Abstract:
BACKGROUND:The Pipeline Embolization Device is a widely utilized flow diverter in the treatment of intracranial aneurysms. OBJECTIVE:To assess the incidence, clinical significance, predictors, and outcomes of in-Pipeline stenosis (IPS). METHODS:Angiographic studies in 139 patients treated between 2011 and 2013 were independently reviewed by 2 authors for the presence of IPS. Multivariable logistic regression analysis was conducted to determine predictors of IPS. RESULTS:A total of 21 (15.8%) patients demonstrated some degree of IPS during the follow-up period at a mean time point of 6.7 months (range, 3-24 months). The stenosis was mild (<50%) in 11 patients, moderate (50%-75%) in 5, and severe (>75%) in 6. None were symptomatic or required further intervention. Sixteen of these 22 patients (73%) had IPS detected within 6 months. IPS was noted in 7.6% (1/13) of patients with posterior circulation aneurysms vs 16.7% (21/126) of those with anterior circulation aneurysms (P = .03). The rate of IPS was 60% (3/5) in patients who did not receive aspirin vs only 14.2% (19/134) in those who received aspirin (P = .02). In multivariable analysis, no aspirin therapy (odds ratio, 10.0; 95% confidence interval, 1.4-67.7; P = .02) and internal carotid artery aneurysm location (odds ratio, 3.1; 95% confidence interval, 1.1-8.8; P = .03) were strong independent predictors of IPS. CONCLUSION:IPS is a common, early, and mostly benign complication. Patients with internal carotid artery aneurysms are more likely to develop IPS. Aspirin plays a key role in preventing IPS. The results of this study further support the safety of flow diverters. ABBREVIATIONS:IPS, in-Pipeline stenosisPED, Pipeline Embolization Device.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Chalouhi N,Polifka A,Daou B,Kung D,Barros G,Tjoumakaris S,Gonzalez LF,Starke RM,Hasan D,Judy B,Rosenwasser RH,Jabbour Pdoi
10.1227/NEU.0000000000000908subject
Has Abstractpub_date
2015-12-01 00:00:00pages
875-9; discussion 879issue
6eissn
0148-396Xissn
1524-4040journal_volume
77pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract:OBJECTIVE:Cerebral autoregulation maintains a relatively stable cerebral blood flow over a range of perfusion pressures. During exercise, regional cerebral blood flow may be elevated in particular areas of the brain. This case report presents the impact of aerobic exercise on intracranially measured pressure and brain ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000371976.21043.C8
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Traumatic intraventricular hemorrhage (IVH) can result in association with acute obstructive hydrocephalus, repetitive malfunction of external ventricular drains (EVDs), and uncontrollable increased intracranial pressure. We report a case showing the safe and effective use of intraventricular r...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199810000-00150
更新日期:1998-10-01 00:00:00
abstract::The use of allogeneic human bone, dura, and fascia has achieved an enduring and accelerating role in the augmentation of spinal fusions and the repair of skeletal and dural defects. Primary sterilization of these nonviable cadaveric tissues magnifies the potential sources and ensures the microbiological sterility of t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198005000-00006
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:Although endovascular technique and related devices continue to improve, recanalization of embolized aneurysm remains a pitfall of this approach. The problem of how to treat the recanalized aneurysm needs to be addressed. OBJECTIVE:To determine the outcomes of patients undergoing repeat embolization for rec...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3182647a97
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To save the patency of the internal carotid artery (ICA) during the treatment of carotid cavernous fistulae or cavernous sinus dural arteriovenous malformations, direct surgery of the cavernous sinus after failure of endovascular treatment was attempted in this study. METHODS:A total of 78 patients with caro...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199710000-00006
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:The dissection of cadaveric specimens is very important for a more sophisticated understanding of neurosurgical anatomic features and approaches. Teaching known approaches to residents or learning new approaches is best performed in a cadaveric laboratory. The utility of neurosurgical cadaveric dissections ca...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199911000-00058
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:Surgical treatment of odontoid fractures that do not allow interfragmentary fracture compression involves either posterior atlantoaxial arthrodesis or additional anterior stabilization using a plate construct. The purpose of this study was to determine the clinical and radiographic outcome after anterior plat...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1227/01.NEU.0000339117.60613.8C
更新日期:2009-04-01 00:00:00
abstract::The time course, anatomic distribution, and extent of changes in cerebral lactate, N-acetyl-L-aspartate (NAA), and other metabolite levels determined by three-dimensional in vivo 1H magnetic resonance spectroscopy and single-voxel spectral analysis after middle cerebral artery occlusion in rats. Increased lactate was ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199601000-00030
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:The snake venom disintegrin contortrostatin (CN) is able to inhibit tumor progression and angiogenesis in vivo and therefore is of considerable interest as a potential antitumor drug. CN specifically binds to certain integrins on the tumor cell and angiogenic endothelial cell surface and inhibits their intera...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000163426.25227.56
更新日期:2005-07-01 00:00:00
abstract::We describe a case of spondylotic lumbar spinal stenosis in an infirm elderly patient successfully treated with multilevel laminotomies. This procedure is less stressful to patients than a full laminectomy. In a selected subgroup of patients with "hourglass" spondylotic stenosis, it may provide adequate decompression....
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198807000-00021
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Improved understanding of rod fracture (RF) in adult spinal deformity could be valuable for implant design, surgical planning, and patient counseling. OBJECTIVE:To evaluate symptomatic RF after posterior instrumented fusion for adult spinal deformity. METHODS:A multicenter, retrospective review of RF in ad...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/NEU.0b013e3182672aab
更新日期:2012-10-01 00:00:00
abstract::The authors report a review of 1808 patients admitted for the treatment of craniocerebral injuries. Eighty-four (4.6%) developed the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Two types of SIADH (severe and mild) were defined on the basis of laboratory findings and clinical signs. SIADH occur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198206010-00001
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:The anterior lumbar interbody fusion (ALIF) procedure has become an accepted fusion technique for treating patients with degenerative disorders of the lumbar spine. Many consider laparoscopic ALIF to be the least invasive approach. A modification of the open laparotomy--the "mini-open" approach--is an attract...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200207000-00015
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Internal drainage of cerebrospinal fluid to the abdominal cavity via a ventriculoperitoneal shunt (VPS) is a common procedure for therapy of obstructive hydrocephalus; because this condition is often caused by brain tumors blocking the natural cerebrospinal fluid pathways, the VPS as an artific...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199806000-00118
更新日期:1998-06-01 00:00:00
abstract::A new head-positioning system has been developed to hold the head firmly during the performance of a computed tomograhic scan and to position the head reproducibly during repeat scans. This can be used to maintain the head in position during long scanning sessions, to relate a lesion to landmarks on scout views, to fo...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198008000-00006
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:The high rate of mutagenesis in malignant cells has been considered to be a primary factor in the appearance of chemotherapy-resistant cell clones in glioblastomas. Quinacrine binds strongly to deoxyribonucleic acid, preventing mutagenesis. We investigated whether quinacrine could improve carmustine therapy i...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200110000-00033
更新日期:2001-10-01 00:00:00
abstract::The use OF chemotherapy to treat patients with brain metastases has been viewed historically with skepticism. To date, a survival benefit has not been demonstrated with the use of systemic chemotherapy in patients with brain metastases. However, the introduction of novel agents and delivery techniques warrants a reexa...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000182740.39014.9a
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Chronic deep brain stimulation of the rodent lateral cerebellar nucleus (LCN) has been demonstrated to enhance motor recovery following cortical ischemia. This effect is concurrent with synaptogenesis and expression of long-term potentiation markers in the perilesional cerebral cortex. OBJECTIVE:To further ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx473
更新日期:2018-11-01 00:00:00
abstract::A case of ulnar neuropathy at the elbow produced by spontaneous intraneural hemorrhage in a patient with acquired immunodeficiency syndrome and thrombocytopenia is reported. Intraneural hemorrhage in patients with bleeding disorders occurs infrequently. It consists of acute intrafascicular bleeding, presumably produci...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199102000-00019
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Desmoplastic infantile gangliogliomas (DIGs) are extremely rare tumors that respond well to treatment. However, their biological behavior remains to be clarified. We describe two patients whose DIGs spontaneously regressed after surgery, without adjuvant therapy. CLINICAL PRESENTATION:A 9-mont...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000084165.60662.6d
更新日期:2003-10-01 00:00:00
abstract::A patient with a planum sphenoidale meningioma mimicking a classic case of pituitary apoplexy is presented. A review of the apoplectiform onset of meningiomas is included. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Although various strategies for prevention of brain disease have been implemented, no substance has been found to be advantageous for prophylaxis against brain injury. OBJECTIVE:While previous work in our laboratory and others have shown positive effects using the omega-3 fatty acid docosahexaenoic acid (DH...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3181ff692b
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To systematically appraise the study design and quality of reporting of randomized controlled trials (RCTs) on neurosurgical procedures and to identify potential defects and biases. METHODS:Randomized controlled trials with at least five patients comparing any neurosurgical procedure against another procedur...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000126873.00845.a7
更新日期:2004-07-01 00:00:00
abstract::The neurosurgical tradition at Jefferson Medical College began in the 19th century with Samuel Gross. In his textbook entitled A System of Surgery, Gross revealed his knowledge of the disorders of the nervous system at a time when innovations were practically inexistent. Gross' work paved the way for William Williams ...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1227/01.neu.0000430299.02714.46
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To assess and compare levels and patterns of expression for integrins alphavbeta1, alphavbeta3, and alphavbeta5 in arteriovenous malformations (AVMs) and cavernous malformations (CCMs) of the brain. MATERIALS AND METHODS:Specimens from 10 AVM and 10 CCM lesions were selected from 112 patients with AVMs and 9...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000192174.55131.09
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:The treatment of residual and/or recurrent pituitary tumors, initially operated on through transsphenoidal and/or transcranial approaches, required a new single approach that would make it possible to excise the tumor from the sella and from the neighboring regions. Surgical complications, such as pneumatocep...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199709000-00007
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to investigate the use of proton magnetic resonance spectroscopic imaging as a prognostic indicator in gamma knife radiosurgery of recurrent gliomas. METHODS:Thirty-six patients with recurrent gliomas were studied with proton magnetic resonance spectroscopic imaging at the time of ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200002000-00011
更新日期:2000-02-01 00:00:00
abstract::In the past, stereotactic surgical intervention for Parkinson's disease was considered indicated only in those patients with active motor manifestations that were refractory to pharmacological therapy, manifestations such as tremor, rigidity, dystonia, and dyskinesia. With the reintroduction and refinement of Leksell'...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199506000-00008
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Traditionally, thoracic fractures that require anterior stabilization are treated through an open thoracotomy approach. Thoracoscopic instrumentation avoids many of the complications associated with an open thoracotomy but is technically challenging. We report the first cases of dual-rod intern...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000119229.92157.66
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. Reported hemorrhage rates have ranged from 62 to 91%, and an aggressive clinical course is more likely than a benign clinical course. We describe the first case of...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neurosurgery/57.4.e809
更新日期:2005-10-01 00:00:00