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Kanazawa R, Uchida T, Higashida T, Watanabe S, Takahashi Y, Yamazaki K. Use of n-butyl-2-cyanoacrylate for microvascular decompression in a Jehovah's witness patient. Br J Neurosurg 2022:1-4. [PMID: 35400248 DOI: 10.1080/02688697.2022.2061913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/15/2021] [Accepted: 03/29/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE We report the application of n-butyl-2-cyanoacrylate (n-BCA) in microvascular decompression (MVD) surgery for a Jehovah's Witness patient. To our best knowledge, this is the first case wherein n-BCA has been employed as an adhesive to the offending artery. CASE PRESENTATION A 55-year-old female Jehovah's Witness patient was suffering from serious right hemifacial spasm. Although MVD surgery was needed, the patient resisted any curative medical treatment involving the application of whole blood products, including fibrin glue. Thus, we proposed several choices using artificial materials, including n-BCA as an adhesive, and received informed consent from the patient. RESULT MVD was performed on the dolichoectatic right vertebral artery and right posterior inferior cerebellar artery. The abnormal vessel response disappeared during the procedure and transposition using n-BCA of the concerned vessels was successful. The patient experienced a favorable postoperative clinical course and has been free from the spasm for a year. No abnormal findings were detected in the radiological examination during the follow-up period. CONCLUSION Although careful follow-up is mandatory, n-BCA is a possible alternative option in MVD surgery.
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Affiliation(s)
| | - Takanori Uchida
- Department of Neurosurgery, Nagareyama Central Hospital, Chiba, Japan
| | | | - Saiko Watanabe
- Department of Neurosurgery, Nagareyama Central Hospital, Chiba, Japan
| | - Yuichi Takahashi
- Department of Neurosurgery, Sassa General Hospital, Tokyo, Japan
| | - Kei Yamazaki
- Department of Neurosurgery, Nagareyama Central Hospital, Chiba, Japan
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Chai S, Xu H, Wang Q, Li J, Wang J, Wang Y, Pool H, Lin M, Xiong N. Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar dolichoectasia: interposition technique versus transposition technique. Acta Neurochir (Wien) 2020; 162:2811-2821. [PMID: 32935153 DOI: 10.1007/s00701-020-04572-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Various techniques of microvascular decompression have been proposed for trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia (VBD) with two main modalities: interposition and transposition. This retrospective study compares the outcomes of two techniques belonging to different modalities for VBD-associated TN. METHODS From January 2011 to April 2017, 39 patients underwent MVD for VBD-associated TN. The transposition method chosen was the biomedical glue sling technique. Patients were divided into the interposition group (n = 16) and the transposition group (n = 23). The radiologic data, intraoperative findings, complications, and outcomes were analyzed. RESULTS The 1-, 3-, and 5-year pain-free (BNI class I) maintenance rates were 100.0, 91.1, and 91.1%, respectively, in the transposition group and 87.5, 74.5, and 58.7% in the interposition group (p = 0.032). Postoperative complications were similar in both groups, but there was a trend for higher incidence of postoperative facial hypoesthesia using the interposition technique (p = 0.06). CONCLUSION In cases of VBD-associated TN, the transposition technique using biomedical glue was superior to the traditional interposition technique in maintaining a pain-free status, with no increase in the incidence of complication.
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Affiliation(s)
- Songshan Chai
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China
| | - Hao Xu
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China
- Department of Neurosurgery, General Hospital of the Yangtze River Shipping, Wu Han Brain Hospital, Wuhan, China
| | - Qiangping Wang
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China
| | - Junjun Li
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China
| | - Jiajing Wang
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China
| | - Yihao Wang
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China
| | - Hendrik Pool
- Department of International Education, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minhua Lin
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China.
| | - Nanxiang Xiong
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China.
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, No.169, Donghu Road, Wuhan, 430071, Hubei, China.
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Spiessberger A, Vogt DR, Fandino J, Marbacher S. Formation of intracranial de novo aneurysms and recurrence after neck clipping: a systematic review and meta-analysis. J Neurosurg 2020; 132:456-464. [PMID: 30797217 DOI: 10.3171/2018.10.jns181281] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 10/26/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Incidence rates of de novo aneurysm formation and recurrence after clip ligation remain controversial. In this meta-analysis, the authors provide data on pooled annual incidence rates and the association of patient characteristics with time to formation of de novo aneurysms and time to recurrence after clipping. METHODS A search of the literature up to June 15, 2016, on PubMed and a systematic review were performed. The association of age, aneurysm rupture status, aneurysm multiplicity, and anatomical location with time to recurrence or formation of de novo aneurysm was estimated using multivariable Cox proportional-hazards models. Kaplan-Meier estimates (event-free survival curves) are shown. Pooled annualized incidence rates of recurrent and de novo aneurysms were estimated using Poisson regression. Proportions of aneurysms and average follow-up times are displayed as bubble plots with LOESS smoothers weighted for study size. RESULTS Of the 7606 articles screened, 92 were included in the study. Case reports on 101 patients with recurrent aneurysms and 132 patients with de novo aneurysms were analyzed. Long-term follow-up studies on de novo aneurysm formation included 13,723 patients with 101,378 patient-years of follow-up; studies on aneurysm recurrence included 5922 patients with 31,055 patient-years of follow-up. Mean time to recurrence was 12.9 ± 6.6 years (mean ± standard deviation), and mean time to de novo formation was 9.3 ± 6.1 years. No association with sex, aneurysm location, and initial rupture could be shown. De novo aneurysms occurred later in patients with multiplicity of aneurysms at diagnosis (HR 0.63, p = 0.03) and in patients with increasing age (HR per 10 yrs 0.88, p = 0.06). Pooled annualized incidence rates were 0.35% for de novo aneurysms and 0.13% for recurrent aneurysms. CONCLUSIONS Despite low reported annual incidence rates, the cumulative risk of 9.6%-22% for aneurysm recurrence or de novo formation 20 years after clip ligation warrants lifelong follow-up. Screening at 5, 10, and 20 years would detect 30.8% (95% CI 23.3%-37.6%), 64.2% (95% CI 55.9%-70.9%), and 95.9% (95% CI 90.9%-97.9%) of de novo aneurysms. Screening for recurrent aneurysms at 10, 15, and 20 years would detect 36.6% (95% CI 26.5%-45.4%), 65.3% (95% CI 54.7%-73.5%), and 95.1% (95% CI 85.8%-96.6%) of lesions.
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Affiliation(s)
| | - Deborah R Vogt
- 2Clinical Trial Unit, Department of Clinical Research, University of Basel, University Hospital Basel, Switzerland
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Hasegawa M, Hatayama T, Kondo A, Nagahiro S, Fujimaki T, Amagasaki K, Arita K, Date I, Fujii Y, Goto T, Hanaya R, Higuchi Y, Hongo K, Inoue T, Kasuya H, Kayama T, Kawashima M, Kohmura E, Maehara T, Matsushima T, Mizobuchi Y, Morita A, Nishizawa S, Noro S, Saito S, Shimano H, Shirane R, Takeshima H, Tanaka Y, Tanabe H, Toda H, Yamakami I, Nishiyama Y, Ohba S, Hirose Y, Suzuki T. Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events. World Neurosurg 2019; 130:e251-e258. [DOI: 10.1016/j.wneu.2019.06.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 10/26/2022]
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Lv X, Chen Z, Liu L, Jiang C, Wang G, Wang J. Rupture of Intradural Giant Aneurysms: The Mode of Treatment, Anatomical, and Mechanical Factors. Neurol India 2019; 67:1194-1199. [PMID: 31744943 DOI: 10.4103/0028-3886.271250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Aneurysm rupture is often a fatal complication of giant intradural aneurysm (GIA) treatments. The purpose of this study was to review aneurysm rupture in GIA treatment. MATERIALS AND METHODS We performed a systematic review on aneurysm rupture related to GIA treatment. For each reported case, we collected the following information: aneurysm location, size and rupture status, the mode of treatment, timing of the hemorrhage, anatomical, and hemodynamic factors. RESULTS We identified 56 aneurysm ruptures related to treatment in 38 published studies. Of the nine intraoperative ruptures, eight occurred during endovascular procedures and one in surgical treatment. Of the 47 delayed ruptures, 72.3% occurred within 2 weeks. The prognosis of intraoperative and delayed ruptures was poor, with 83.9% experiencing death. Of these aneurysms, 75% were initially unruptured. Of the delayed ruptured aneurysms, 21.3% had prior surgical treatment, 74.4% had prior endovascular treatment, and 4.3% had prior combined surgical and endovascular treatments. Vertebrobasilar artery (VBA) location was significantly associated with aneurysm rupture after treatment, occurring at 57.2%. Flow diverter (FD) treatment seemed to elevate the delayed rupture proportion of giant paraclinoid internal carotid artery (ICA) aneurysms from 22.0% to 42.9%. FD treatment did not lower the rupture risk of giant VBA aneurysms and the corresponding death rate. CONCLUSION Intraoperative and delayed aneurysm ruptures were the most challenging in endovascular treatment of GIAs. Giant VBA aneurysm had the highest rupture risk after treatment. FD seemed to elevate the delayed rupture proportion of giant paraclinoid aneurysms.
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Affiliation(s)
- Xianli Lv
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zhiyong Chen
- Department of Neurosurgery, Qinhunangdao Jungong Hospital, Qinhuangdao, China
| | - Liguo Liu
- Department of Neurosurgery, Jikuang Hospital, Jixi, Heilongjiang, China
| | - Chuhan Jiang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Guihuai Wang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jin Wang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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Tamada T, Mikami T, Komura S, Suzuki H, Ukai R, Sugita S, Hasegawa T, Mikuni N. Pseudoaneurysm presenting around polytetrafluoroethylene fiber following microvascular decompression: A case report and literature review. J Clin Neurosci 2019; 63:231-234. [PMID: 30732984 DOI: 10.1016/j.jocn.2019.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/28/2019] [Indexed: 10/27/2022]
Abstract
We report the first case of pseudoaneurysm associated with polytetrafluoroethylene fiber used in microvascular decompression (MVD). A 62-year-old female who had undergone MVD for hemifacial spasm 30 years ago presented with a 4-month history of progressive facial palsy. Computed tomography angiography revealed a large thrombosed aneurysm originating from the right posterior inferior cerebellar artery and having a mass effect upon the pons. The aneurysm was treated by trapping and bypass procedure. Intraoperatively, the pseudoaneurysm adhered to the dura mater, and the thrombus contained a large amount of polytetrafluoroethylene fiber. The cause and management of pseudoaneurysm after MVD is discussed.
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Affiliation(s)
- Tomoaki Tamada
- Department of Neurosurgery, Sapporo Medical University, Japan
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University, Japan.
| | - Syoichi Komura
- Department of Neurosurgery, Sapporo Medical University, Japan
| | - Hime Suzuki
- Department of Neurosurgery, Sapporo Medical University, Japan
| | - Ryo Ukai
- Department of Neurosurgery, Sapporo Medical University, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Japan
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Delayed Development of Aneurysms Following Gamma Knife Surgery for Trigeminal Neuralgia: Report of 2 Cases. World Neurosurg 2016; 99:813.e13-813.e19. [PMID: 27890752 DOI: 10.1016/j.wneu.2016.11.069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 11/13/2016] [Accepted: 11/15/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Delayed development of intracranial aneurysms is an extremely rare complication of gamma knife surgery (GKS), with only 6 cases been reported to date. There are no reported cases after GKS performed to treat trigeminal neuralgia (TN). Of the 6 aforementioned cases, none referred to the natural history or pathophysiology of GKS-related intracranial aneurysm formation. CASE DESCRIPTION We treated 2 patients with subarachnoid hemorrhage (SAH) resulting from rupture of an intracranial aneurysm that developed long after GKS. Case 1 involved a 77-year-old man who had undergone GKS to treat recurrent TN after microvascular decompression surgery. At 13 years after the GSK, he developed SAH from a ruptured left anterior inferior cerebellar artery in close vicinity to the left trigeminal nerve. He died from a premature rupture before intervention could be instituted. Case 2 involved a 72-year-old woman who developed SAH at 9 years after undergoing GKS for TN. A ruptured left superior cerebellar artery aneurysm was treated successfully with endovascular occlusion of the parent artery. She recovered well after the surgery, and was discharged to the rehabilitation hospital with a modified Rankin Scale score of 2. CONCLUSION Long-term observations are necessary after GKS performed for TN owing to the possibility of formation of intracranial aneurysms near the irradiated region.
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Transposition of the Vertebral Artery With Fibrin Glue Adhesive in Microvascular Decompression. ACTA ACUST UNITED AC 2010. [DOI: 10.1097/wnq.0b013e3181ebaee3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Souza SCD, Oliveira WLD, Soares DFDOS, Briglia CH, Athanázio PR, Cerqueira MDD, Guimarães PH, Carreiro MC. Comparative study of suture and Cyanoacrylates in skin closure of rats. Acta Cir Bras 2008; 22:309-16. [PMID: 17625670 DOI: 10.1590/s0102-86502007000400013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 04/18/2007] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To compare the biocompatibility of ethyl-cyanoacrylate (ECA) and octylcyanoacrylate (OCA) wound closures to sutures in rat skin. METHODS Twenty-four male Wistar rats were subjected to three incisions which were closed using ECA, OCA or sutures . Rats were divided into four groups which received biopsies on the 3rd, 7th, 14th or 21st post-operative days. Necrosis, inflammation, dermatitis, infection, dehiscence, cicatricial enlargement and costs were examined; the histopathology evaluated was epithelialization, deep openings, foreign substance reaction, residues of synthesis material, fibrosis, inflammation, dehiscence and necrosis. RESULTS The tissue adhesives presented the largest dehiscence levels, and ECA the lowest cost while the other measures were similar. Regarding histopathology, deep openings were more common with OCA and granulomas were most frequently obtained with ECA. The two tissue adhesives produces less inflammation than the inicial suture from post-operative day 7, while ECA and OCA cause similar inflammatory reactions. ECA did not differ significantly from OCA and sutures on other measures. CONCLUSION ECA was well tolerated in this study and did not induce necrosis, allergic reactions or infections, presenting several advantages in relation to OCA and sutures, including lower costs and fewer complications.
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Kudo T, Iihara K, Murao K, Hayashi K, Ayabe J, Miyamoto S. Dissecting aneurysm of the vertebral artery developed after microvascular decompression for hemifacial spasm. Interv Neuroradiol 2006; 12:145-7. [PMID: 20569620 DOI: 10.1177/15910199060120s124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2005] [Accepted: 12/15/2005] [Indexed: 11/17/2022] Open
Abstract
SUMMARY We report a rare case of a ruptured de novo dissecting aneurysm induced by ethyl 2-cyanoacrylate. A 39-year-old woman underwent microvascular decompression for left hemifacial spasm. The offending vessel was left posterior inferior cerebellar artery (PICA). Left vertebral artery (VA) was mobilized and affixed to the dura mater with cyanoacrylate to remove pressure of PICA to the root exit zone of the facial nerve. The left VA was found to be intact at the time of the operation. One year later, the patient sufferd subarachnoid haemorrhage (SAH) caused by rupture of a newly-developed dissecting aneurysm of the left VA. Endovascular occlusion of the dissecting site was performed using Guglielmi detachable coils. We suppose mechanical injury and chemical reaction of ethyl 2-cyanoacrylate induced dissecting aneurysm.
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Affiliation(s)
- T Kudo
- Department of Neurosurgery, National Cardiovascular Center; Osaka, Japan -
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