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Ge Y, Lai Q, Guo W, Xu X. Risk factors for postoperative late deterioration in patients with spinal dural arteriovenous fistulas. Front Neurol 2024; 15:1412237. [PMID: 39040537 PMCID: PMC11260714 DOI: 10.3389/fneur.2024.1412237] [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: 04/08/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
Background Approximately 86% of patients with spinal dural arteriovenous fistulas (SDVAFs) exhibit clinical improvement after surgery. However, 12%-55.8% of these patients experience late deterioration (LD) after an initial period of improvement. The risk factors for LD remain unclear. The aim of this study was to explore the risk factors for LD in SDVAF patients. Methods The clinical data of patients who were admitted to two tertiary hospitals between June 2014 and May 2022 were reviewed. Patients were divided into two groups: the LD group and the no LD group. The severity of neurological dysfunction (NDF) was evaluated using the Modified Aminoff and Logue Scale. Univariable and multivariable Cox regression analyses were performed. Results A total of 105 eligible patients were enrolled, with a mean age of 57.55 ± 9.42 years. The LD group comprised 37 individuals, while the no LD group consisted of 68 individuals. According to the univariable analysis, preoperative NDF severity and treatment strategy were associated with the risk of LD. According to the multivariable analysis, patients who underwent microsurgery (MS) had a lower risk of LD than did those who underwent endovascular treatment (EVT; HR 0.197, 95% CI 0.085-0.457), and patients with severe NDF had a higher risk of LD than did those with mild NDF (HR 3.604, 95% CI 1.226-10.588), whereas the risk of LD in patients with moderate NDF was similar to that of patients with mild NDF (HR 1.352, 95% CI 0.519-3.524). Conclusion EVT and severe preoperative NDF are independent risk factors for LD.
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Affiliation(s)
- Yuanhong Ge
- Department of Neurosurgery, Chengdu Second People’s Hospital, Chengdu, China
| | - Qingjia Lai
- Department of Rehabilitation, Care Alliance Rehabilitation Hospital of Chengdu, Chengdu, China
| | - Wei Guo
- Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University, Xi’an, China
| | - Xuejun Xu
- Department of Neurosurgery, Chengdu Second People’s Hospital, Chengdu, China
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Wei H, Li Y, Li L, Hu Q, Shi M, Cheng L, Jiang X, Zhou Y, Chen S, Ji Y, Chen L. Novel organoid construction strategy for non-involuting congenital hemangioma for drug validation. J Biol Eng 2023; 17:32. [PMID: 37106420 PMCID: PMC10142414 DOI: 10.1186/s13036-023-00348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Non-involuting congenital hemangiomas (NICHs) are fully formed vascular tumors at birth with distinctive clinical, radiologic, and histopathological profiles. In the literature, there is no effective therapy strategy for patients with NICH except surgery. Currently, no cell line or animal model exists for studying the mechanism of NICH and drug validation. We plan to construct a new strategy by constructing NICH organoids for further study. RESULT Here, we report a novel NICH organoid system construction and optimization process. Both HE and immunohistological staining exactly matched NICH tissue. We further performed transcriptome analysis to elucidate the characteristics of NICH organoids. Both NICH tissue and NICH organoids manifested similar trends in download sites. NICH organoids display novel features to new cells derived from organoids and show spectacular multiplication capacity. In the preliminary verification, we found that cells splitting from NICH organoids were human endothelial cells. Drug validation demonstrated that trametinib, sirolimus, and propranolol showed no inhibitory effects on NICH organoids. CONCLUSION Our data show that this new NICH-derived organoid faithfully captured the features of this rare vascular tumor. Our study will boost further research on the mechanism of NICH and drug filtering in the future.
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Affiliation(s)
- Haoche Wei
- State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yanan Li
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China
- Med-X Center for Informatics, Sichuan University, Chengdu, 610041, China
| | - Li Li
- Institute of Clinical Pathology West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Qian Hu
- Department of Hematology, West China Hospital, Sichuan University, Sichuan, 610041, China
| | - Mingsong Shi
- State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Linbo Cheng
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xile Jiang
- Clinical Nutrition Department, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yanting Zhou
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnocentric of Ministry of Education, Zunyi Medical University, Zunyi, Guizhou, 563006, China
| | - Siyuan Chen
- Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yi Ji
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, 610041, China.
| | - Lijuan Chen
- State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China.
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Three-year outcome following neonatal encephalopathy in a high-survival cohort. Sci Rep 2022; 12:7945. [PMID: 35562399 PMCID: PMC9106703 DOI: 10.1038/s41598-022-12091-x] [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] [Received: 10/03/2021] [Accepted: 05/03/2022] [Indexed: 11/20/2022] Open
Abstract
This study investigated the 3-year clinical outcomes in relation to the severity of encephalopathy in high-survival infants who underwent therapeutic hypothermia. This retrospective observational study was conducted in level II/III neonatal intensive care units in Japan. The nationwide cohort included 474 infants registered in the Baby Cooling Registry of Japan between January 2012 and December 2016. Clinical characteristics, mortality rate and severe neurological impairment at age 3 years were evaluated. Of the infants, 48 (10.4%), 291 (63.1%) and 122 (26.5%) had mild, moderate and severe encephalopathy, respectively, upon admission. By age 3, 53 (11.2%) infants died, whereas 110 (26.1%) developed major disabilities. The mild group survived up to age 3. In the moderate group, 13 (4.5%) died and 44 (15.8%) developed major disabilities. In the severe group, 39 (32.0%) died by age 3. Adverse outcomes were observed in 100 (82.0%) infants. Mortality was relatively low in all subgroups, but the incidence of major disabilities was relatively high in the severe group. The relatively low mortality and high morbidity may be due to Japanese social and ethical norms, which rarely encourage the withdrawal of intensive life support. Cultural and ethical backgrounds may need to be considered when assessing the effect of therapeutic interventions.
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Kurzawski J, Zandecki L, Janion-Sadowska A, Piatek L, Jaroszynska A, Domagala S, Sadowski M, Baranska E. Choosing a treatment method for post-catheterization pseudoaneurysms guided by the late to early velocity index. Sci Rep 2021; 11:16678. [PMID: 34404860 PMCID: PMC8370979 DOI: 10.1038/s41598-021-96062-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/15/2021] [Indexed: 11/16/2022] Open
Abstract
Ultrasound-guided thrombin injection (UGTI) is often the first-line treatment for iatrogenic post-catheterization pseudoaneurysms (psA). There are also first reports of the use of biologically derived tissue glues (TG) instead of sole thrombin especially when UGTI was unsuccessful or in case of psA recurrence. Previously, we have established that a late to early velocity index (LEVI) < 0.2 could be a predictor of an increased risk of psA recurrence after standard UGTI. In this paper, we report our first experiences when the choice of the first-line treatment method was based on LEVI assessment. From May 2017 till January 2020 we included 36 patients with psA. Of them, 10 had LEVI < 0.2 and they underwent ultrasound-guided tissue glue injection (UGTGI) with biological TG and 26 had LEVI > 0.2 and they underwent UGTI. The injection set containing human thrombin and fibrinogen was used for UGTGI. Bovine thrombin was used for UGTI. The success rate was 100% and no psA recurrence was detected during a 2-week follow-up. It was significantly better when compared to the expected recurrence rates based on our previous 14 years of experience (0% vs. 13%, p = 0.01). All complications (10% in the UGTGI group and 15% in the UGTI group) were mild and transient and included clinical symptoms of paresthesia, numbness, tingling, or pain. Their rates were comparable to the rates we previously reported. No significant differences in other characteristics were observed. The approach to choose the first-line treatment method for iatrogenic psA based on LEVI is encouraging. It may increase the success rate and avoid unnecessary repetition of the procedure, without increasing complication rate while keeping costs of the procedure reasonable.
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Affiliation(s)
- Jacek Kurzawski
- Swietokrzyskie Cardiology Center, ul. Grunwaldzka 45, 25-736, Kielce, Poland
| | - Lukasz Zandecki
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland.
| | | | - Lukasz Piatek
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Anna Jaroszynska
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Szymon Domagala
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Marcin Sadowski
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
| | - Edyta Baranska
- Jan Kochanowski University, Collegium Medicum, al. IX Wiekow Kielc 19A, 25-317, Kielce, Poland
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Serratrice N, Baucher G, Reyre A, Brunel H, Fuentes S, Dufour H. Management of two cavernous sinus dural arteriovenous fistulae by direct microsurgical approach and catheterization of the superior ophthalmic vein. Neurochirurgie 2019; 65:397-401. [PMID: 31207250 DOI: 10.1016/j.neuchi.2019.05.005] [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] [Received: 01/09/2019] [Revised: 04/30/2019] [Accepted: 05/17/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND In case of cavernous sinus dural arteriovenous fistula, transvenous embolization of the cavernous sinus via the inferior petrosal sinus is generally sufficient. However, when inferior petrosal sinus access is challenging, various alternative approaches have been reported, with corresponding difficulties and risks. CASE REPORTS We report the management of two cases of life-threatening cavernous sinus dural arteriovenous fistula revealed by a typical cavernous sinus syndrome. Conventional approaches were unsuccessful, and a direct microsurgical approach was performed, with catheterization of the superior ophthalmic vein. This combined approach safely accessed the cavernous sinus, and obtained complete occlusion of the fistulae by Onyx® embolization. CONCLUSIONS This procedure could be an interesting alternative option in the treatment of cavernous sinus dural arteriovenous fistula when conventional approaches are not possible.
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Affiliation(s)
- N Serratrice
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, 13385 Provence-Alpes-Côte d'Azur, France.
| | - G Baucher
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, 13385 Provence-Alpes-Côte d'Azur, France.
| | - A Reyre
- Department of Neuroradiology, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, 13385 Provence-Alpes-Côte d'Azur, France.
| | - H Brunel
- Department of Neuroradiology, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, 13385 Provence-Alpes-Côte d'Azur, France.
| | - S Fuentes
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, 13385 Provence-Alpes-Côte d'Azur, France.
| | - H Dufour
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, 13385 Provence-Alpes-Côte d'Azur, France.
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Lin T, Zhu L, He Y. Clinical outcome observation of the embolization of orbital vascular malformation with medical glue under direct intra-operative view. BMC Ophthalmol 2018; 18:330. [PMID: 30572848 PMCID: PMC6302419 DOI: 10.1186/s12886-018-1002-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 12/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background Orbital vascular malformation often encircles normal tissue with ill-defined borders. It is easy to bleed during resection operation, making surgical treatment difficult and lesions hard to be removed completely. In this study we aimed to summarize the treatment outcomes by embolizing orbital vascular malformation with intraoperative intracavitary injection of medical glue . Methods A retrospective observational and cross-sectional case series study enrolled 31 patients (male = 9, female = 22) with orbital vascular malformations, who were treated from March 2008 to September 2017 at our institution. The clinical features, operation records, pathological reports and follow-up data were analyzed. Results The location of vascular malformations involved intraorbital (14 cases), superficial area of eyelid and/or face (7 cases), both intraorbital and superficial area (10 cases). Imaging examination showed a solitary mass with regular shape in 8 cases and a space occupying lesion with irregular shape and ill-defined margins in 23 cases. There were 9 cases had optic nerve involved. Surgical debulkling were performed via skin incision on the mass surface (5 cases), lateral orbitotomy (2 cases), and anterior orbitotomy (24 cases). During the operation, lesions were partly exposed and injected with medical glue. The amount of injected glue was 0.25 ml to 2.5 ml in divided doses. The lesions and remnant glue were removed after the glue had turned hard. The whole procedure caused less bleeding and was easier performing than usual. Topical skin aseptic inflammation took place on the same side of the superficial eyelid lesions in 3 cases. One patient suffered from sudden central retinal artery embolism on the third day post operation. With timely rescue and appropriate procedure, visual acuity recovered to 20/32. There were no recurrences in 29 cases. Conclusions Embolization of orbital vascular malformation with medical glue intraoperatively made it easy to control hemorrhage. Surgeons should be careful with glue application methods in order to avoid complications.
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Affiliation(s)
- Tingting Lin
- Tianjin Medical University Eye Hospital, School of Optometry and Ophthalmology, TMU, Tianjin Medical University Eye Institute, No.251 Fu Kang Road, Nankai District, Tianjin, 300384, People's Republic of China
| | - Limin Zhu
- Tianjin Medical University Eye Hospital, School of Optometry and Ophthalmology, TMU, Tianjin Medical University Eye Institute, No.251 Fu Kang Road, Nankai District, Tianjin, 300384, People's Republic of China
| | - Yanjin He
- Tianjin Medical University Eye Hospital, School of Optometry and Ophthalmology, TMU, Tianjin Medical University Eye Institute, No.251 Fu Kang Road, Nankai District, Tianjin, 300384, People's Republic of China.
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