Global Differences in the Present and Future Management of Cerebral Aneurysms

Alshafai, Nabeel; Cusimano, Michael D.; Falenchuk, Olesya

doi:10.1016/j.wneu.2013.01.092

Cited by 11 publications

(8 citation statements)

References 16 publications

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“…Our single center experience has proved that global trend of increasing utility of endovascular treatments is not only limited to urban and suburban setup, but it is also feasible in rural setup as well. [8]…”

Section: Discussionmentioning

confidence: 99%

Successful Endovascular Neurosurgical Practice in Resource-poor Exclusive Rural Neuro-hospital Setup

Harsha¹

2016

Journal of Neurosciences in Rural Practice

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Aim:The aim of this study to evaluate the feasibility of establishing endovascular neurosurgery in remote resource-poor neuro-hospital setup and evaluate its outcome.Materials and Methods:Retrospective analysis of diagnostic and therapeutic endovascular neurosurgical procedures performed during September 2013–June 2016.Results:A total of 174 diagnostic cerebral and spinal digital subtraction angiograms and 70 major endovascular neurosurgeries were performed during the period. The endovascular neurosurgical procedures included 54 aneurysms coiled, 4 cerebral arteriovenous malformation embolization, 2 dural arteriovenous fistulas embolization, 2 cerebral tumor embolizations, 2 intracranial stentings, 5 extracranial carotid stentings, 1 transverse sinus stenting. No complications were seen during diagnostic procedures. Operation related morbidity of 1.4% and mortality of 1.4% seen, with a procedural success rate of 97.2%.Conclusion:Endovascular neurosurgery is feasible in resource-poor remote rural exclusive neuro-hospital setup with procedural success rate and outcomes comparable to existing literature.

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Section: Discussionmentioning

confidence: 99%

Successful Endovascular Neurosurgical Practice in Resource-poor Exclusive Rural Neuro-hospital Setup

Harsha¹

2016

Journal of Neurosciences in Rural Practice

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“…North Americans and Europeans show similar ratios of coiling to clipping, whereas the rest of the world shows preponderance for clipping. [21] Patients may decrease their quality of life if knowing they are living with an unruptured aneurysm. [22]…”

Section: Discussionmentioning

confidence: 99%

Surgical management of unruptured cerebral aneurysms in the elderly: An institution experience

et al. 2019

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Background and Purpose: The elderly population is increasing in the world, especially in developed countries. The gain in life expectancy is remarkable in Japan, consequently incidence of aneurysms increases in this population. The purpose of this study is to evaluate the surgical treatment and outcome of patients aged more than 75 years treated for unruptured intracranial aneurysms. Patients and Methods: We conducted a retrospective study for unruptured cerebral aneurysms operated between September 2014 and August 31, 2018, in Fujita Health University, Banbuntane Hotokukai Hospital, for people aged more than 75 years. A demographic study was done. We also studied aneurysm location, aneurysm size, outcome, duration of stay, and complications. Results: About 61 patients aged more than 75 years were operated in 4 years, comprising 12 males and 45 females. The mean age was 79.32 ± 3.29 years. Mean size of the aneurysm was 6.22 ± 3.28. Aneurysm location ( P = 0.0037), associated risk factors ( P = 0.006), and association of hypertension and diabetes ( P = 0.0362) influence outcome. Length of stay is directly correlated with outcome ( P = 0.009). Conclusions: Elder patients with hypertension and diabetes or associated risk factors having a posterior circulation aneurysm have a poor diagnosis.

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“…At some high-volume academic centres with low complication rates, surgical clipping remains the preferred treatment for some patients 24. Clipping is also more likely to be recommended than endovascular treatment in many countries outside USA and Western Europe, which may reflect disparities in available resources 25. Nevertheless, the trend is towards the increased use of endovascular treatment of aneurysms worldwide.…”

Section: Role Of Open Cerebrovascular Surgerymentioning

confidence: 99%

Contemporary endovascular and open aneurysm treatment in the era of flow diversion

Mazur

Taussky

Park

et al. 2017

J Neurol Neurosurg Psychiatry

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Clinical outcomes have improved considerably over the last decade for patients with ruptured and unruptured aneurysms. Modern endovascular techniques, such as flow diversion, are associated with high aneurysm occlusion rates and have become a popular treatment modality for many types of aneurysms. However, the safety and effectiveness of flow diversion has not yet been established in trials comparing it with traditional aneurysm treatments. Moreover, there are some types of aneurysms that may not be appropriate for endovascular coiling, such as wide-necked aneurysms located at branch points of major vessels, large saccular aneurysms with multiple efferent arteries, dolichoectatic aneurysms, large aneurysms with mass effect, when there are technical complications with endovascular treatment, when patients cannot tolerate or have contraindications to antiplatelet therapy or in the setting of a subarachnoid haemorrhage. For these cases, open cerebrovascular surgery remains important. This review provides a discussion on the current trends and evidence for both flow diversion and open cerebrovascular surgery for complex aneurysms that may not be suitable for coiling. We emphasise a continued important role for surgical treatment in certain situations.

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Global Differences in the Present and Future Management of Cerebral Aneurysms

Cited by 11 publications

References 16 publications

Successful Endovascular Neurosurgical Practice in Resource-poor Exclusive Rural Neuro-hospital Setup

Successful Endovascular Neurosurgical Practice in Resource-poor Exclusive Rural Neuro-hospital Setup

Surgical management of unruptured cerebral aneurysms in the elderly: An institution experience

Contemporary endovascular and open aneurysm treatment in the era of flow diversion

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