Initial multicenter technical experience with the Apollo device for minimally invasive intracerebral hematoma evacuation.

Abstract:

BACKGROUND:No conventional surgical intervention has been shown to improve outcomes for patients with spontaneous intracerebral hemorrhage (ICH) compared with medical management. OBJECTIVE:We report the initial multicenter experience with a novel technique for the minimally invasive evacuation of ICH using the Penumbra Apollo system (Penumbra Inc, Alameda, California). METHODS:Institutional databases were queried to perform a retrospective analysis of all patients who underwent ICH evacuation with the Apollo system from May 2014 to September 2014 at 4 centers (Medical University of South Carolina, Stony Brook University, University of California at San Diego, and Semmes-Murphy Clinic). Cases were performed either in the neurointerventional suite, operating room, or in a hybrid operating room/angiography suite. RESULTS:Twenty-nine patients (15 female; mean age, 62 ± 12.6 years) underwent the minimally invasive evacuation of ICH. Six of these parenchymal hemorrhages had an additional intraventricular hemorrhage component. The mean volume of ICH was 45.4 ± 30.8 mL, which decreased to 21.8 ± 23.6 mL after evacuation (mean, 54.1 ± 39.1% reduction; P < .001). Two complications directly attributed to the evacuation attempt were encountered (6.9%). The mortality rate was 13.8% (n = 4). CONCLUSION:Minimally invasive evacuation of ICH and intraventricular hemorrhage can be achieved with the Apollo system. Future work will be required to determine which subset of patients are most likely to benefit from this promising technology.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Spiotta AM,Fiorella D,Vargas J,Khalessi A,Hoit D,Arthur A,Lena J,Turk AS,Chaudry MI,Gutman F,Davis R,Chesler DA,Turner RD

doi

10.1227/NEU.0000000000000698

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

243-51; discussion 251

eissn

0148-396X

issn

1524-4040

journal_volume

11 Suppl 2

pub_type

杂志文章,多中心研究
  • Dangerous rises in blood pressure upon heating of trigeminal rootlets; increased bleeding times in patients with trigeminal neuralgia.

    abstract::During radiofrequency (RF) heating of trigeminal rootlets, we regularly measured blood pressure rises to 250 to 300 mm Hg, confirming two previous reports. We also found abnormally increased bleeding times in 12% of 127 patients awaiting operation for trigeminal neuralgia. These two facts probably explain 6 fatalities...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198511000-00022

    authors: Sweet WH,Poletti CE,Roberts JT

    更新日期:1985-11-01 00:00:00

  • Neurosurgery and Manned Spaceflight.

    abstract::There has been a renewed interest in manned spaceflight due to endeavors by private and government agencies. Publicized goals include manned trips to or colonization of Mars. These missions will likely be of long duration, exceeding existing records for human exposure to extra-terrestrial conditions. Participants will...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyy531

    authors: Panesar SS,Fernandez-Miranda JC,Kliot M,Ashkan K

    更新日期:2020-03-01 00:00:00

  • Vertebral hemangioma symptomatic during pregnancy--report of a case and review of the literature.

    abstract::A spinal tumor complicating pregnancy is a rare condition. A 25-year-old woman who became paraplegic during the 35th week of her second pregnancy presented during the postpartum period. She underwent two surgical interventions, and the cord compression caused by a T5 vertebral body hemangioma with laminar involvement ...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/00006123-199302000-00022

    authors: Tekkök IH,Açìkgöz B,Sağlam S,Onol B

    更新日期:1993-02-01 00:00:00

  • Stenting and secondary coiling of intracranial internal carotid artery aneurysm: technical case report.

    abstract:OBJECTIVE AND IMPORTANCE:Endovascular stents have been successfully used in the treatment of fusiform and dissecting aneurysms of the peripheral circulation and extracranial carotid and vertebral arteries. Technical limitations related to the inability to navigate the stent and the delivery system through tortuous vasc...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199811000-00130

    authors: Mericle RA,Lanzino G,Wakhloo AK,Guterman LR,Hopkins LN

    更新日期:1998-11-01 00:00:00

  • The neurosurgeon as innovator and entrepreneur.

    abstract::INNOVATION IS THE driving force behind progress in neurosurgery. Most significant innovations require commercialization to ensure appropriate development and ultimate distribution to patients. There are several key factors that determine whether a particular innovation is likely to be commercially successful. Relation...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200007000-00035

    authors: Firlik AD,Lowry DW,Levy AJ,Hirsch RC

    更新日期:2000-07-01 00:00:00

  • The Impact of Intracranial Tumor Proximity to White Matter Tracts on Morbidity and Mortality: A Retrospective Diffusion Tensor Imaging Study.

    abstract:Background:Using diffusion tensor imaging (DTI) in neurosurgical planning allows identification of white matter tracts and has been associated with a reduction in postoperative functional deficits. Objective:This study explores the relationship between the lesion-to-tract distance (LTD) and postoperative morbidity and...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyw040

    authors: Meyer EJ,Gaggl W,Gilloon B,Swan B,Greenstein M,Voss J,Hussain N,Holdsworth RL,Nair VA,Meyerand ME,Kuo JS,Baskaya MK,Field AS,Prabhakaran V

    更新日期:2017-02-01 00:00:00

  • Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.

    abstract:BACKGROUND:With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. OBJECTIVE:To develop and evaluate the usefulness of a n...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000583

    authors: Alaraj A,Luciano CJ,Bailey DP,Elsenousi A,Roitberg BZ,Bernardo A,Banerjee PP,Charbel FT

    更新日期:2015-03-01 00:00:00

  • Neurogenic tumors of the brachial plexus: report of two cases.

    abstract::Two cases of solitary neurogenic tumors of the brachial plexus unassociated with von Recklinghausen's disease are presented. One patient had a malignant schwannoma. The lesion of the other patient was benign and was diagnosed pathologically as a plexiform neurofibroma. These uncommon neurogenic tumors of the brachial ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-197901000-00014

    authors: Richardson RR,Siqueira EB,Oi S,Nunez C

    更新日期:1979-01-01 00:00:00

  • Spine Oncology-Metastatic Spine Tumors.

    abstract::Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understand...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyw084

    authors: Choi D,Bilsky M,Fehlings M,Fisher C,Gokaslan Z

    更新日期:2017-03-01 00:00:00

  • Repeat endovascular treatment in post-embolization recurrent intracranial aneurysms.

    abstract:OBJECTIVE:The purpose of this study was to describe clinical situations requiring repeat embolization in patients previously treated by endovascular coil embolization for intracranial aneurysms, and to report on our experiences of repeat embolization (RE). METHODS:A total of 466 patients harboring 522 intracranial ane...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000194188.51731.13

    authors: Kang HS,Han MH,Kwon BJ,Kwon OK,Kim SH

    更新日期:2006-01-01 00:00:00

  • Moderate grade astrocytoma presenting in a 4-month-old child with a family history of von Recklinghausen's neurofibromatosis spanning four generations: a case report.

    abstract::Intracranial gliomas are found in association with von Recklinghausen's neurofibromatosis. However, few truly neonatal lesions have been identified and studied. This case report concerns a 4-month-old child who was found to have a massive thalamic glioma of moderate grade. Four paternal generations had suffered from d...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198312000-00014

    authors: Epstein NE,Rosenthal AD,Selman J,Osipoff M,Hyman RA

    更新日期:1983-12-01 00:00:00

  • Impaired immunocompetence in patients with malignant gliomas: the possible role of Tg-lymphocyte subpopulations.

    abstract::T-lymphocyte subpopulations (Tg or "suppressor cells" and Tm or "helper cells") in the peripheral blood of 16 patients with malignant intracranial gliomas were analyzed. The number of Tm-lymphocytes was very close to normal in both pre- and postoperative samples, whereas Tg-lymphocytes were significantly increased pre...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198205000-00004

    authors: Gerosa MA,Olivi A,Rosenblum ML,Semenzato GP,Pezzutto A

    更新日期:1982-05-01 00:00:00

  • Haemophilus influenzae meningitis in the presence of a cerebrospinal fluid shunt.

    abstract::Haemophilus influenzae meningitis in the presence of a cerebrospinal fluid shunt has been reported uncommonly. Staphylococcus aureus and Staphylococcus epidermidis, the most common etiological agents, are usually acquired by contiguous spread from an intraoperative or perioperative source. These infections usually occ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198601000-00013

    authors: Petrak RM,Pottage JC Jr,Harris AA,Levin S

    更新日期:1986-01-01 00:00:00

  • Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors.

    abstract::Intraoperative brain mapping techniques were used to localize language cortex, sensorimotor pathways, and seizure foci in children with supratentorial brain tumors. The methods of direct cortical and subcortical stimulation, in addition to electrocorticography, enabled us to maximize tumor resection, minimize morbidit...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-198911000-00015

    authors: Berger MS,Kincaid J,Ojemann GA,Lettich E

    更新日期:1989-11-01 00:00:00

  • Inhibitory effects of sodium butyrate on proliferation and invasiveness of human glioma cells.

    abstract:OBJECTIVE:Sodium butyrate (SB), a differentiation-inducing agent, has been demonstrated to inhibit cellular proliferation in a number of human cell lines. Its precise mechanisms remain to be clarified, however. We investigated molecular mechanisms of SB-induced growth suppression as well as the effects of SB on the inv...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200108000-00031

    authors: Ito N,Sawa H,Nagane M,Noguchi A,Hara M,Saito I

    更新日期:2001-08-01 00:00:00

  • Functional activity within brain tumors: a magnetic source imaging study.

    abstract:OBJECTIVE:To determine whether low-grade gliomas contain functional cortical activity more often than high-grade gliomas within radiologically defined abnormal tissue. METHODS:Patients with intra-axial cerebral lesions located in the vicinity of eloquent brain cortex preoperatively underwent magnetic source imaging. A...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200112000-00005

    authors: Schiffbauer H,Ferrari P,Rowley HA,Berger MS,Roberts TP

    更新日期:2001-12-01 00:00:00

  • Local Control and Toxicity of Multilevel Spine Stereotactic Body Radiotherapy.

    abstract:BACKGROUND:Spine stereotactic body radiotherapy (sSBRT) is commonly limited to 1 or 2 vertebral levels given a paucity of efficacy and toxicity data when more than 2 levels are treated. OBJECTIVE:To prove our hypothesis that multilevel sSBRT could provide similar rates of local control (LC) (primary endpoint) and toxi...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz348

    authors: Beeler WH,Speth KA,Broderick MT,Jairath NK,Ballouz D,Gharzai LA,Jackson WC,Kim MM,Owen D,Szerlip NJ,Paradis KC,Spratt DE

    更新日期:2020-02-01 00:00:00

  • Failure of Flow Diverter Therapy: Predictors and Management Strategies.

    abstract::Flow diversion is a safe and effective treatment for many types of brain aneurysms. Even so, there remain some aneurysms that persist despite initial treatment. In studies with the longest follow-up (5 yr), at least 5% of aneurysms persist with this treatment modality. As the cumulative experience and clinical indicat...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz305

    authors: Bonney PA,Connor M,Fujii T,Singh P,Koch MJ,Stapleton CJ,Mack WJ,Walcott BP

    更新日期:2020-01-01 00:00:00

  • Management of bilateral locked facets of the cervical spine.

    abstract::The management of 15 cases of bilateral locked facets of the cervical spine is reviewed. The C-6, C-7 interspace was the most common interspace involved. There were 4 females and 11 males who were 16 to 63 years old (average, 26 years). Thirteen patients had a complete spinal cord lesion with loss of function below th...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198102000-00002

    authors: Sonntag VK

    更新日期:1981-02-01 00:00:00

  • Outcome after stereotactic thalamotomy for dystonia and hemiballismus.

    abstract::The outcome after single or staged stereotactic thalamotomies in 17 patients with dystonia and 2 patients with hemiballismus is reviewed. All patients were severely disabled by their movement disorders despite optimal pharmacological therapies. Eight of the patients with dystonia (47%) showed moderate improvement imme...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/00006123-199503000-00009

    authors: Cardoso F,Jankovic J,Grossman RG,Hamilton WJ

    更新日期:1995-03-01 00:00:00

  • Extracranial-intracranial (EC-IC) arterial bypass: past performance and current concepts.

    abstract::The authors present a review of published experience with intracranial-extracranial arterial bypass grafting. The procedure is technically feasible and has a relatively low morbidity and mortality when performed by experienced microvascular surgeons. However, its therapeutic value is still unproven. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-197807000-00014

    authors: Samson DS,Boone S

    更新日期:1978-07-01 00:00:00

  • Supraorbital-pterional approach to skull base lesions.

    abstract::A surgical approach to the skull base is described. It allows excellent exposure of the cranial base with minimal brain retraction. Deep lesions can be handled via subfrontal, transsylvian, or subtemporal routes during the same operation. This approach is most suitable for large lesions in the suprasellar, parasellar,...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198710000-00006

    authors: Al-Mefty O

    更新日期:1987-10-01 00:00:00

  • Facial palsy and its management in the Kitab al-Hawi of Rhazes.

    abstract::More than 1000 years ago, Rhazes practiced rudimentary neurology. This monumental physician wrote more than 200 books in his lifetime and died a blind pauper in the 10th century AD. His Kitab al-Hawi (Liber Continens) was one of the most famous and detailed medical texts of the ancient world. Here, we discuss the life...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1227/01.NEU.0000345639.46737.67

    authors: Shoja MM,Tubbs RS,Loukas M,Shokouhi G,Ardalan MR

    更新日期:2009-06-01 00:00:00

  • High-resolution magnetic resonance imaging is a noninvasive method of observing injury and recovery in the peripheral nervous system.

    abstract:OBJECTIVE:Noninvasive observation of degenerating and regenerating peripheral nerves could improve the diagnosis and treatment of nerve injuries. We constructed a novel phased-array radiofrequency coil to permit magnetic resonance imaging (MRI) observation of the sciatic nerve and its target muscles in rats after injur...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000069534.43067.28

    authors: Aagaard BD,Lazar DA,Lankerovich L,Andrus K,Hayes CE,Maravilla K,Kliot M

    更新日期:2003-07-01 00:00:00

  • Positron emission tomographic studies on cerebral hemodynamics in patients with cerebral contusion.

    abstract::Positron emission tomography is currently one of the most useful methods for measurements of cerebral hemodynamics and oxygen metabolism, because it facilitates accurate analysis of the local cerebral circulation in three-dimensional quantitative images. In this study, we performed positron emission tomography studies...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199006000-00009

    authors: Tenjin H,Ueda S,Mizukawa N,Imahori Y,Hino A,Yamaki T,Kuboyama T,Ebisu T,Hirakawa K,Yamashita M

    更新日期:1990-06-01 00:00:00

  • Comparison of laser and radiofrequency dorsal root entry zone lesions in cats.

    abstract::Dorsal root entry zone lesions are effective in the control of intractable pain in several types of spinal cord injuries. Traditionally, these lesions have been made with the radiofrequency technique. This is effective, but has the drawback of being laborious, and there is a significant incidence of permanent weakness...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198503000-00008

    authors: Levy WJ,Gallo C,Watts C

    更新日期:1985-03-01 00:00:00

  • Reactivation of herpes virus after surgery for epilepsy in a pediatric patient with mesial temporal sclerosis: case report.

    abstract:OBJECTIVE:This case report is presented to raise the awareness of the potential risk of reactivation of herpes simplex virus (HSV) encephalitis after intracranial surgery. CLINICAL PRESENTATION:The case of an 8-year-old male patient who suffered a reactivation of HSV encephalitis after undergoing amygdalohippocampecto...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199903000-00106

    authors: Bourgeois M,Vinikoff L,Lellouch-Tubiana A,Sainte-Rose C

    更新日期:1999-03-01 00:00:00

  • Risk factors for hemorrhagic presentation in patients with dural arteriovenous fistulae.

    abstract:OBJECTIVE:Intracranial dural arteriovenous fistulae (DAVFs) can present as disabling intracranial hemorrhage. The aim of this study was to investigate the independent effects of specific demographic and clinical variables on hemorrhagic presentation in patients with DAVFs. METHODS:All patients with DAVFs evaluated at ...

    journal_title:Neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.1227/01.neu.0000317311.69697.fc

    authors: Singh V,Smith WS,Lawton MT,Halbach VV,Young WL

    更新日期:2008-03-01 00:00:00

  • Cerebral hemorrhage from amyloid angiopathy and coronary thrombolysis.

    abstract::Coronary thrombolysis with streptokinase or tissue plasminogen activator is useful for the treatment of acute myocardial infarction in selected patients. This treatment is associated with local hemorrhagic complications and age-related cerebral hemorrhage. Coronary thrombolysis is contraindicated in patients with tran...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199209000-00025

    authors: Leblanc R,Haddad G,Robitaille Y

    更新日期:1992-09-01 00:00:00

  • Radiation therapy in the treatment of cerebral astrocytoma.

    abstract::With the advent of more sensitive diagnostic techniques, we are encountering an increasing number of young patients harboring cerebral astrocytoma. The great danger in such patients is that the astrocytoma cells will undergo dedifferentiation to a higher state of malignancy. An essential question is whether the use of...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198706000-00028

    authors: Morantz RA

    更新日期:1987-06-01 00:00:00