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Atallah O, Alrefaie K, Al Krinawe Y. Crucial trials in neurosurgery: a must-know for every neurosurgeon. Neurosurg Rev 2024; 47:126. [PMID: 38512522 PMCID: PMC10957582 DOI: 10.1007/s10143-024-02358-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Oday Atallah
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg Street. Nr. 1, 30625, Hannover, Germany.
| | - Khadeja Alrefaie
- Faculty of Medicine, Royal College of Surgeons in Ireland, Busaiteen, Bahrain
| | - Yazeed Al Krinawe
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg Street. Nr. 1, 30625, Hannover, Germany
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Saal-Zapata G, Durand-Castro W, Valer-Gonzales D, Flores-Quijaite JEM, Rodriguez-Varela R. Endovascular trends in the treatment of intracranial aneurysms in a Peruvian reference center. J Neurosci Rural Pract 2023; 14:655-659. [PMID: 38059237 PMCID: PMC10696328 DOI: 10.25259/jnrp_282_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/01/2023] [Indexed: 12/08/2023] Open
Abstract
Objectives Endovascular treatment of intracranial aneurysms (IAs) has evolved in recent years and is currently the preferred treatment worldwide. We analyzed the trends in the number of patients, number of aneurysms, aneurysm characteristics, and techniques used in a pure endovascular cohort of patients treated in a reference center. Materials and Methods Between 2010 and 2020, a retrospective data collection of patients who underwent endovascular intervention of IAs was performed. We used the Mann-Kendal test to evaluate the trends. In addition, the moving-average technique was used to assess smoother curves. Results Eight hundred and forty-five aneurysms were treated in 765 patients, the mean age was 53.9 ± 14.6 years and 81% were women. The number of patients (P = 0.016) and aneurysms (P = 0.003) increased significantly. Unruptured (P = 0.029) and posterior communicating artery aneurysms increased their frequency of treatment (P = 0.042). Balloon remodeling (P = 0.01) and the use of flow diverters showed a positive trend (P = 0.016). Conclusion There have been an increased number of patients and aneurysms treated endovascularly at our institution, including unruptured and posterior communicating aneurysms. Advanced endovascular techniques also increased. Comparative studies including surgical cases must be done in our region to determine the best approach.
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Affiliation(s)
- Giancarlo Saal-Zapata
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru
| | - Walter Durand-Castro
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru
| | - Dante Valer-Gonzales
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru
| | | | - Rodolfo Rodriguez-Varela
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru
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Maeda K, Kawano Y, Suyama Y, Kawarazaki S, Irie K, Kuwabara K, Nagaoka S, Gi H, Kanemoto Y. Clinical Experience of Using an 8 French Newton Shaped Catheter (Neuro-EBU) During Endovascular Treatment: A Case Series of 21 Patients. Cureus 2022; 14:e26049. [PMID: 35859981 PMCID: PMC9288855 DOI: 10.7759/cureus.26049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/28/2022] Open
Abstract
The first step in endovascular treatment is the stable placement of a guide catheter (GC) into the target parent vessel. However, sufficient GC stabilization is sometimes difficult to obtain when the approach route has severe tortuosity. Here, we report our experience with and the usefulness of the 8 French (Fr) Newton-shaped Neuro-EBU vascular catheter (SILUX Co., Ltd., Kawaguchi City, Saitama Prefecture, Japan), which is rigid over its entire length except near the tip, in a case series of 21 patients. Of the 21 cases, 19 cases were successfully treated using the Neuro-EBU. The 8 Fr Newton-shaped Neuro-EBU might be useful both as a special GC and as a wire exchange catheter when placement of the conventional GC is difficult due to severe tortuosity of the access route. Although rarely used, the Neuro-EBU catheter can serve as a practical alternative when the access route is challenging. To the best of our knowledge, there are no detailed reports on the technical use of the Newton-shaped vascular catheter in the field of neurointervention. We present the usefulness of the specially shaped 8 Fr guide catheter.
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Saal-Zapata G, Durand W, Vallejos R, Valer D, Flores J, Rodriguez R. PHIL Migration to Internal Carotid Artery and Middle Cerebral Artery: Late Mechanical Retrieval with Solitaire AB Stent. JOURNAL OF CLINICAL INTERVENTIONAL RADIOLOGY ISVIR 2021. [DOI: 10.1055/s-0040-1710152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractPrecipitating hydrophobic injecting liquid (PHIL) is a novel embolic agent used in the endovascular treatment of arteriovenous malformations (AVM) and arteriovenous fistulas. Complications can occur during embolization with migration of the liquid embolic material to normal vasculature. In these cases, use of a stent retriever is an option for removal of the plug. Herein, we present the case of a patient who presented with a right occipital hemorrhage due to a ruptured occipital AVM fed by the calcarine and parieto-occipital arteries with venous drainage to the straight sinus. Embolization via the anterior circulation through the right posterior communicating artery was attempted but PHIL migrated to right internal carotid artery and middle cerebral artery due to kinking and rupture of the microcatheter. The patient developed mild left hemiparesis. When this complication occurred, no stent retriever was available at our institution and 1 day later, the Solitaire AB stent was used to remove the plug of PHIL successfully, with good reperfusion of the proximal and distal vessels. The patient improved after the procedure and was discharged home without deficit. Mechanical stent retrievers can be used in cases of migration of liquid embolic agents to normal vasculature with good clinical and radiological results.
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Affiliation(s)
- Giancarlo Saal-Zapata
- Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru
| | - Walter Durand
- Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru
| | - Ricardo Vallejos
- Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru
| | - Dante Valer
- Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru
| | - Jesús Flores
- Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru
| | - Rodolfo Rodriguez
- Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru
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Liu Z, Bilia AR. Editorial: Novel Targets and the Application of Targeting Techniques in the Treatment of Cerebrovascular Disease. Front Pharmacol 2019; 10:1359. [PMID: 31798455 PMCID: PMC6864885 DOI: 10.3389/fphar.2019.01359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 10/28/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zhidong Liu
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Zhidong Liu, ; Anna Rita Bilia,
| | - Anna Rita Bilia
- Department of Chemistry, University of Florence, Florence, Italy
- *Correspondence: Zhidong Liu, ; Anna Rita Bilia,
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Wang ML, Zhang LX, Wei JJ, Li LL, Zhong WZ, Lin XJ, Zheng JO, Li XF. Granulocyte colony-stimulating factor and stromal cell-derived factor-1 combination therapy: A more effective treatment for cerebral ischemic stroke. Int J Stroke 2019; 15:743-754. [PMID: 31564240 DOI: 10.1177/1747493019879666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Drugs that promote angiogenesis include statins, recombinant human granulocyte colony-stimulating factor, and stromal cell-derived factor-1. Low doses of atorvastatin could significantly increase the vascular expressions of endothelial growth factor, and the number of peripheral blood endothelial progenitor cells (EPCs), thus improving angiogenesis and local blood flow. G-CSF is an EPC-mobilization agent used in ischemia studies for targeting angiogenesis after cerebral ischemia via EPCs. In previous clinical trials, consistent conclusions have not been reached about the effectiveness of G-CSF on ischemic stroke. Therefore, the therapeutic effect of G-CSF and its combination with other medicines need further experimental verification. It is known that atorvastatin, rhG-CSF, and SDF-1 are considered the most promising neuroprotective candidates, but a comprehensive comparison of their effects is lacking. AIMS To compare the effects of atorvastatin, stromal cell-derived factor-1, and recombinant human granulocyte colony-stimulating factor on ischemic stroke. METHODS Adult male Sprague-Dawley rats were randomly allocated to three groups: normal, sham-operated, and middle cerebral artery occlusion operated. Middle cerebral artery occlusion operated rats were further allocated into saline, atorvastatin, recombinant human granulocyte colony-stimulating factor, and recombinant human granulocyte colony-stimulating factor + stromal cell-derived factor-1 groups. Neurological function evaluation, cerebral infarction and the blood-brain barrier integrity analysis, identification of angiogenic factors, assessment of angiogenesis, expression of growth-associated protein-43, neuroglobin, glial cell-derived neurotrophic factor, and cleaved caspase 3, were performed. RESULTS Compared with atorvastatin or recombinant human granulocyte colony-stimulating factor alone, recombinant human granulocyte colony-stimulating factor + stromal cell-derived factor-1 treatment improved neurological performance, reduced cerebral infarction and blood-brain barrier disruption after stroke, and increased the content of stromal cell-derived factor-1, vascular endothelial growth factor, monocyte chemotactic protein 1, and basic fibroblast growth factor in peripheral blood. In addition, recombinant human granulocyte colony-stimulating factor + stromal cell-derived factor-1 promoted greater angiogenesis than atorvastatin or recombinant human granulocyte colony-stimulating factor alone and increased the expression of growth-associated protein-43, neuroglobin, and glial cell-derived neurotrophic factor, while decreasing the levels of cleaved caspase 3 in the brain after ischemic stroke. CONCLUSIONS Combination therapy with recombinant human granulocyte colony-stimulating factor and stromal cell-derived factor-1 is more effective than atorvastatin or recombinant human granulocyte colony-stimulating factor alone in protecting against stroke-induced damage and could be an optimal therapeutic strategy for stroke.
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Affiliation(s)
- Ming-Li Wang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li-Xiang Zhang
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jun-Jie Wei
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lv-Li Li
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Wei-Zhang Zhong
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xin-Jing Lin
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jin-Ou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-Feng Li
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Okumura E, Tsurukiri J, Ota T, Jimbo H, Shigeta K, Amano T, Ueda M, Matsumaru Y, Shiokawa Y, Hirano T. Outcomes of Endovascular Thrombectomy Performed 6-24 h after Acute Stroke from Extracranial Internal Carotid Artery Occlusion. Neurol Med Chir (Tokyo) 2019; 59:337-343. [PMID: 31281169 PMCID: PMC6753251 DOI: 10.2176/nmc.oa.2018-0296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Thrombectomy has demonstrated clinical efficacy against acute ischemic stroke caused by intracranial occlusion of the internal carotid artery (ICA), even if performed 6–24 h after onset. This study investigated the outcomes of thrombectomy performed 6–24 h after stroke onset caused by extracranial ICA occlusion. Of 586 stroke patients receiving thrombectomy during the past 3 years and registered in the Tama Registry of Acute Endovascular Thrombectomy database, 24 were identified with ICA occlusion (14 extracranial and 10 intracranial), known to be well 6–24 h before presentation, and with pre-stroke modified Rankin Scale (mRS) score of 0 or 1. Clinical outcomes measured were the rate of functional independence at 90 days according to mRS score of 0–2 and 90 day mortality rate. Of patients with extracranial ICA occlusion, two received additional carotid stenting with thrombectomy. The median interval between the last time the patient was known to be well and hospital arrival was 601 (interquartile range, 476–729 min). Both the rate of functional independence at 90 days and 90 day mortality were comparable between patients with extracranial or intracranial ICA occlusion (36% vs. 40% and 7% vs. 10%, respectively). No symptomatic intracranial hemorrhages occurred within 24 h following treatment of extracranial ICA occlusion. Thrombectomy performed 6–24 h after extracranial ICA results in acceptable functional outcome. Further clinical study is warranted to better define the temporal window of thrombectomy for acceptable functional outcome in patients with extracranial ICA occlusion.
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Affiliation(s)
- Eitaro Okumura
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
| | - Junya Tsurukiri
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
| | - Takahiro Ota
- Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center
| | - Hiroyuki Jimbo
- Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center
| | - Keigo Shigeta
- Department of Neurosurgery, National Hospital Organization Disaster Medicine Center
| | - Tatsuo Amano
- Department of Stroke and Cerebrovascular Medicine, Kyorin University
| | - Masayuki Ueda
- Department of Neurology and Stroke Medicine, Tokyo Metropolitan Tama Medical Center
| | - Yuji Matsumaru
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, University of Tsukuba
| | | | - Teruyuki Hirano
- Department of Stroke and Cerebrovascular Medicine, Kyorin University
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Ji H, Xu L, Wang Z, Fan X, Wu L. Effects of thymosin β4 on oxygen‑glucose deprivation and reoxygenation‑induced injury. Int J Mol Med 2018; 41:1749-1755. [PMID: 29328391 DOI: 10.3892/ijmm.2018.3369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 01/04/2018] [Indexed: 11/06/2022] Open
Abstract
Cerebral ischemia causes severe brain injury and results in selective neuronal death through programmed cell death mechanisms, including apoptosis and autophagy. Minimizing neuronal injury has been considered a hot topic among clinicians. The present study elucidated the effect of thymosin β4 (Tβ4) on neuronal death induced by cerebral ischemia/reperfusion in PC12 cells that were subjected to oxygen‑glucose deprivation and reoxygenation (OGD/R). The survival, apoptotic and autophagy rates of PC12 cells were investigated. Tβ4 pre‑conditioning prior to OGD/R was performed to evaluate PC12‑cell viability and the protective mechanisms of Tβ4. Tβ4 significantly increased cell survival after OGD/R. Tβ4 inhibited the release of lactate dehydrogenase, downregulated malondialdehyde and upregulated the activities of glutathione peroxidase and superoxide dismutase. In addition, Tβ4 attenuated OGD/R‑associated decreases in the expression of P62 and the anti‑apoptotic protein B‑cell lymphoma‑2, as well as the upregulation of autophagy mediators, including autophagy‑related protein‑5 and the ratio of microtubule‑associated protein 1 light chain 3 (LC3) II vs. LC3 I. These results suggested that Tβ4 effectively inhibits cell apoptosis and autophagy induced by OGD/R. To the best of our knowledge, the present study was the first to report on the antioxidant, anti‑apoptotic and anti‑autophagic effects of Tβ4 in neuronal‑like PC12 cells. These results suggested that Tβ4 may be explored as a potential treatment for cerebral ischemia.
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Affiliation(s)
- Hua Ji
- Department of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang 310053, P.R. China
| | - Linhao Xu
- Department of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang 310053, P.R. China
| | - Zheng Wang
- Department of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang 310053, P.R. China
| | - Xinli Fan
- Department of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang 310053, P.R. China
| | - Lihui Wu
- Department of Clinical Medicine, Hangzhou Medical College, Hangzhou, Zhejiang 310053, P.R. China
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