scholarly journals The p64 flow-diverting stent in the treatment of difficult cerebral vascular aneurysms: technical features and results

2021 ◽  
Vol 23 (1) ◽  
pp. 74-82
Author(s):  
V. S. Kiselev ◽  
A. O. Sosnov ◽  
A. M. Perfiliev ◽  
R. R. Gafurov

Introduction. Since the appearance of the first flow-diverting stents (FDS) Pipeline (Covidien, USA) and Silk (Balt Extrusion, France) in 2008, numerous studies have been conducted that have shown their high efficiency in the treatment of difficult aneurysms, accompanied by a low frequency long-term recanalization with a moderate risk of developing intra- and postoperative complications, thus making them an alternative to the classic use of coils.The study objective is to evaluate the results of the p64 PPS using in the treatment of patients with cerebral aneurysms of various localization in a single neurosurgical hospital.Materials and methods. In the department of vascular neurosurgery of the Federal Neurosurgical Center, Novosibirsk for the period from June 2017 to December 2019, 90 patients (10 (11.1 %) male, 80 (88.9 %) female) with cerebral aneurysms were operated using p64 FDS.Results. All 90 patients received 93 p64 FDS. In 79 (87.8 %) patients, only a stent was implanted, in 9 (12.2 %) – in combination with coils. Follow-up after 6 months was observed in 39 (43.3 %) patients, while it should be noted that no patient showed an increase in neurological deficit. The complete occlusion rate after 6 months was 76.9 %. A favorable treatment outcome according to the modified Rankin Scale at the time of discharge was obtained in 82 (91.1 %) patients. Mortality was in 1 (1.1 %) case.Conclusion. The p64 FDS is an effective endovascular device in the treatment of patients with difficult cerebral aneurysms and has a rather low incidence of intra- and postoperative complications.

Author(s):  
Marcelo Bolcato ◽  
ana Carolina Dalmonico ◽  
Leo Ditzel ◽  
Savio Machareti ◽  
Thiago Yoshida ◽  
...  

Introduction : Endovascular flow diverters are increasingly used for the treatment of cerebral aneurysms. We assessed the safety and efficacy of the Flow Diverters in a consecutive series of 53 patients and 60 aneurysms. Methods : Inclusion criteria were wide‐neck, blister‐like, or fusiform aneurysms independent of size, treated with the FRED, PIPELINE and SILK between December 2014 and Junho 2021. Assessment criteria were aneurysm occlusion, manifest ischemic stroke, bleeding, or death. The occlusion rate was assessed at 6 months and 1 year with DSA by using the Raymond classification and the O'Kelly‐Marotta grading scale. Results : Fifty three patients (mean age 54.3 years;81.1% female) with 60 aneurysms were treated with 9 Silk, 38 FREDs and 13 Pipeline. Aneurysm size ranged from 2.5 to 30 mm. Deployment of the Flow diverters was successful in 52 aneurysms. Three patient developed mild stroke symptoms that fully receded within days, 4 patients occlusion total carotid because resistant antiagregation and another patient’s development Swelling syndrome. There has been one death. Initial follow‐up at 6 months showed complete occlusion in 90% of the overall study group and 93,33% at 1 year. Conclusions : The flow diverter is a safe device for the treatment of cerebral aneurysms of various types. Our data reveal high occlusion rates at 6 months and 1 year. Long‐term occlusion rates are expected.


2012 ◽  
Vol 48 (4) ◽  
pp. 234-244 ◽  
Author(s):  
Cynthia Zikes ◽  
Timothy McCarthy

Bilateral ventriculocordectomy through a ventral median laryngotomy was performed for the treatment of idiopathic laryngeal paralysis in 88 dogs. The purpose of this retrospective analysis was to provide long-term follow-up for a large number of dogs surgically managed with this technique. A combination of medical record and completed client questionnaire information provided short-term (14 days) follow-up for 88 dogs and long-term (>6 mo) follow-up for 42 dogs. Major short-term postoperative complications were identified in 3 of 88 (3.4%) patients. Major long-term complications were identified in 3 of 42 (7.1%) patients. The results of surgery were considered to be very satisfactory in 93% and unsatisfactory in 7%. Three dogs in this series developed aspiration pneumonia. Bilateral ventriculocordectomy through a ventral median laryngotomy is associated with a low incidence of both short- and long-term complications. Due to the ease of this procedure, the minimal surgical trauma to the patient, and the satisfactory results, this surgery should be considered an option for the treatment of idiopathic laryngeal paralysis in the dog.


2018 ◽  
Vol 20 (2) ◽  
pp. 27-34 ◽  
Author(s):  
A. O. Sosnov ◽  
V. S. Kiselev ◽  
R. R. Gafurov ◽  
A. М. Perfilev

The study objectiveis to evaluate the effectiveness of surgical treatment of intracranial aneurysms with the use of flow diverting stents (FDS).Materials and methods.In 2016, in the Federal Neurosurgical Center (Novosibirsk) 64 patients (11 men, 53 women, mean age – 50.1 ± 11.4 years) with intracranial aneurysms were operated on; 69 FDS were implanted. Total number of occluded aneurysms 64.Results.The digital subtraction angiography control after 6 months demonstrated, that the total occlusion rate with was in 71 % cases, subtotal – in 29 %. An excellent and good functional outcome (modified Rankin scale 0–2) was obtained in 60 (93.7 %) patients, poor (modified Rankin scale 3–5) – in 4 (6.3 %). Complications rate were 4.7 %, death rate – 0 %.Conclusion.The implantation of FDSs is an effective method for the treating of cerebral aneurysms, including cases, when using alternative endovascular techniques has a high risk of recanalization, and the microsurgical treatment has an increased operating risk.


2004 ◽  
Vol 17 (5) ◽  
pp. 1-4 ◽  
Author(s):  
Pascal Jabbour ◽  
Christopher Koebbe ◽  
Erol Veznedaroglu ◽  
Ronald P. Benitez ◽  
Robert Rosenwasser

Object The treatment of wide-necked cerebral aneurysms represents a challenging problem for neurosurgeons. The recent development of stents has provided clinicians with the ability to treat these aneurysms while keeping the parent vessel patent. The long-term occlusion rate of aneurysms treated with stent-assisted coil placement has yet to be investigated. The authors report the use of a new intracranial stent—the Neuroform microstent—in the treatment of unruptured wide-necked cerebral aneurysms. Methods Thirty-two patients harboring unruptured wide-necked intracranial aneurysms underwent a stent-assisted coil placement procedure. Patients were pretreated with antiplatelet agents, and a stent was positioned across the neck of the aneurysm. The next step was the insertion of coils into the aneurysm cavity. Patients received anticoagulation therapy for 24 hours after the procedure. All 32 patients with unruptured wide-necked cerebral aneurysms were suitable candidates for this procedure. Occlusion of at least 90% of the aneurysm was achieved in 24 patients (75%) and 0% occlusion was observed in five patients (15%). Two patients experienced thromboembolic events, one of which was directly related to the stent. The overall complication rate was 6.3%. Conclusions Intracranial stents will be used more frequently in the new era of endovascular management of wide-necked cerebral aneurysms. With some technical improvements and more data on long-term occlusion rates, this new modality should improve the occlusion of wide-necked cerebral aneurysms while protecting the parent vessel.


2020 ◽  
Vol 19 (4) ◽  
pp. 150-176
Author(s):  
S. V. Chernyshov ◽  
S. I. Sychev ◽  
A. A. Ponomarenko ◽  
E. G. Rybakov

INTRODUCTION: the NOSES technique allows one to remove specimen without incisions on the anterior abdominal wall and is accompanied by fewer complications by reducing the frequency of wound infections. The results of these surgical operations on colorectal tumors are presented in a limited number of heterogeneous studies, which necessitates obtaining objective data using metaanalysis.STUDY OBJECTIVE: compare the short and long-term outcomes of two methods for surgical treatment of colorectal cancer.MATERIALS AND METHODS: a systematic review is carried out in accordance with PRISMA practice and recommendations.RESULTS: nine comparative studies were selected for the period from 2014 to 2019. 1693 patients were included in the meta-analysis: in 765 (45%), the tumor preparation was removed transanally (NOSES group) and in 928 (55%) it was removed via minilaparotomic access (LA group). The tumor size in the NOSES group was 0.5 cm smaller (OR=0.5, CI95% 0.2-0.8, p=0.0004) than in the LA group. In regards to other parameters the groups had no publication bias. The duration of the operation when comparing NOSES with LA was comparable (p =0.11). VAS pain was on average 2 points (OR=1.8, CI95% 1.2-2.4, p<0.00001) more pronounced in the LA group. The postoperative bed day was less in the group with transanal removal of the preparation (OR=0.8, CI95% 0.4-1.3, p=0.0003). The chance of developing postoperative complications in the NOSES group was (OR=0.5, CI95% 0.4-0.8, p=0.0004) with a frequency of 62/765 (8%) cases, compared with the control group - 130/931 (14%). The chance of developing wound infection was higher in the LA group (OR=0.2, CI95% 0.1-0.3, p <0.00001). There were no differences in the incidence of colorectal anastomotic leakage (p=0.97). There were also no differences in the five-year overall (p=0.74) and cancer-specific survival (p=0.76).CONCLUSION: using NOSES technologies creates better conditions for the rehabilitation of patients due to the low frequency of postoperative complications due to the absence of wound infection and is a safe manipulation. However, the presence of publication biases requires a careful interpretation of the data obtained.


Author(s):  
N Bobrova ◽  
N Trofimova

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular fluid outflow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.


Author(s):  
S.V. Borshch ◽  
◽  
R.M. Vil’fand ◽  
D.B. Kiktev ◽  
V.M. Khan ◽  
...  

The paper presents the summary and results of long-term and multi-faceted experience of international scientific and technical cooperation of Hydrometeorological Center of Russia in the field of hydrometeorology and environmental monitoring within the framework of WMO programs, which indicates its high efficiency in performing a wide range of works at a high scientific and technical level. Keywords: World Meteorological Organization, major WMO programs, representatives of Hydrometeorological Center of Russia in WMO


2020 ◽  
Vol 20 ◽  
Author(s):  
L. Hajba ◽  
A. Guttman

: Adeno-associated virus (AAV) is one of the most promising viral gene delivery vectors with long-term gene expression and disease correction featuring high efficiency and excellent safety in human clinical trials. During the production of AAV vectors,there are several quality control (QC)parameters that should be rigorously monitored to comply with clini-cal safety and efficacy. This review gives a short summary of the most frequently used AVV production and purification methods,focusing on the analytical techniques applied to determine the full/empty capsid ratio and the integrity of the encapsidated therapeutic DNA of the products.


2014 ◽  
Vol 7 (6) ◽  
pp. 914-916 ◽  
Author(s):  
Didier Clarençon ◽  
Sonia Pellissier ◽  
Valérie Sinniger ◽  
Astrid Kibleur ◽  
Dominique Hoffman ◽  
...  

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