 100 patient-years) and cardiovascular mortality was 21.0% (2.2 per 100 patient-years). Baseline 8-iso-prostaglandin F2α was associated with cardiovascular mortality (HR 1 pg/mL 1.010, 95% CI 1.001–1.021, p = 0.036) with the optimal cut-off ≤ 364 pg/mL for higher survival rate (HR 0.460, 95% CI 0.224–0.942, p = 0.030). Asymmetric dimethylarginine > 1.01 μmol/L measured 18–36 h after surgery also predicted cardiovascular death (HR 2.467, 95% CI 1.140–5.340, p = 0.020). Additionally, elevated 8-iso-prostaglandin F2α measured at the same time point associated with all-cause mortality (HR 1 pg/mL 1.007, 95% CI 1.000–1.014, p = 0.048). Conclusions: Our findings indicate that in advanced coronary disease, increased oxidative stress, reflected by 8-iso-prostaglandin F2α before bypass surgery and enhanced asymmetric dimethylarginine accumulation just after the surgery are associated with cardiovascular death during long-term follow-up

The remodeling technique of balloon-assisted Guglielmi detachable coil placement in wide-necked aneurysms: experience at the University of Illinois at Chicago

2000 ◽  
Vol 93 (3) ◽  
pp. 388-396 ◽  
Author(s):  
Victor A. Aletich ◽  
Gerard M. Debrun ◽  
Mukesh Misra ◽  
Fady Charbel ◽  
James I. Ausman
Keyword(s):  
Cerebral Aneurysms ◽  
Detachable Coil ◽  
Content Type ◽  
Guglielmi Detachable Coil ◽  
Alternative Approach ◽  
Long Term Follow Up ◽  
The University ◽  
Fine Print

Object. Reports in the literature have offered discussions of the feasibility, efficacy, and safety of balloon-assisted Guglielmi detachable coil (GDC) placement in wide-necked intracranial aneurysms, which was first described by Jacques Moret as the “remodeling technique.” In this article the authors summarize their results in a subset of aneurysms treated with GDCs using the remodeling technique.Methods. This report contains a retrospective analysis of 72 patients with 75 aneurysms who underwent 79 endovascular procedures performed using the remodeling technique. Morphological outcome was determined at the end of each procedure and by reviewing available follow-up angiograms. Clinical assessments and outcomes are reported using a modified Glasgow Outcome Scale.Coils were placed in 66 (88%) of 75 aneurysms selected for treatment. In eight aneurysms (11%) treatment failures occurred due to the tortuosity of the vessel used to reach the aneurysms or because of balloon inadequacies.Incorporating all available follow-up data the authors found that 50 (78%) of 64 aneurysms were completely or subtotally (> 95%) occluded and eight (12%) of 64 were incompletely (< 95%) occluded. Since the time of coil placement, eight aneurysms have progressed to complete occlusion and another five have exhibited progressive thrombosis on follow-up angiograms. In three aneurysms there has been neck remnant growth. Surgical clipping was performed to treat six aneurysms after an initial coil placement procedure. Permanent incidences of morbidity were limited to four patients and there were three deaths directly related to the procedure.Conclusions. The remodeling technique shows promise in increasing the number of cerebral aneurysms amenable to treatment by endovascular coil placement, and offers an alternative approach to aneurysms that have met with failed surgical treatment or are surgically inaccessible. Long-term follow-up review is needed to determine the final outcome of aneurysms treated by this technique.

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