Intentional Replantation – The novel technique for the management of separated instrument in apical third of tooth: A case report

Intentional replantation is a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. In this article, intentional replantation is described and discussed as a treatment approach for failed root canal treatment with broken instrument periapically in mandibular second molar.

Coiling Using Dual Microcatheter Technique—A Novel Approach

Posterior circulation aneurysms are difficult to treat, and if an incorporated artery is arising from the neck of aneurysm, management becomes much more challenging. Here, we are describing a novel technique used to treat a patient with a large, wide-necked left vertebral artery (VA)-posterior inferior cerebellar artery (PICA) junctional aneurysm. PICA seems to be arising from the aneurysm neck, but the aneurysm neck was not very clearly defined. So, we placed a second microcatheter into PICA, which not only allowed the coils to be placed in the aneurysm, without disrupting the flow through PICA but also helpful in assessing the aneurysmal occlusion. This technique allowed coils to be placed successfully without compromising flow through PICA.

The Mini-Cross Prefenestration for Endovascular Repair of Aortic Arch Pathologies

Objective: To examine the feasibility, integrity, efficacy, and safety of endovascular repair of the aortic arch pathologies with the mini-cross prefenestration (MCPF) on stent grafts.Methods: First, to prove the feasibility of the MCPF, an in-vitro prefenestration experiment was conducted. Second, to examine the integrity of the MCPF stent grafts, a fatigue test was conducted. Then, the membranes and metal structures of stent grafts were examined by light microscopy and scanning electron microscopy (SEM). Third, a clinical experiment was conducted to investigate the efficacy and safety of this novel technique (ClinicalTrials.gov Identifier: NCT04544579).Results: All the 12 branch stents were successfully implanted and flared in vitro. After the fatigue test stimulating a 5-year cardiac cycle, no obvious disintegration or fracture was found in light microscopy or SEM. From December 2017 to February 2020, 26 patients with left subclavian arteries and/or left common carotid arteries involved received the novel technique. The endovascular repair with the MCPF was successfully performed on all the 26 (100%) patients. Eighteen (69.2%) patients underwent the reconstruction of the left subclavian artery (LSCA) only. The fenestrations of both the LSCA and left common carotid artery (LCCA) were conducted in 8 (30.8%) patients. Median operative time was 120 [interquartile range (IQR), 95–137.5] min and median revascularization time of the LSCA and LCCA was 30.5 (IQR, 22.8–42.0) s and 20.0 (IQR, 18.0–32.0) s separately. During the median follow-up duration of 38.9 (range, 18.8–44.2) months, one case needed an open surgery because of retrograde type A aortic dissection 3 months after implantation and no other complications or mortality occurred. The maximum aortic diameters were significantly decreased in patients with thoracic aortic dissection and thoracic aortic aneurysm (p < 0.05).Conclusion: The existing evidence demonstrated the safety, rapid branch artery revascularization, and positive aortic remodeling of the novel technique. Long-term observation is warranted to prove the durability.

Awake tracheal intubation: videolaryngoscopy in a pediatric institution: a case report.

Formal guidelines for awake tracheal intubation have recently been published providing a streamlined process for the first time. We present a case of awake videolaryngoscopy in the pediatric setting, not previously reported. Application of guidelines and careful team preparation facilitated performance of a novel technique in our pediatric institution.

The use of a single-piece bone flap for cranial reshaping in anterior craniosynostosis patients: clinical experience and a description of a novel technique

Background Craniosynostosis is known as premature closure of one or more of the cranial sutures. Anterior craniosynostosis involves anterior plagiocephaly and trigonocephaly. One of the issues in anterior craniosynostosis skull reshaping is maintaining an aesthetically pleasing forehead curve. Therefore, in this article, we demonstrate our novel technique to use a single-piece bone flap for cranial reshaping of the anterior mold in patients diagnosed with anterior craniosynostosis. A retrospective record review of patients who underwent single piece bone flap cranial reshaping for correction of unicoronal synostosis (UCS) and metopic synostosis (MS) at an Academic Institute in Riyadh, Saudi Arabia, between 2018 and 2020, was conducted. Results Six non-syndromic consecutive patients were included. Three of the patients had MS. The mean age at surgery was 11.16 months (range, 6–19 months). The average OR time was 315 min (range, 263–368 min). The average intraoperative blood loss was 225 ml (range, 100–400 ml). All patients had achieved acceptable functional and aesthetic results. Conclusion Our novel technique is an innovative and efficient reconstructive technique to simultaneously address MS and UCS and minimize intraoperative bleeding and surgery time. However, more studies with more cases are required.