Abstract:
BACKGROUND:VerifyNow-directed personalized antiplatelet therapy for aneurysm embolization with a Pipeline Embolization Device (PED) remains controversial. Evaluate thrombotic complications between patients who received VerifyNow-directed personalized antiplatelet therapy versus those who did not after PED flow diversion of complex cerebral aneurysms. METHODS:This was a retrospective cohort of consecutive patients undergoing flow diversion with PED at the Medical University of South Carolina between January 2012 and May 2018. Patients who received VerifyNow-directed personalized antiplatelet therapy were compared with those who received antiplatelet therapy without platelet function testing. Patients with a P2Y12 reaction unit (PRU) ≥194 were deemed to be clopidogrel hyporesponsive. The primary outcome is the rate of thrombotic complications, and the secondary outcomes are the rate of hemorrhagic and thrombotic complications stratified by PRU and high-risk clinical and procedure-related candidate predictors. RESULTS:Thrombotic complications were not different between patients managed with (n = 159) versus without (n = 110) VerifyNow (6.9% vs. 7.3%; P = 0.911). Hemorrhagic complications were also no different (3.1% vs. 4.5%; P = 0.550). PRU stratification revealed no difference in thrombotic or hemorrhagic complications (P = 0.488 and P = 0.136, respectively). The only significant predictors for thrombotic complications were the presence of diabetes (OR 2.9; P = 0.034), obesity (OR 5.1; P ≤ 0.001), fusiform aneurysm (OR 3.3; P = 0.023), posterior circulation implantation (OR 3.4; P = 0.016), and >1 PED implanted (OR 2.4; P = 0.046). CONCLUSIONS:The role of VerifyNow and personalized antiplatelet therapy in patients undergoing flow diversion with PED to treat complex aneurysms did not demonstrate a benefit in reducing thrombotic complications.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Neyens R,Donaldson C,Andrews C,Kellogg R,Spiotta Adoi
10.1016/j.wneu.2020.03.046subject
Has Abstractpub_date
2020-06-01 00:00:00pages
e674-e682eissn
1878-8750issn
1878-8769pii
S1878-8750(20)30514-3journal_volume
138pub_type
杂志文章abstract:BACKGROUND:Malignant peripheral nerve sheath tumors are rare, and intracranial occurrences are even more rare. Treatment strategies have varied widely. This article reports the first case of a malignant peripheral nerve sheath tumor of the abducens nerve and provides a literature review that includes 61 cases of intrac...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.08.007
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Patients with neurofibromatosis type 2 (NF2) are prone to develop multiple intracranial neoplasms, such as schwannomas of the cranial nerves and meningiomas. The aim of our study was to investigate 1) the median growth rate per year, 2) the growth-free interval, and 3) the growth patterns of NF2-associated in...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.10.060
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Granular cell tumor (GCT) is a relatively uncommon predominantly benign lesion that usually presents as a solitary, painless cutaneous or submucosal nodule. Most of these tumors are found in the tongue. Although GCT is believed to have a Schwann cell origin, reports of GCT in peripheral and spinal nerves are...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.10.012
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to examine the clinical effect of postoperative hyperbaric oxygen (HBO) therapy on symptoms and signs in the ventriculoperitoneal (VP) shunt insertion treatment of idiopathic normal pressure hydrocephalus (iNPH). METHODS:We conducted a retrospective analysis of 61 patients treated at...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.003
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformations; they frequently cause progressive myelopathy including gait disturbances and sensory disorders. CASE DESCRIPTION:We report a rare case of a middle-aged man who experienced right-sided chest pain and ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.03.138
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Oncotic aneurysm is a rare condition with a high mortality rate. Because no consensus has been reached regarding therapeutic strategy for ruptured oncotic aneurysm, treatment remains challenging. CASE DESCRIPTION:A 35-year-old woman developed sudden onset of severe headache. Computed tomography showed subar...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.049
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Brainstem cavernous malformations (CMs) are benign lesions, often show an acute onset, and result in a high rate of morbidity. Surgical resection could inhibit the progressive deterioration of neurologic function caused by repetitive hemorrhage. This study aimed to summarize timing, approaches, and technique...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.008
更新日期:2019-02-01 00:00:00
abstract::Terminal myelocystocele is a rare type of neural tube malformation, consisting of a skin-covered lumbosacral mass, highly associated with other complex abdominal malformations within the OIES complex (omphalocele, imperforate anus, exstrophy of the cloaca and spinal defects). We present a case of a premature female wi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.135
更新日期:2020-12-19 00:00:00
abstract:BACKGROUND:Cavum septum pellucidum (CSP), which is often found incidentally in a few populations, occasionally becomes symptomatic if enlarged significantly. Wilson disease (WD) is an uncommon autosomal recessive inborn defect in copper metabolism characterized by abnormal accumulation of copper in various tissues, par...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.032
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Brain aneurysms (BAs) are the most common intracranial vascular condition, with an overall incidence of 1%-2%. Among the common causes of their initial formation and growth, the role of radiation therapy (RT) has been reported in some studies. The aim of the present study is to report the most relevant featu...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.09.157
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The long-term outcome after carotid endarterectomy (CEA) is determined by many confounding factors. Ischemic heart disease (IHD) is linked to atherosclerotic stroke, and it is an important cause of death during the perioperative and follow-up periods after CEA. We aimed to investigate mortality and long-term...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.11.092
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:X-linked hypophosphatemia (XLH) is the most common inherited form of renal phosphate wasting and inherited rickets. Patients have hyperplasia of fibrochondrocytes in tendons and ligaments, causing the structures to thicken and calcify. Thickening of the lamina, hypertrophy of facet joints, and calcification ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.07.076
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The role of adjuvant radiation after gross total resection (GTR) for grade II meningioma is evolving, prompting further evaluation in NRG-BN003, a phase 3 national trial. Furthermore, the relationship between facility volume and outcomes in patients with grade II meningioma after GTR has not been examined at...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.05.030
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Cases of nail gun injuries to the head and neck are rare, and treatment approach varies with each case based on location and extent of injury. CASE DESCRIPTION:We present a case of a 52-year-old male who fell off a roof holding a pneumatic nail gun and accidentally shot himself with a nail through the right...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.083
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Internal carotid artery (ICA) reconstruction is still the most effective treatment for a blood blister-like aneurysm (BBA) on the supraclinoid segment of the ICA, and clipping after wrapping has the most precise effects. However, the materials used are most often artificial. This study examined the use of au...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.186
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Atlantoaxial instability, a common finding in patients with Down syndrome (DS), is attributed to laxity of ligamentous structures. Cervical spondylosis identified in these patients has a pathogenesis of ligament laxity and early degeneration compared with the normal population. No cases have been reported sh...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.07.040
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Pediatric cerebral ganglioneuroblastoma is an exceedingly rare tumor. CASE DESCRIPTION:We describe the case of a 4-year-old boy with sudden mental status decline who was found to have a large intracranial lesion with intraventricular extension. CONCLUSION:Management of the case and pathologic findings are ...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.02.115
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVES:Gross total resection for glioblastoma (GBM) has been associated with better prognosis. However, it is not always feasible, and the threshold for the extent of resection required for better prognosis has been controversial. Therefore, we compared the survival and clinical outcomes of patients with GBM who ha...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.237
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Determining the risks of treatment of unruptured intracranial aneurysms is critical in the decision-making process of management. Most studies have reported the results for endovascular or surgical management. Our objective was to better delineate the risk estimates for unruptured intracranial aneurysms trea...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.005
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficiency and safety of a unilateral approach for bilateral foramen decompression in minimally invasive transforaminal lumbar interbody fusion (miTLIF) for the treatment of bilateral foraminal stenosis. METHODS:Treatment of 52 levels of bilateral foraminal stenosis in 48 patients was perform...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.06.009
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To compare outcomes in the setting of spontaneous intracerebral hemorrhage (ICH) in patients taking aspirin (acetylsalicylic acid [ASA]) versus patients taking clopidogrel before hospitalization. METHODS:Patients admitted to the neurosurgical service with a spontaneous ICH while taking an antiplatelet agent ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.02.010
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The most commonly performed nerve transfers in upper trunk (UT) or partial brachial plexus injuries (BPIs) include the spinal accessory nerve to suprascapular nerve, Oberlin, and, lately, radial nerve (RN) (branch to triceps) to axillary nerve (AN) transfers. Routinely, the former 3 procedures are performed ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.139
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:In endovascular embolization of intracranial aneurysms, a tortuous cervical internal carotid artery can limit guiding catheter access to a sufficiently high position. Although intermediate distal access catheters can go beyond the tortuous segment of internal carotid arteries, they may increase the risk of p...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.023
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Morphometric analysis or examination of symptoms in patients with Chiari malformation type I (CM-I) with various associations does not suffice for evaluation of surgical outcome of these patients. We assessed the relationship of morphologic changes in brain and spinal cord and disease symptoms with changes i...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.108
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:The treatment of hypothalamus-invading craniopharyngiomas, based on pediatric experience, is subtotal resection (STR) with radiotherapy. This strategy sometimes leads to uncontrollable tumor progression. In adults, with the use of endoscopic endonasal surgery (EES), does removing the hypothalamic part of the ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.037
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Smoking is a known risk factor for inferior health outcomes. Retrospective analyses of large datasets may assess whether such risk is manifested or mitigated in clinical practice. Although many risk factor analyses use the National Surgical Quality Improvement Program (NSQIP) and National (Nationwide) Inpati...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.180
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Atherosclerotic stenosis of the extracranial internal carotid artery accounts for 15%-20% of ischemic strokes, depending on the population studied. Carotid endarterectomy (CEA) is the most frequently performed operation to prevent stroke. METHODS:Since the 1990s, several randomized controlled trials have be...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2011.05.037
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:Postoperative cerebrospinal fluid (CSF) leak in neurosurgery remains a significant source of morbidity. TissuePatchDural (TPD), a novel impermeable adhesive membrane, can be used to reinforce dural closure in cases considered at high risk to develop postoperative CSF leak. METHODS:A retrospective, single-cen...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.09.022
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Traumatic posterior fossa subdural hemorrhage (SDH) is a rare subtype of subdural hemorrhage in head injuries. Existing data on its pathophysiology and outcome are currently limited; therefore, the condition is not yet fully understood. The present study aimed to determine the incidence, outcome, and prognos...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2018.07.191
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:The use of endovascular treatment for ruptured middle cerebral artery (MCA) aneurysms, which have been more likely to be recommended for neurosurgical clipping because of the complex anatomic configuration, remains controversial. In the present study, the angiographic and clinical outcomes of endovascularly t...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.wneu.2019.01.066
更新日期:2019-07-01 00:00:00