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Cerebral Aneurysm

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161. Treatment of Ruptured Intracranial Aneurysms in China.

: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by He xuying, Zhujiang Hospital: Ruptured Intracranial Aneurysms Unruptured Intracranial Aneurysms Prospective cohort study China Additional relevant MeSH terms: Layout table for MeSH terms Aneurysm Intracranial Aneurysm Rupture Vascular Diseases Cardiovascular Diseases Intracranial Arterial Diseases Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Wounds and Injuries (...) Treatment of Ruptured Intracranial Aneurysms in China. Treatment of Ruptured Intracranial Aneurysms in China. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Treatment of Ruptured Intracranial Aneurysms

2018 Clinical Trials

162. Endovascular Treatment of Wide Neck Intracranial Aneurysms With the LEO + Stent : The LEO + II Cohort Study

using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: Child, Adult, Older Adult Sexes Eligible for Study: All Accepts Healthy Volunteers: No Sampling Method: Non-Probability Sample Study Population All patients with ruptured or not ruptured intracranial aneurysms demonstrated by cerebral arteriography treated with LEO + stent Criteria Inclusion Criteria: All patients with ruptured or not ruptured intracranial aneurysms (...) : April 20, 2018 Last Verified: April 2018 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: No Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Aneurysm Intracranial Aneurysm Vascular Diseases Cardiovascular Diseases Intracranial Arterial Diseases Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System

2018 Clinical Trials

163. Degradation of the Glycocalyx in Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

) Sharing Statement: Plan to Share IPD: Undecided Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Ischemia Subarachnoid Hemorrhage Brain Ischemia Cerebral Infarction Pathologic Processes Intracranial Hemorrhages Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases (...) Degradation of the Glycocalyx in Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage Degradation of the Glycocalyx in Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please

2018 Clinical Trials

164. Evaluation of Iliac and Renal Artery for Mechanism of Intracranial Aneurysm in ADPKD

specimens can be obtained. The objective of this study is to investigate the mechanism of intracranial aneurysm in ADPKD patients by analyzing iliac and renal artery characteristics. Condition or disease Intervention/treatment Kidney Transplant; Complications Polycystic Kidney Diseases Aneurysm, Brain Procedure: Kidney transplantation Detailed Description: ADPKD is associated with PKD1 gene on chromosome 16 and PKD2 gene on chromosome 4 and these gene respectively code polycystin 1 and polycystin 2 (...) Evaluation of Iliac and Renal Artery for Mechanism of Intracranial Aneurysm in ADPKD Evaluation of Iliac and Renal Artery for Mechanism of Intracranial Aneurysm in ADPKD - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2018 Clinical Trials

165. Hydrogel coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms: a meta-analysis of randomized controlled trials. Full Text available with Trip Pro

Hydrogel coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms: a meta-analysis of randomized controlled trials. Recent studies have shown conflicting results regarding the effect of hydrogel coils for treating intracranial aneurysm compared to bare platinum coils. We implemented a meta-analysis to assess the value of hydrogel coils in intracranial aneurysm treatment.The MEDLINE, EMBASE, and Cochrane Library databases were searched for randomized controlled (...) trials (RCTs) which had evaluated hydrogel coils versus bare platinum coils for intracranial aneurysms.We pooled 1526 patients from 4 RCTs with the mean follow-up time of more than 16 months. Hydrogel coils had reductions on mid-term recurrence (RR 0.78, 95% CI 0.65 to 0.94, P = 0.008) and residual aneurysm (RR 0.71, 95% CI 0.57 to 0.88, P = 0.002), but didn't show any significant differences in other favorable outcomes such as functional recovery, mortality and so on. In the subgroup analysis, we

2018 BMC Neurology

166. Impact of isolated cerebral perfusion technique for aortic arch aneurysm repair in elderly patients. (Abstract)

Impact of isolated cerebral perfusion technique for aortic arch aneurysm repair in elderly patients. In aortic surgery, a severely atherosclerotic aorta is a known risk factor for perioperative stroke. The authors adopted a novel procedure of selective cerebral perfusion, named isolated cerebral perfusion (ICP), for the prevention of stroke during aortic arch operations.Between January 2010 and June 2016, 48 patients (mean age, 80 ± 3 years) at Yokohama City University Medical Center, Yokohama (...) into the LCCA were performed. Extracorporeal circulation through the bilateral axillary arteries and selective cerebral perfusion to the LCCA were simultaneously started. Finally, at a bladder temperature of 25°C, clamping of the brachiocephalic and left subclavian arteries was performed.Preoperative evaluation by enhanced computed tomography confirmed that 62.2% of patients had severely atherosclerotic aortas and 37.8% had shaggy aortas. The overall 30-day mortality rate was 2.1%, whereas that for elective

2018 Annals of Thoracic Surgery

167. Intracranial aneurysm distribution and characteristics according to gender. (Abstract)

Intracranial aneurysm distribution and characteristics according to gender. Female sex is associated with a greater prevalence of cerebral aneurysms. However, it also might be linked to the location and size of the aneurysm. The aim of this study was to find the link between female sex and aneurysm characteristics.Our study group consisted of 357 patients admitted to the hospital with both unruptured and ruptured aneurysms confirmed by Digital Subtraction Angiography or Computed Tomography (...) Angiography and aneurysmal subarachnoid haemorrhage confirmed by head CT. Patients' medical records were analyzed for necessary information including, but not limited to medical history, blood test results, and aneurysm prevalence, size and location.Women constituted 232 (64.98%) of all patients. In this group, compared to males, we observed a more common occurrence of multiple aneurysms (1.35 ± 0.67 vs. 1.2 ± 0.57; p = .046) and left internal carotid artery aneurysms (25.88% vs. 13.93%; p < .01

2018 British Journal of Neurosurgery

168. Safety of coiling with stent placement for the treatment of ruptured wide-necked intracranial aneurysms: a contemporary cohort study in a high-volume center after improvement of skills and strategy. Full Text available with Trip Pro

Safety of coiling with stent placement for the treatment of ruptured wide-necked intracranial aneurysms: a contemporary cohort study in a high-volume center after improvement of skills and strategy. OBJECTIVEThe authors compared the contemporary perioperative procedure-related complications between coiling with stent placement and coiling without stent placement for acutely ruptured aneurysms treated in a single center after improvement of interventional skills and strategy.METHODSIn (...) , hemorrhagic complications, or ischemic complications.CONCLUSIONSThe perioperative procedure-related complications and mortality rate did not differ significantly between the coiling/stent group and the coiling/no-stent group for patients with acutely ruptured aneurysms. Considering the better angiographic follow-up results, coiling with stent placement might be a feasible, safe, and promising option for treatment in the acute phase of selected wide-necked ruptured intracranial aneurysms.

2018 Journal of Neurosurgery

169. Surgical treatment and perioperative management of intracranial aneurysms in Chinese patients with ischemic cerebrovascular diseases: a case series. Full Text available with Trip Pro

an average age of 66 (46-78) years, and proportion of males was 39% (12 males). There were 35 unruptured intracranial aneurysms with a diameter more than 5 mm. There were 20 posterior communicating and anterior choroidal aneurysms (57%), seveb middle cerebral aneurysms (20%), and eight anterior communicating aneurysms (23%), with 21 lobular aneurysms (60%). Twenty-nine patients had normal neurological function (Glasgow Outcome Scale [GOS] 5), one patient with mild neurological defect (GOS 4), and one (...) no recurrence of intracranial aneurysms after operation.The current case series found that minimally invasive surgical approach and intraoperative monitoring, supplemented by effective management of cerebrovascular perfusion, circulation and coagulation, can promote the treatment of intracranial aneurysms and prevent the development of cerebral ischemia and aneurysm rupture in Chinese patients with ischemic cerebrovascular diseases. Future studies with large sample size will be needed to confirm the results

2018 BMC Neurology

170. Growth and rupture of unruptured intracranial aneurysms. Full Text available with Trip Pro

Growth and rupture of unruptured intracranial aneurysms. OBJECTIVERisk factors for growth of unruptured intracranial aneurysms (UIAs) during a lifelong follow-up in relation to subsequent rupture are unknown. The author's aim in this study was to investigate whether risk factors for UIA growth are different for those that lead to rupture than for those that do not.METHODSThe series consists of 87 patients with 111 UIAs diagnosed before 1979, when UIAs were not treated. A total follow-up time (...) of the patients was 2648 person-years for all-cause death and 2182 years when patients were monitored until the first rupture, death due to unrelated causes, or the last contact (annual incidence of aneurysm rupture, 1.2%). The follow-up time between aneurysm measurements was 1669 person-years. Risk factors for UIA growth were analyzed in relation to subsequent rupture.RESULTSThe median follow-up time between aneurysm measurements was 21.7 years (range 1.2-51.0 years). In 40 of the 87 patients (46%), the UIAs

2018 Journal of Neurosurgery

171. Morphological parameters as factors of 12-month neurological worsening in surgical treatment of patients with unruptured saccular intracranial aneurysms: importance of size ratio. Full Text available with Trip Pro

Morphological parameters as factors of 12-month neurological worsening in surgical treatment of patients with unruptured saccular intracranial aneurysms: importance of size ratio. OBJECTIVEIt is well known that larger aneurysm size is a risk factor for poor outcome after surgical treatment of unruptured saccular intracranial aneurysms (USIAs). However, the authors have occasionally observed poor outcome in the surgical treatment of small USIAs and hypothesized that size ratio has a negative (...) impact on outcome. The aim of this paper was to investigate the influence of size ratio on outcome in the surgical treatment of USIAs.METHODSProspectively collected clinical and radiological data of 683 consecutive patients harboring 683 surgically treated USIAs were evaluated. Dome-to-neck ratio was defined as the ratio of the maximum width of the aneurysm to the average neck diameter. The aspect ratio was defined as the ratio of the maximum perpendicular height of the aneurysm to the average neck

2018 Journal of Neurosurgery

172. Intracranial pressure responsiveness to positive end-expiratory pressure is influenced by chest wall elastance: a physiological study in patients with aneurysmal subarachnoid hemorrhage. Full Text available with Trip Pro

Intracranial pressure responsiveness to positive end-expiratory pressure is influenced by chest wall elastance: a physiological study in patients with aneurysmal subarachnoid hemorrhage. Respiratory system elastance (ERS) is an important determinant of the responsiveness of intracranial pressure (ICP) to positive end-expiratory pressure (PEEP). However, lung elastance (EL) and chest wall elastance (ECW) were not differentiated in previous studies. We tested the hypothesis that patients

2018 BMC Neurology

173. Delayed Branching Artery Occlusion Caused by Clip Rotation after Intracranial Aneurysm Clippings Full Text available with Trip Pro

Delayed Branching Artery Occlusion Caused by Clip Rotation after Intracranial Aneurysm Clippings Clip rotation after clipping is a major cause of delayed cerebral ischemia and may occur after any of several intraoperative monitoring techniques. We experienced 3 cases of clip rotation in 3 patients after clipping between March 2011 and December 2013. One of these patients has permanent motor weakness of the left upper extremity because of delayed occlusion of the right M1 lenticulostriate artery (...) . The other two developed delayed occlusion of the frontopolar artery or of the A1 perforating artery, but did not have any neurologic deficits. Clinicians need to exercise great care not to compromise distal blood flow after clipping intracranial aneurysms. We present 3 cases in which clip rotation occurred after aneurysm clipping and progressively compromised blood flow of a nearby branching artery.

2018 Case reports in neurology

174. Multiple coronary and cerebral aneurysms in a patient with chronic thromboangiitis Full Text available with Trip Pro

Multiple coronary and cerebral aneurysms in a patient with chronic thromboangiitis A 73-year-old man had multiple coronary aneurysms that resulted in acute myocardial infarction on the day before surgery for cerebral aneurysms. Emergent coronary angiography revealed that the lesion that caused the myocardial infarction was a distal left circumflex artery, and two huge coronary aneurysms were also found in the left circumflex artery. A two-stage treatment strategy was planned, including coronary (...) aneurysm surgery, followed by cerebral aneurysm surgery. He underwent coronary artery aneurysmorrhaphy with closure of the ostia of the afferent and efferent arteries, and coronary artery bypass grafting with a saphenous vein graft applied to the left circumflex artery. The pathological findings suggested chronic thromboangiitis, as the inflammatory cells were observed to have infiltrated the coronary artery wall. The tissue remodeling of the aneurysmal wall indicated a positive response to tenascin C

2018 Journal of cardiology cases

175. Recurrence of Small Cerebral Aneurysms (< 4 mm) Treated Endovascularly Using Target® Nano™ Coils Full Text available with Trip Pro

Recurrence of Small Cerebral Aneurysms (< 4 mm) Treated Endovascularly Using Target® Nanoâ„¢ Coils In our series, endovascular coiling with Target® Nano™ coils (Stryker Neurovascular, Fremont, CA, USA) with diameters of 1 or 1.5 mm exhibited favorable technical feasibility in the treatment of small cerebral aneurysms (< 4 mm). However, little is known about the recurrence of small cerebral aneurysms treated using Target® Nano™ coils. We investigated recurrence following the treatment of small (...) cerebral aneurysms using Target® Nano™ coils.Between January 2012 and November 2013, 143 patients with 148 small cerebral aneurysms (< 4 mm) were included our study. A total of 135 cerebral aneurysms (91.2%) were unruptured; 45 cerebral aneurysms (30.4%) were treated by endovascular coiling using Target® Nano™ coils. Follow-up radiological images were obtained for 132 cerebral aneurysms (89.2%) over a range of 3 to 58 months (mean, 34.3 months; standard deviation, 14.2).In the group treated with Target

2018 Journal of cerebrovascular and endovascular neurosurgery

176. Cerebral Aneurysms in Judicial Precedents Full Text available with Trip Pro

Cerebral Aneurysms in Judicial Precedents From November 30, 2016, the Korean Government carried the revised Medical Dispute Mediation and Arbitration Act into effect. Mediation will start automatically without agreements of the defendant, when the outcome of the patient was death, coma more than a month or severe disability. Cerebral aneurysm has a definite risk of bad outcome, especially in the worst condition. Any surgical intervention to this lesion has its own high risk of complications (...) . Recently, Seoul central district court decided 50% responsibility of the doctors who made a rupture of the aneurysm during coiling (2015Ga-Dan5243104). We reviewed judicial precedents related to cerebral aneurysms in lawsuit using a web search.We searched judicial precedents at a web search of the Supreme Court, using the key words, "cerebral aneurysm".There were 15 precedents, six from the Supreme Court, seven from the High Court, and two from district courts. Seven precedents were related

2018 Journal of Korean Neurosurgical Society

177. Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms Full Text available with Trip Pro

Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Here, we retrospectively analyzed the clinical data of 428 patients with ruptured CA between 2010 and 2015. Patients' demographic data, including gender, age, history of smoking, alcohol, hypertension, diabetes and hypercholesterolemia, Hunt-Hess and Fisher grade, occurrence of hydrocephalus (...) , aneurysm location, time to surgery, delayed ischemic neurological deficit (DIND) and peak leukocyte of blood test from day 1 to 3 after aneurysmal rupture were recorded and analyzed. In the multivariable analysis model, gender, Fisher grade, time to surgery and hydrocephalus were not relevant to poor outcome. However, Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were significantly associated with adverse outcome. The respective increased risks were 5.2- (OR5.24, 95% CI 1.67

2018 Scientific reports

178. Estrogen Deficiency Promotes Cerebral Aneurysm Rupture by Upregulation of Th17 Cells and Interleukin‐17A Which Downregulates E‐Cadherin Full Text available with Trip Pro

Estrogen Deficiency Promotes Cerebral Aneurysm Rupture by Upregulation of Th17 Cells and Interleukin‐17A Which Downregulates E‐Cadherin Estrogen deficiency is associated with the development of cerebral aneurysms; however, the mechanism remains unknown. We explored the pathway of cerebral aneurysm development by investigating the potential link between estrogen deficiency and inflammatory factors.First, we established the role of interleukin-17 (IL-17)A. We performed a cytokine screen (...) increase aneurysm formation in normal mice or in estrogen-deficient mice. In cell migration assays, E-cadherin inhibition promoted macrophage infiltration across endothelial cells (P<0.05), which may be the mechanism for the estrogen deficiency/IL-17/E-cadherin aneurysm pathway.Our data suggest that estrogen deficiency promotes cerebral aneurysm rupture by upregulating IL-17A, which downregulates E-cadherin, encouraging macrophage infiltration in the aneurysm vessel wall.© 2018 The Authors. Published

2018 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

179. NF-κB-Mediated Inflammation in the Pathogenesis of Intracranial Aneurysm and Subarachnoid Hemorrhage. Does Autophagy Play a Role? Full Text available with Trip Pro

NF-κB-Mediated Inflammation in the Pathogenesis of Intracranial Aneurysm and Subarachnoid Hemorrhage. Does Autophagy Play a Role? The rupture of saccular intracranial aneurysms (IA) is the commonest cause of non-traumatic subarachnoid hemorrhage (SAH)—the most serious form of stroke with a high mortality rate. Aneurysm walls are usually characterized by an active inflammatory response, and NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) has been identified (...) shown that autophagy mediates the normal functioning of vessels, so its disturbance can be associated with vessel-related disorders. Early brain injury, delayed brain injury, and associated cerebral vasospasm are among the most serious consequences of IA rupture and are associated with impaired function of the autophagy⁻lysosomal system. Further studies on the role of the interplay between autophagy and NF-κB-mediated inflammation in IA can help to better understand IA pathogenesis

2018 International journal of molecular sciences

180. Morphological parameters and anatomical locations associated with rupture status of small intracranial aneurysms Full Text available with Trip Pro

Morphological parameters and anatomical locations associated with rupture status of small intracranial aneurysms Characterization of the rupture risk factors for small intracranial aneurysms (SIAs, ≤5 mm) is clinically valuable. The present study aims to identify image-based morphological parameters and anatomical locations associated with the rupture status of SIAs. Two hundred and sixty-three patients with single SIAs (128 ruptured, 135 unruptured) were included, and six morphological (...) parameters, including size, aspect ratio (AR), size ratio (SR), height-width ratio (H/W), flow angle (FA) and aneurysm width-parent artery diameter ratio, and the aneurysm locations were evaluated using three-dimensional geometry, and were used to identify a correlation with aneurysm rupture. Statistically significant differences were observed between ruptured and unruptured groups for AR, SR, H/W, FA, and aneurysm locations, from univariate analyses. Logistic regression analysis further revealed that AR

2018 Scientific reports

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