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Vanloon M, Penders D, Verbraeken B, Menovsky T. Letter: Risk of Bone Wax Migration During Retrosigmoid Craniotomy for Microvascular Decompression: Case-Control Study. Oper Neurosurg (Hagerstown) 2024; 26:621-622. [PMID: 38506528 DOI: 10.1227/ons.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/26/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Maarten Vanloon
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht , Netherlands
| | - Dylan Penders
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk , Belgium
| | - Barbara Verbraeken
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk , Belgium
- Department of Pathology, Antwerp University Hospital (UZA), Edegem , Belgium
| | - Tomas Menovsky
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk , Belgium
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem , Belgium
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Verbraeken B, Aboukais R, Voormolen M, Van der Zijden T, Boogaarts HD, Vanloon M, Menovsky T. Posterior Cerebral Artery-to-Superior Cerebellar Artery Side-to-Side Bypass via Extreme Lateral Supracerebellar Infratentorial Approach: Technical Note. World Neurosurg 2024; 186:108-115. [PMID: 38521223 DOI: 10.1016/j.wneu.2024.03.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Difficult-to-treat aneurysms of the distal posterior cerebral artery (PCA) can often be treated by parent artery occlusion. A cerebrovascular bypass can complement PCA occlusion to curb the risk of ischemic complications. An in situ bypass may be considered when the occipital artery or superficial temporal artery cannot serve as a bypass donor. This article describes the use of a side-to-side bypass of superior cerebellar artery as a donor to the PCA via an extreme lateral supracerebellar infratentorial approach (ELSCIT). This bypass approach can be a useful surgical strategy for PCA revascularization. METHODS A 40-year-old woman underwent a side-to-side PCA-superior cerebellar artery bypass via the ELSCIT approach for to treat a complex and previously coiled PCA aneurysm. The bypass was followed by endovascular aneurysm and parent artery occlusion. RESULTS Postoperatively, the patient experienced transient, partial trochlear nerve palsy of the left eye without ischemic lesions on magnetic resonance imaging. The clinical condition was stable, and angiography showed a patent bypass and complete aneurysm occlusion 12 months after surgery. CONCLUSIONS The ELSCIT approach offers access to the medial and distal PCA that is suitable for a side-to-side PCA-superior cerebellar artery bypass. This type of approach and bypass may be of value when revascularization of a P2-P3 portion of the PCA is needed, but a suitable occipital artery or superficial temporal artery is not available.
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Affiliation(s)
- Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Department of Pathology, Jessa Hospital Hasselt, Hasselt, Belgium
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Hospital Nord, Lille, France
| | - Maurits Voormolen
- Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Thijs Van der Zijden
- Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Hieronymus D Boogaarts
- Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Maarten Vanloon
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Verbraeken B, Lammens M, Van Rompaey V, Ahmed M, Szewczyk K, Hermans C, Menovsky T. Efficacy and histopathological effects of self-assembling peptides RADA16 and IEIK13 in neurosurgical hemostasis. Nanomedicine 2021; 40:102485. [PMID: 34748959 DOI: 10.1016/j.nano.2021.102485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/13/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
There is a continued need for effective hemostatic agents that are safe for neurosurgical use. Self-assembling peptide hydrogels have been suggested as novel hemostatic agents. They offer some advantages for neurosurgical hemostasis (e.g., transparency), but their efficacy and safety for neurosurgery has not been established. In this paper, the efficacy and safety of two self-assembling peptides, RADA16 and IEIK13, are explored for hemostasis of oozing bleeding on the rat cerebral cortex (n=56). Chronic safety was evaluated by neuropathological evaluation at one, four, and twelve weeks after craniotomy (n=32). An inactive control and oxidized cellulose served as comparators. Mean time-to-hemostasis was significantly shorter for RADA16 and IEIK13 compared to controls, while safety evaluation yielded similar results. Histopathological response consisted primarily of macrophage infiltration at the lesion site in all groups. This study confirms the hemostatic potential and safety of RADA16 and IEIK13 for hemostasis in the rat brain.
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Affiliation(s)
- Barbara Verbraeken
- Department of Translational Neuroscience, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Department of Neurosurgery, Antwerp University Hospital (UZA), Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Martin Lammens
- Department of Translational Neuroscience, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Department of Pathology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital (UZA), Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Melek Ahmed
- Department of Pathology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Krystyna Szewczyk
- Department of Translational Neuroscience, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Christophe Hermans
- Department of Pathology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, 2650 Edegem, Belgium; Center for Oncological Research (CORE), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Tomas Menovsky
- Department of Translational Neuroscience, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Department of Neurosurgery, Antwerp University Hospital (UZA), Drie Eikenstraat 655, 2650 Edegem, Belgium.
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Verbraeken B, Lavrysen E, Aboukais R, Menovsky T. Polyvinyl Alcohol Sponges to Facilitate Cerebral Bypass Surgery: Technical Note. World Neurosurg 2021; 156:53-55. [PMID: 34508907 DOI: 10.1016/j.wneu.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The standard way of isolating bypass vessels from surrounding structures during cerebral bypass surgery has been to use a rubber dam or neurosurgical patty. Here, the use of polyvinyl alcohol (PVA) sponges is described as a possible upgrade from these traditional bypass dams. METHODS PVA sponges were used to isolate bypass arteries from surrounding tissues during microvascular anastomosis in 25 patients undergoing bypass surgery at our institution. RESULTS There were no adverse events related to the use of PVA for microvascular anastomosis. PVA sponges offered some specific advantages when compared with rubber and cottonoid dams. CONCLUSIONS Although preliminary, our experience using PVA sponges during microvascular anastomosis suggests some of their properties can facilitate cerebral bypass surgery.
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Affiliation(s)
- Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Eno Lavrysen
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Verbraeken B, Aboukais R, Voormolen M, Boogaarts HD, Leclerc X, Lejeune JP, Menovsky T. Extreme Lateral Supracerebellar Infratentorial Approach (ELSCIT) for Occipital Artery-to-Posterior Cerebral Artery Bypass: Results in 3 Cases. World Neurosurg 2021; 152:214-220. [PMID: 34023461 DOI: 10.1016/j.wneu.2021.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE/BACKGROUND The need for revascularization of the distal posterior cerebral artery (PCA) in the treatment of PCA aneurysms is a contentious issue. Approaches to the PCA, such as the subtemporal route, carry significant perioperative risk. This risk at times outweighs the risk of ischemia associated with endovascular PCA sacrifice. This paper describes the use of an extreme lateral supracerebellar infratentorial (ELSCIT) approach as an alternative technique for distal PCA revascularization. METHODS Between 2016 and 2019, 3 patients underwent a PCA bypass via the ELSCIT approach for the treatment of a PCA aneurysm. In all cases, an end-to-side anastomosis to the P2- or P3-segment of the PCA was made, with the occipital artery as a donor. Bypass procedures were followed by endovascular parent artery occlusion, without ischemic complications. RESULTS In all 3 cases, the ELSCIT approach offered a broad enough surgical corridor to perform an occipital artery-to-PCA bypass. One patient suffered a cerebrospinal fluid leak that was surgically treated. Patients' clinical conditions were stable on follow-up (mean follow-up of 34 months). All 3 aneurysms remained occluded, and no ischemia was detected on magnetic resonance imaging. CONCLUSIONS The ELSCIT approach offers an alternative route to the distal PCA for extracranial-to-intracranial bypass with seemingly low perioperative morbidity and good surgical access to the PCA.
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Affiliation(s)
- Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Hopital Nord, Lille, France
| | - Maurits Voormolen
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Hieronymus D Boogaarts
- Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Xavier Leclerc
- Department of Neuroradiology, Lille University Hospital, Hopital Nord, Lille, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, Hopital Nord, Lille, France
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Aboukais R, Tétard MC, Devalckeneer A, Boussemart P, Bourgeois P, Bricout N, Verbraeken B, Menovsky T, Leclerc X, Lejeune JP. Ruptured blood blister like aneurysm: does the best therapeutic option really exist? Neurosurg Rev 2021; 44:2767-2775. [PMID: 33411092 DOI: 10.1007/s10143-020-01463-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
Our study aimed to evaluate the outcome of patients with ruptured blood-blister like aneurysm (BBLA) in our institution by comparing microsurgical selective treatment to endovascular treatment using flow-diverter stent (FD). Our study included 18 consecutive patients treated for BBLA between 2004 and 2020. Until 2014, microsurgery was preferred in all patients with BBLA (n = 10). Significant postoperative morbi-mortality was recorded at this time and led us to change therapeutic strategy and to favor FD as first-line treatment in all patients (n = 8). Postprocedural complications and BBLA occlusion were recorded. High WFNS score (> 2) was noted in 6 patients of microsurgical group and in 2 of endovascular group. In microsurgical group, ischemic lesions were noted in 6 patients and led to death in 3 patients. Immediate BBLA occlusion was obtained in all patients. Favorable outcome after 3 months (mRS < 3) was recorded in 4 of the 7 survivors. In endovascular group, ischemic lesions were noted in 4 patients. One patient died from early postprocedural BBLA rebleeding. Scarpa hematoma was noted in 3 patients with surgical evacuation in 1. Persistent BBLA at 3 months was recorded in 4 patients without rebleeding, but further FD was required in 1 with growing BBLA. Favorable outcome was noted in 6 of the 7 survivors. Although, rate of morbi-mortality appear lower in patients treated with FD, neurological presentation was better and BBLA diagnosis remains questionable in this group. Moreover, persistent BBLA imaging with potential risk of rebleeding after FD deserves to be discussed.
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Affiliation(s)
- Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France.
| | - Marie Charlotte Tétard
- Department of Neurosurgery, Saint-Etienne University Hospital, Saint-Priest-en-Jarez, France
| | - Antoine Devalckeneer
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France
| | - Pierre Boussemart
- Neurosurgical Intensive Care Department, Lille University Hospital, Lille, France
| | - Philippe Bourgeois
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France
| | - Nicolas Bricout
- Department of Neuroradiology, Lille University Hospital, Lille, France
| | - Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Xavier Leclerc
- Department of Neuroradiology, Lille University Hospital, Lille, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France
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Verbraeken B, Achahbar SE, Kamerling N, Yperzeele L, Voormolen M, Van Havenbergh T, Menovsky T. Complete Transection of Optic Nerve After Endovascular Coiling of a Large Ophthalmic Artery Aneurysm. World Neurosurg 2019; 132:81-86. [DOI: 10.1016/j.wneu.2019.08.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 12/21/2022]
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Aboukais R, Verbraeken B, Leclerc X, Gautier C, Henon H, Vermandel M, Menovsky T, Lejeune JP. Superficial temporal artery-middle cerebral artery anastomosis patency correlates with cerebrovascular reserve in adult moyamoya syndrome patients. Neurochirurgie 2019; 65:146-151. [DOI: 10.1016/j.neuchi.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
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Verbraeken B, Aboukais R, Lejeune JP, Lukes A, Menovsky T. Letter: Superficial Temporal Artery: Distal Posterior Cerebral Artery Bypass Through the Subtemporal Approach: Technical Note and Pilot Surgical Cases. Oper Neurosurg (Hagerstown) 2018; 15:46-47. [PMID: 29982804 DOI: 10.1093/ons/opy168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - Anton Lukes
- Department of NeurosurgeryLindenhofspitalBern, Switzerland
| | - Tomas Menovsky
- Department of NeurosurgeryAntwerp University HospitalEdegem, Belgium.,University of AntwerpAntwerp, Belgium
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Van Pelt C, De Coster W, Thiery M, Parewijck W, De Baere C, Verbraeken B, Derom R. Preinduction cervical ripening with prostaglandin E2: influence on psychomotor evolution in the first year. Eur J Obstet Gynecol Reprod Biol 1984; 18:299-301. [PMID: 6597115 DOI: 10.1016/0028-2243(84)90051-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The long-term effects of elective preinduction of labor at term by extra-amniotic instillation of prostaglandin E2 in methylhydroxyethylcellulose gel were evaluated in 20 children. No untoward effect of this procedure on the neurologic state of the newborn or the psychomotor development of the children during the first 12 months was found.
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